Question about drugs/pain ...

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simonm
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Question about drugs/pain ...

Post by simonm » Sat Oct 28, 2017 6:38 pm

For whatever reason there has recently been more publicity about drug addition in the USA. I read a few articles today and then did a little internet search. On some forums I saw people asking about the drugs they were taking (oxycodone and relatives). What struck me was people mentioning taking the the stuff for a decade or so apparently to combat pain. Pain specialists were explicit mentioned.

Maybe I am very fortunate but I don't really understand what kind of pains get long term painkiller treatment instead of of treatment to tackle the cause of the pain. Yes, I can understand that there may be relatively rare issues that cause long term pain but that 3%-5% of a large country's population is suffering from chronic pain seems to be beyond belief. What kinds of pain would be the initial reason for such ongoing prescriptions?

Wuuthrad
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Re: Question about drugs/pain ...

Post by Wuuthrad » Sat Oct 28, 2017 7:15 pm

Opioid addiction is a major problem and it's not all related to the legitimate treatment of pain.

There's a lot of fraud in the medical industry. In recent years the DEA has uncovered massive illegal operations involving doctors pharmacists and street level dealers, making hundreds of arrests. One pharmacist distributed
as many as 90,000 pills illegally! And doctors encouraging people to falsify their reports of pain, saying it is more so they can write a prescription.

Just two days ago the billionaire manufacturer of the opioid fentanyl was arrested on racketeering charges:

"Mr. Kapoor and his company stand accused of bribing doctors to overprescribe a potent opioid and committing fraud on insurance companies solely for profit."

I cannot speak with much authority to the pain issue but I believe this illegal activity to be a big part of the problem. I do know that alternatives exist to prescription opioids for the treatment and management of pain.

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Re: Question about drugs/pain ...

Post by khayes » Sat Oct 28, 2017 7:26 pm

Lots of causes for chronic pain - I know people with fibromyalgia, also chronic fatigue - who live with constant pain. My wife has residual pain from a shingles attack - because it's nerve-related there's not much in the way of treatment that works in the long run.
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Re: Question about drugs/pain ...

Post by CathyCate » Sat Oct 28, 2017 7:53 pm

Unfortunately, I have 2 relatives so afflicted.

My husband died recently from complications associated with multiple myeloma (a blood cancer). The final year or so was pretty hard and involved compression (spine) fractures, pressure sores etc. Thank goodness, painkillers were prescribed and readily available. Nurses had to coax him to avail himself of much needed relief without fear of addiction. [He watched a lot of cable news and succumbed occasionally to the current media hype].

I have a sister with rheumatoid arthritis. Pain meds regularly prescribed and available out East were suddenly off limits and withheld when she relocated to the MidWest. Go figure.
Same patient, same afflictions, same need for relief to aid mobility. Now she is offered invasive and expensive procedures that are pretty ineffective. At 70+ the pills (and @ limited dosages) had been working just fine. Why risk, paralysis, incontinence, death and bankruptcy with no real cure in sight?

Every situation is different. Each patient along with their medical team will require latitude and understanding. There is no single solution that fits all.

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Re: Question about drugs/pain ...

Post by PeteJ » Sun Oct 29, 2017 11:57 am

There is certainly something very odd about the overuse of pills and potions in the US. Entire generations of young people seem to be unable to get through the day without medication.

Alan Green
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Re: Question about drugs/pain ...

Post by Alan Green » Sun Oct 29, 2017 12:23 pm

Rheumatoid arthritis - you do not want to find out how painful it is and I would not wish that kind of pain on anyone. I take the drugs; it prevents the pain and the last three and a half years have been pain-free. If I stop the methotrexate, the disease will take hold again

a human
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Re: Question about drugs/pain ...

Post by a human » Mon Oct 30, 2017 3:08 am

There are plenty of legitimate reasons to take pain medicine. But I think it is too easy for a doctor to write a script in the 6 minutes allocated to a patient in the U.S.

I have ongoing pain due to nerve damage after being hit by an SUV. However, I don't take pain killers other than the occasional OTC nsaid or Tylenol. I try to distract my mind from being in the habit of pain and ignore it. Meditation, prayer, music, exercise, stretching, walking. Compared to most people, my pain tolerance is high, and I am blessed that I have full range of motion and can be active.

There is some interesting reading about retraining the mind to break the cycle of pain ... one book is "Back in Control" written by a back surgeon, who prefers not to do the surgeries! He uses mental exercises to break the mind's habit of expecting pain. I use a couple when I have a real flair up.

