Rethinking pain management to curb drug abuse
By Kathryn Reed
Understanding drug addiction – by the user, health care professionals and loved ones – is the first step.
Terri Cherry, retired pharmacist from Barton Health, this week gave a talk about prescription drug abuse. She emphasized that it is a disease, not a weakness – and certainly no one makes a conscious decision to become addicted.
“Addictive habits have common physical attributes. They release the chemical dopamine. It’s a feel good drug; a euphoric feeling, positive reinforcement so you want to do it again. That’s part of the addiction cycle,” Cherry said.
In 2015, 10.3 million people in the United State were using opioids for non-medical reasons, Cherry said. Between 2004 and 2011, visits to emergency rooms for misuse or abuse of opioids increased 153 percent.
Opioids are both legal and illegal. They include OxyContin, Vicodin, codeine, morphine, fentanyl, and heroine.
One of the problems with pain management is that people want to get to where they don’t have any pain. That, according to Cherry, can be an unrealistic expectation. It is also one of the ways to become addicted – people erasing the pain with just one more pill.
“People need to accept there may be some level of pain. They need to work toward regaining function rather than strive for being pain free,” Cherry said.
People also need to take some responsibility. It starts with family and friends often being the first supplier. They have some leftover meds and willingly share them. Cherry said that must stop for a variety of reasons. When those run out, it’s a trip to the doctor’s office. Patients need to ask questions – to question the dosage and quantity, to make sure it’s appropriate for them.
“Start low, go slow” is Cherry’s mantra for drugs. She also advocates for non-pharmaceutical practices such as massage, using heat and/or ice, aromatherapy, music, anti-inflammatories and anti-depressants.
Naloxone is a drug that reverses an opioid overdose. Pharmacists are allowed to prescribe it without going to a doctor.
“It effectively blocks opioid receptors. The goal is to try to save some lives,” Cherry said. Seeking immediate medical care is still necessary.
She said the pharmacies in South Lake Tahoe require a prescription because the pharmacists have not gone through the training to be able to dispense the drug on their own. Rite-Aid, Cherry said, will administer it without a doctor’s prescription, but it must be ordered.
Cherry said those more prone to becoming addicted to prescription meds have a family history of abuse, use multiple providers, take multiple drugs, have medication with high doses, have a mental illness, are low income, lack education and live a rural area.
Addiction, though, is a disease that can strike anyone – any age, ethnicity, income level or profession.
The medical community and the drug manufacturers are responsible for this mess. Destroyed lives, human and financial cost are staggering meanwhile drug companies and the medical industry made billions. Disgusting.
Gosh, if only there were some readily available, natural and relatively safe alternative to pharmaceutical drugs that could help manage pain.
The philosophy of using opiates to treat pain has evolved. Barton Health focuses on multiple methods to control pain. We encourage non-addictive options for pain control, such as non-addictive pain relievers, acupuncture, aromatherapy, physical therapy, relaxation therapy, and exercise. We also consider underlying issues that may be causing additional pain, such as substance abuse, mental health issues, stress, or a chronic disease. As appropriate, we do prescribe pain medication for an appropriate period of time that will help keep the pain under control.
In order to better address the needs of our community members with chronic pain, Barton is in the process of bringing on a physician board-certified in pain management. This physician looks at pain management as a multifaceted approach and will help each patient with chronic pain create an individualized pain management plan.
Barton recognizes the importance of addressing substance abuse in our community. We are working with community partners, like the Drug Free Coalition, to address these issues as well as working with our patients to ensure that their pain management program is appropriate. This recent lecture is another example of how we educate the community and address the complexity of prescription drug use and abuse.
While the situation has become a huge problem it’s good to see Barton take a hard look at pain management and get control of opioid use.
If only big pharma would have cared just a bit instead of being worried about the billions of dollars they made at the expense of the problems they caused.