Chronic pain is hard to live with and many people take prescription painkillers so that they can have some kind of normalcy in their lives. But now it seems that it is getting harder to get the appropriate painkillers needed because of those who abuse the system. Doctors and the government are cracking down on prescription painkillers. The Office of National Drug Control Policy is running an advertising campaign about the dangers of prescription drug abuse.
But for those of us who are taking our pain medication as prescribed, just how dangerous are painkiller like Vicodin and OxyContin?
MSN Health & Fitness website has taken seven myths about painkillers and given us the facts!
Myth #1: “Toughing it out” is always better than taking painkillers to relieve pain.
Russell Portenoy, chair of Pain Medicine and Palliative Care at Beth Israel Medical Center in New York City, says that those who refuse medications despite being in severe pain are putting themselves, their jobs and relationships at risk.
Uncontrolled pain is associated with adverse consequences in terms of daily functioning, mood, sleep, overall quality of life, energy level, the ability to work and marital relationships.
By refusing pain medication, you can actually be causing your body to create more pain. Studies show that persistent pain causes changes in the brain and spinal cord that leads to more pain.
Myth #2: People on opioids are always impaired, cannot work demanding jobs or drive safely.
This studyof drivers on steady doses of opioids shows that there is no impairment. Dr. Gavril Pasternak, a neurologist at Memorial Sloan-Kettering Cancer Center in New York City says:
What people are concerned most about is judgment and somnolence. Would I recommend that someone just starting opioids drive? Of course not. But I would give the same advice to someone starting a sleeping pill. Once someone has been on the same dose for a while, they can.
Once people are on steady doses, their bodies have become tolerant to sedative effects of the drug.
Myth #3:When taken as directed, opioids are more likely to kill you than aspirin, ibuprofen or naproxen.
Pasternak says this is false. He says when opioids are taken as directed, they are safe drugs.
The vast majority of opioid-related deaths occur amongst recreational users or deliberate suicides. Deaths amongst pain patients are rare in fact, recent research finds that even for people with advanced illnesses, use of high-dose opioids does not significantly increase risk of death.
Nearly three times as many people die from complications of correctly taking painkillers like aspirin and ibuprofen known as non-steroidal anti-inflammatory drugsthan die from opioid overdose.
Myth #4: Accidental overdose is common among pain patients.
Dr. Richard Payne, professor of medicine and divinity at Duke University, says most opioid overdoses are not the result of medical use.
As patients take opioids over weeks and months, they develop a tolerance to the respiratory depressive effect, which is the thing that can cause death.
Instead, the vast majority of opioid overdoses involve combinations of drugs that cause sedation typically alcohol and sleeping pills or anti-anxiety medications like Valium or Xanax.
This study shows that approximately 80% of opioid overdoses are caused by this type of drug mixing. Also with many overdoses, patients have used their prescription drugs in a non-medical fashion by injecting or snorting.
Myth #5: Most people who get addicted to painkillers are accidental addicts. They sought pain treatment and had no prior history of drug problems.
I didn’t want to misinterpret this myth, so I am quoting the exact wording used in the article:
When a Florida newspaper covered the OxyContin epidemic in 2003, it later had to retract its series, in part because a man portrayed as an innocent victim of a pill-pushing doctor actually had a prior federal cocaine conviction.
Inadvertently, the paper had illustrated the real story of painkiller addiction: The vast majority of people who become addicted to prescription opioids have significant prior histories of drug problems.
Nearly 80 percent of OxyContin addicts have taken cocaine, for example, according to large national survey research. This means either that pain patients prescribed OxyContin suddenly start using cocaineor, more plausibly, that most people who misuse opioids have a past or current drug problem.
We published dataon this; we looked at people who had Oxycontin addiction who presented for treatmentessentially, nobody had gotten addicted to Oxycontin who hadnt previously been using opioids recreationally, says Thomas McLellan, professor of psychiatry at the University of Pennsylvania.
More than three-fourths of the patients who had misused OxyContin in this national sample of addicts in treatment had never received a prescription for it.
Even having chronic medical problemswhich includes chronic paindid not increase risk for OxyContin addiction.
If you do not have a personal or family history of addictionespecially if you have never suffered psychiatric problems like depression, schizophrenia or bipolar disorder, and especially if you are middle-aged or olderyour risk for developing addiction during pain treatment is vanishingly low, says Portenoy.
Myth #6: Addiction is inevitable if opioids are taken long-term or in high dosesand the risk of addiction is very high for short term use.
Dr. Pasternak says this myth was developed because of confusion regarding the nature of addiction. He says:
Many people believe that addiction is simply needing a substance to functionbut if this were the case, everyone would have to be considered addicted to food, air and water. To the average person, addiction is going cold turkey they view addiction as physical dependence.
Dr. Portenoy says that addiction is highly unlikely in patients who do not have prior history of addiction or a family history of addiction. When Portenoy conducted his own research on over 200 patients who were treated for chronic pain with OxyContin over a 3-year period, no new cases of addiction were reported.
Myth #7: Opioid withdrawal is very debilitating and potentially deadly.
Pasternak says that you can probably take 80% of patients off of opioid drugs, decreasing their dose by 50% every other day, and they will be asymptomatic.
If pain medications are stopped suddenly, patients may go through withdrawal and not even realize their flu-like symptoms are related to quitting their pain meds suddenly.
While withdrawal from alcohol or barbiturates is potentially fatal if not properly managed, even the worst opioid withdrawal is unlikely to be deadly. However, withdrawal can be risky if the patient is still in pain or on other drugs.