I refused to take narcotics/opiods even at my worst - I do not tolerate them well at all. Nor can I understand how people function daily while under the influence of narcotics. From my perspective, I think the problem stems from the avarice of drug manufacturers and the proliferation of "ask you doctor" drug ads. The population has been conditioned to think a pill will cure all your ills. Then there are secondary drugs to heal the side effects of the primary drugs. Fah. Try to eat well, exercise and maintain a reasonable weight are what most of use should be doing. And I recommend staying out of the way of SUVs!
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Re: Question about drugs/pain ...

Post by Andrew Pohlman » Mon Oct 30, 2017 6:43 pm

Pain is super subjective. And some people have been conditioned to take pain killers for any little pain or discomfort. For cancer patients, it will eventually come down to comfort or consciousness. Other diseases, like degenerative disk disease, cause so much pain that pharmacology is needed.

But the opiod epidemic has little to do with pain. People doing poorly in life turn to opioids for comfort. We have seen that their own ignorance can kill them, when they use Fentanyl (100X morphine) at the same dosages as more common Vicodin --> OD. Consequently, In the SF Bay Area, we pass out Narcan nasal spray like Halloween candy. Narcan = $80, while an ER resuscitation can cost about $50K.

For pain, many new studies show that no drugs are needed at all, in some cases. Distraction is the biggest tool in the non-pharmacological toolkit. So reading, listening to music, playing music, anything that can distract the pain can work. This is because the pain pathways are shared with other nerve bundles. So if you are reading or listening to music, the pain signals are literally blocked out of the neural highway, so to speak. But drug companies cannot make money from steamy Barbara Cartland novels... An accounting of the vile ethics of "pushing pills for profits" is underway now. I'm sure it will turn out the way it always does - the rich and powerful will get off Scott free.
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Re: Question about drugs/pain ...

Post by Laudiesdad69 » Tue Oct 31, 2017 10:53 pm

simonm wrote:
Sat Oct 28, 2017 6:38 pm
For whatever reason there has recently been more publicity about drug addition in the USA. I read a few articles today and then did a little internet search. On some forums I saw people asking about the drugs they were taking (oxycodone and relatives). What struck me was people mentioning taking the the stuff for a decade or so apparently to combat pain. Pain specialists were explicit mentioned.

Maybe I am very fortunate but I don't really understand what kind of pains get long term painkiller treatment instead of of treatment to tackle the cause of the pain. Yes, I can understand that there may be relatively rare issues that cause long term pain but that 3%-5% of a large country's population is suffering from chronic pain seems to be beyond belief. What kinds of pain would be the initial reason for such ongoing prescriptions?
My wife has had arthritis since she was 16. At 56 she had both knees and a hip replaced. The bearing surfaces of the bones in these joints looked like the surface of the moon- full of craters. That is from bone on bone contact. She is on a fentanyl patch. As she has arthritis in her neck, back, shoulders and left hip. And to top it off she had one of her knee kits put in wrong and she has pain from that.

I should add that I use Marijuana almost exclusively for migraines. My doctor recommends it versus using something like percocet. And it is good for the nausea that comes with the migraines. I have had them so bad that I wound up in the ER and got shots of demerol and vistaril. It keeps me out of the hospital.

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David Gutowski
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Re: Question about drugs/pain ...

Post by David Gutowski » Wed Nov 15, 2017 7:04 am

Didn't they come out with a futuristic movie recently that dealt with pain. You could go to the doctor or wherever the place was in the movie and they would give you pain so you could feel something. The movie dealt with a society so relaxed and stress free on opioids and the like no one really knew what pain was. I know it's just a movie, but maybe that's what most people want today; to live totally without any discomfort. I used to refer to it as Joy-Joy. Look at the alcohol, tobacco and drug consumption in the world today...and caffeine, chocolate, sugar, energy drinks etc. It's definitely Joy-Joy time for most of us even though we know its not good for us and can have such horrible side effects, so why is anyone surprised when opioids come into play...especially when they are so easy to get: "Oh doctor, I've got this back ache and it hurts so much...please give me something for it." And they do. And we feel wonderful and pain free. One of the members said we should try to pay a lot more attention to good health. Go for a walk, get regular exercise, eat "right," get a hobby, get a positive interest and motivation in life that doesn't alter your personality or keep you high and stoned or engaged in Joy-Joy... but, you can talk yourself blue in the face and people don't listen, unfortunately, until the damage is done. I know there are people in real pain and they legitimately need relief, but so many people have made pain relief an ingrained habit and just can't or won't live without it. So why is anyone surprised.

