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.
Barbara K. says
Thanks for this post. These myths need to be debunked so people with pain can get the help they need.
Robert R says
The way to bust a myth is through Information, Education, and Confrontation. Only 2 % of all med schools offer classes in pain-management, so although MD’s have a background in chemistry, they have little or no education in applied pain- management. Between the gov. “war on drugs,” the media’s compliance with what the gov. wishes the public to know, and the many myths that life dependant decisions are made on, the struggle for people in intractable chronic pain or even acute pain to find the correct treatment is nearly statistically impossible.
When 80% of all drugs that are diverted to the streets are diverted before they are accessible to a MD’s prescription pad, we see that the drugs is big business.
People in chronic pain need their medications and because 75% are undertreated it is hard to believe that they are selling or giving away their medications as fast as they get them.
If we follow the money we can see that where these illegal drugs like Oxy-contin are coming from is the manufacturer, distribution networks, rouge pharmacies, off shore/ illegal web pharmacies, theft of and from pharmacies, rather than the small amounts pain patients are having one hell of a time acquiring and need to use in a legal way for pain relief.
We need to turn the war on drugs upside down and shake like hell and watch whose pockets the money comes from.
Why should the legit. pain patient pay for the hype, theft, sales, and diversion of pain meds and legal pressure ?
Yes lets start with the myths and then head right for the top and that is the phony war on drugs that puts millions of dollars in billionaires pockets and tens of millions of illegal doses of drugs in the streets every year . – – — Robert
Sources U of Wi. Studies on drug diversions.
Academy of Pain Management stats on med schools and pain classes.
If you don’t work for the pharmaceutical companies, especially Purdue Pharma, you should. Do you have any idea how much harm is caused by those worn out mantras? They come straight out of the marketing plans for the drug companies. And all the study’s? They were all underwritten and funded by who else? but the same good old pharm boys. All those study’s and reports are being re-written as we speak, because of the tragic results of those unfounded, poorly tested words that encouraged many inappropriate prescribing practices. Please do your homework. Do you know you are quoting from self-serving study’s produced in the 90’s? I am also a chronic pain patient. And I need/require pain medication. But I don’t like being lied to or living in a la-la land. If you can’t see that things have gone terribly wrong here with the pharmaceuticals, doctor education, and chronic pain, in relation to prescribing opiates, then you are over-medicated and not thinking clearly. Which is exactly where they want you, while they collect your money. I’m sorry if I sound harsh, but I’m pretty disgusted with the whole situation. I don’t think these 7 little myths answers all the questions, much less addresses the problems of the subject. “Each to his own”, at any rate, and we all are only responsible for our own actions. I wish all of you the best.
nathan harris says
I think Annie’s comments are relevant. There are a lot of people who need pain medication for sure. Purdue knew how addictive OxyContin was, yet they marketed as though it wasn’t. There are far to many families and individuals who have been devastated by OxyContin because it was “misunderstood”
I am having new problems with my doctors. Someone convinced them, the drug salesmen, that to treat chronic pain I should also be taking an anti depressant, an anti seizure, and several other meds that have nothing to do with my personal health.
Luckily I got free samples of each of these types and I was able to read their side effects.
Granted I am on a high dose of meds for my pain. Ive got it real bad.
The last thing I need is for a lazy pain doctor being fooled by a drug salesman that tells him his slowest moving drug….”Shitzen” made for chronic BS….is also great for chronic pain.’
I am wondering if Viagra had been a failure when it was introduced, would it have also become GREAT for use with Chronic pain meds too?
STOP TRYING TO FOOL THE PATIENTS. YOU CAN FOOL A BUSY DOCTOR THAT WORRIES OVER HIS CAREER WHEN PRESCRIBING HIGH DOSES…But, dont try to fool a patient that is also has a masters in chemistry.
Doctors, give your patients phenagren that med for upset stomach. Its properties enhance the drugs and do no more harm….stop being fooled by the drug salesmen.
Fortunate for me and possibly you all as well, I had to have my normal meds filled today. So, I asked pointed questions to the head pharmacist with 25 years experience filling meds of all types.
I asked her, “Is there such a thing as too much MS Contin? Is there a dose level that is so high it stands to kill you quick or slowly?” Her answer was direct, “No, not really”, she said to me. “Unless of course you are started on such a high dose to begin with and your breathing stops.” “That is too high a dose.” She was asked then if someone were to be raised over a 9 year period from 200-1000mgs per day that would not be considered too high a dose? Again, the answer was no.
Next, I asked her about these “Non Intent” meds. What a strange name. The meaning is simple, these meds were never meant to be used with or for chronic pain. So, I asked her what was her opinion of the multitude of meds now being prescribed that are Non Intent meds? She told me from her training and her experience, they were useless. She said that they seemed like a con. But, she did go on to agree with me concerning a Non Intent med that has been around for ever and that I first experienced when being given large doses of demerol for surgery. I was also given Phenegren. Its for vomiting. It keeps you from vomiting and has next to no side effects. It can make you sleepy she said when mixed with pain meds because it increases their ability to dull your pain receptors. And, its dirt cheap. But, its not new!
Is anyone else starting to see a patern? Our new Anti BS pill just isnt what we thought it would be and it actually has proven to have 14 different really bad side effects. And it doesnt work even well for what it was meant to be originally used for. BUT, dont get me wrong. Viagra wasnt meant for what its used for and Im told it works great for the other use. It was to be used for those with low blood pressure. It was a failure. Except in one instance.
My next question was, of all these Non Intent Meds, is there ones that actually work? A few she said. Not many and most complain badly about side effects.
My final question to her was this….So, if these Non Intent meds are now being prescribed, in the millions she told me, and they have so many bad side effects compared to their good results, then why are chronic pain doctors prescribing these meds?
She didnt have a direct answer. So, I sort of lead her…I asked,,,If the Chronic Pain Doc is so busy as it is, could it actually be the pill salesman fooling these docs into trying their crappy pills in their marketing efforts and to make money by stating all failed pills for their Origianl intent are good for chronic pain? She said that I was being too broad and that in todays medicine it is actually the pill salesman doing 99% of the research and information presentations to the doctors. I asked her what can we do? Be a real informed and researching patient such as yourself and have your questions in writing for these docs.
SORRY,,,, A GREAT BIG PS…..THE PHARMACIST ALSO told me that the Anti Seizure med I was asking about….She had never actually filled it for Seizures. “There are about 9 pills for seizures that work better, are cheaper and dont have the same side effects.
God, dont you feel like your being treated as if you were all fools?