Drug Abuse Articles
Drug Abuse Articles: and Pain Management
By Ned Wicker
In a January 2010 editorial from the “Annals of Internal Medicine,” we learned that opioids are the “most commonly prescribed” medicines in this country and that the rate of prescriptions for this class of drug has risen 800% in the past ten years. The opinion pieced centered on the idea that the practices surrounding the prescribing of opioids need to change. For every good deed, there will invariably be somebody out there ready to abuse it for their own purposes. And so it is with any kind of pain medication, especially oxycontin and similar drugs.
The good that the drugs are capable of delivering are all too often negated because people make bad decisions for their own, selfish reasons. Of course, there are controls on the prescribing of these medicines, but there is no national data base, and when a crafty person goes doctor shopping, there are few checks and balances on that activity.
Then, there are the nearly invisible drug dealers; those people who use some of prescribed limit and sell the remaining pills. There are people who are responsible. I have a friend who is a caner patient. He has been battling multiple myeloma for over eight years now and part of his treatment is a prescription for oxycontin.
Interestingly, he is completely aware of the highly addictive nature of this opioid and he has been proactive in taking steps to ensure that he, like millions of others, doesn’t get overly dependent on it. I say “overly” because he does take the drug on a daily basis, one pill in the morning, just to take the edge off and get through the day.
Actually, he could be taking this drug several times per day, but realizing the potential for addiction, he has chosen to explore alternative methods of pain management. For many years he has practiced meditation, and that practice has been the doorway to relief from the physical ill effects of his cancer and the drugs used to treat it. Another friend recently died after a week-long stay in a hospice facility. He also had major pain management issues and was on “comfort measures” for some time before his passing. He had a morphine drip going, controlled by a press of the thumb giving him a dose about six times an hour.
While he had no concern over becoming addicted, he wanted to limit the pain-killing medication because it put him to sleep. Family and friends were with him during his last couple of weeks and he wanted to be present with them.
One of his dearest friends was a message therapist and “Reiki Master”, and her expertise helped him through and all but took him off the morphine, even though he had major and legitimate pain issues. We are body, mind and spirit, and so all three need treatment. It is the calming of the spirit that can control physical pain. In our society we want relief and we want it now. Oxycontin and other powerful, highly addictive drugs can knock out the pain, but only for a short time.
I am not suggesting that doctors not prescribe pain medication, but that they also offer an alternative and holistic approaches to the problem.
The 800% increase in the prescriptions tells the story. Sadly, even the prescriptions that are legitimate, legal and well-intended can wind up on the street for recreational purposes.
Let’s say I have a prescription for 30 pills, but I only use eight of them. I can probably illegally sell the remaining 22, recover the cost of the prescription and even make a profit. It’s wrong, it’s illegal, it’s immoral, but it happens every day. I once worked at a large, urban hospital and as you can imagine there was a very busy emergency department. One of the ER nurses told me about the people who come to the ER and abuse the system, hoping to get drugs.
They say their knee hurts and even though the examination renders no signs of any physical reason why their knee should hurt, they become outraged when the doctor tells them to go home and rest it.
The angry patient will go to another hospital and go through the same act in hopes of scoring. So much time and money is wasted on these people, who are more than happy to call a lawyer and tell them a sad tale about how they were refused treatment. Are there really 800% more legitimate reasons for prescribing opiates? Or is our society and the drug manufacturers putting that much pressure on doctors?
Before you assess the blame and pluck off the low-hanging fruit, consider that it all begins with personal responsibility. We need to monitor ourselves and have greater controls on the prescribing of opioid drugs.
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