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Re: Question about drugs/pain ...

Post by bear » Wed Nov 15, 2017 1:59 pm

simonm wrote:
Sat Oct 28, 2017 6:38 pm
For whatever reason there has recently been more publicity about drug addition in the USA. I read a few articles today and then did a little internet search. On some forums I saw people asking about the drugs they were taking (oxycodone and relatives). What struck me was people mentioning taking the the stuff for a decade or so apparently to combat pain. Pain specialists were explicit mentioned.

Maybe I am very fortunate but I don't really understand what kind of pains get long term painkiller treatment instead of of treatment to tackle the cause of the pain. Yes, I can understand that there may be relatively rare issues that cause long term pain but that 3%-5% of a large country's population is suffering from chronic pain seems to be beyond belief. What kinds of pain would be the initial reason for such ongoing prescriptions?
I believe american society has gone off the deep end. The teachers in our grade schools have been educated and trained to teach our children. Many of these teachers have decades of experience and yet their qualifications are the subject of constant review and children are required to take repeated standardized tests. The results of the tests are then used to question the competency of teachers.
So, the competency of teachers is questioned in an area for which they were trained and yet when a teacher recommends that a child be put on "medication", (teachers are not trained in medicine) there seems, in many cases, an unquestioned willingness to accept the "diagnosis".
I believe that the result fosters an attitude in the minds of children "have a problem, take a pill".
The response to the prescription drug problem by authorities is to limit the amount of medication in any single prescription. This forces the legitimate user to make more frequent trips to the pharmacy often at a higher cost. In rural areas, this is especially difficult.
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Re: Question about drugs/pain ...

Post by cefyn » Wed Nov 15, 2017 5:02 pm

I'm prescribed Morphine patches, which I stick on my upper arms, which last for 7 days. These were prescribed as pain relief following a fall and subsequent broken back and surgery. Far better than taking pain relief pills, which made me so drowsy I couldn't drive, or play guitar. I couldn't function without them - seriously!

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Re: Question about drugs/pain ...

Post by Jeffrey » Wed Nov 15, 2017 6:51 pm

Andrew Pohlman wrote:
Mon Oct 30, 2017 6:43 pm
Pain is super subjective. And some people have been conditioned to take pain killers for any little pain or discomfort. For cancer patients, it will eventually come down to comfort or consciousness. Other diseases, like degenerative disk disease, cause so much pain that pharmacology is needed.

But the opiod epidemic has little to do with pain. People doing poorly in life turn to opioids for comfort. We have seen that their own ignorance can kill them, when they use Fentanyl (100X morphine) at the same dosages as more common Vicodin --> OD. Consequently, In the SF Bay Area, we pass out Narcan nasal spray like Halloween candy. Narcan = $80, while an ER resuscitation can cost about $50K.

For pain, many new studies show that no drugs are needed at all, in some cases. Distraction is the biggest tool in the non-pharmacological toolkit. So reading, listening to music, playing music, anything that can distract the pain can work. This is because the pain pathways are shared with other nerve bundles. So if you are reading or listening to music, the pain signals are literally blocked out of the neural highway, so to speak. But drug companies cannot make money from steamy Barbara Cartland novels... An accounting of the vile ethics of "pushing pills for profits" is underway now. I'm sure it will turn out the way it always does - the rich and powerful will get off Scott free.
100% agree with this.
A honest conversation about chronic pain requires a deeper understanding of pain in relation to the patient. What I see in a day to day practice are physicians pressed for time who dont have the time for a proper diagnosis let alone delve deeper into the nature of the pain, for example coping strategies. Imo pain management is something which should get more attention in our health care system.

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Re: Question about drugs/pain ...

Post by MessyTendon » Fri Nov 17, 2017 3:26 pm

Doctors are violating the oath by helping people become junkies for profit. That is what is going on in America. Sad but true.

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Re: Question about drugs/pain ...

Post by dory » Sat Nov 18, 2017 5:08 am

I was told by a pharmacist when picking up pills for my husband following surgery that he thinks there are biologically 3 groups of people with respect to opioids. Some peopke like my husband and me actively dislike them because they have bad side effects for us, and will only tolerate them when the pain is worse than the side effects. Others are pretty much indifferent to them, but again, willing to take them if in pain. He says there is a third group who try them and feel they are the best thing they have ever experienced. Members of this third group are not doomed to addiction but are at great risk of it. He claims we are not on an even playing field with respect to opioids and I tend to agree.
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