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    What to Do When Painkillers Don’t Work


    According to the Centers for Disease Control and Prevention, doctors today prescribe three times more opioids than they did 20 years ago.

    According to the National Institutes of Health, chronic pain is a serious problem that affects more than 100 million Americans. Doctors who treat pain are in an awkward spot because of this. Opioids can have serious side effects such as mental clouding, nausea, respiratory depression, and even death. Opioids can also lead to dependence.

    A panel of panelists met at an NIH Pathways to Prevention workshop in September 2014 to examine the issue. They discovered that many studies on opioid painkillers used for chronic pain were too brief, some lasting less than six weeks. Additionally, there was evidence that they pose a higher risk of overdose and abuse.

    “At the end of the workshop we called for further investigation of opioids in treatment of chronic pain,” said David C. Steffens MD, MHS, who was a professor and chair of psychology at the University of Connecticut Health Center School of Medicine. He took part in two-day workshop. We hope that those who prescribe these medications to acute pain (e.g., in the context of a sports injury or work) will be more cautious with the amount of pills they prescribe.

    Dr. Steffens and the other panelists came to the conclusion, too, that the main problem was a lack of knowledge about the best pain treatment methods and a system of health care that tends to default to the simplest, rather than to the best.

    The Person Behind the Pain

    What does this mean for doctors who prescribe opioid painkillers to chronic pain patients?

    “They tell us that we will have to be more creative and thoughtful about how we manage chronic painful,” Gary Kaplan, DO founder and medical director at the Kaplan Center for Integrative Medicine and author of Total Recovery, Solving the Mystery Of Chronic Pain and Depression. “We often focus on the thing, rather than the person.”

    Dr. Kaplan says that the report also shows that opioid painkillers are best used for short-term pain like post-surgical pain and not for chronic conditions.

    The findings’ supporters also believe that the health care system must be more cautious about who prescribes narcotics to patients.

    Opioid painkillers can be tempting for addicts,” states John Stamatos MD, director of pain management at Syosset Hospital in Syosset. “The problem with these medications is that the body becomes more sensitive to them and patients need more of them over time. This can quickly spiral out of control if patients are not closely monitored.

    Related: 6 Natural and Cheap Chronic Pain Remedies

    He also points out that some patients absolutely require opioid painkillers.

    Dr. Stamatos says, “If you have a person who has had three back operations and is still in pain, what do you do? Just deal with it.” We can’t leave them in severe pain and watch their lives.

    Stamatos monitors his patients’ daily activities to ensure that they are well-managed. He says, “I assess whether patients make it to work, exercise, take care of their children, and do all the other tasks they have to do in their day.” “If they’re just lying down on the couch, it is clear that they are not taking painkillers in a proper manner.”

    A Different Approach to Pain Management

    Stamatos states that there are many alternatives to opioids. These include injections, muscle relaxants or non-narcotic painkillers such as non-steroidal antiinflammatory medications (NSAIDs).

    Kaplan states that science is showing us that techniques like acupuncture and meditation play an important role in managing chronic pain. However, they are often underutilized.

    It can also be a great way to get rid of stress. Stamatos explains that physical activity can help strengthen your muscles and allow you to get back to living.

    Kaplan states that one takeaway from the NIH workshop about opioid painkillers was that doctors must be cautious. He says that doctors have been too quick in prescribing opioid painkillers. “We need to take a more comprehensive and thoughtful approach to chronic pain treatment.”



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