13 February, 2008


Please see this abstract:


It's a review of available data on people who are living in chronic pain that is not caused by cancer. Important for fibromyalgians is the fact that "Patient diagnoses included back pain (31), neuropathy (20), joint pain (13), visceral pain (7), reflex sympathetic dystrophy (RSD) (7), headache (5), and fibromyalgia (3)." The number of people in the study with the specified pain/problem is the number in parentheses. Fibromyalgia can, essentially, include all the types of pain mentioned before it except that associated with RSD.

Perhaps the most important thing this study does is dispel the crushingly stupid argument that people in chronic pain get addicted to painkillers: "In a study of 11,882 patients who received narcotics, only four patients became addicted. Other studies report a slightly higher incidence."

And this is one of THE MAIN reasons we (people in chronic pain) are denied opioids? Shave my taint!

Another great thing discussed is the fact that "It is also necessary to differentiate between pseudoaddiction and addiction. Pseudoaddiction is a term that has been applied to patients who develop behaviors reminiscent of the addict as a result of iatrogenic undertreatment of pain. According to these criteria, the authors found only one case of addiction (1%) in a patient with a history of substance abuse."

One. Case. And the one person had a history of substance abuse. Nothing more to say, case made.

One's tolerance increasing to mammoth proportions is a reason always given so physicians can feel comfortable denying patients (especially young ones) opioids. Uh-oh! Here's more from the abstract:

"Pharmacological tolerance is defined as the need for increasing doses to maintain drug effect. This study demonstrated no pharmacological tolerance occurred. The study also showed it is possible to use opioid substitution to find, in most patients (81%), a good balance between adverse side effects and good pain relief."

This post will end with the abstract's final paragraph. Please see a previous post to see how pissed off this issue (the non- and under-prescribing of opioid analgesics to people in chronic pain) gets me. Also know that tomorrow I'm letting Dr 9 read it. And then I'm going to ask him how he can NOT prescribe me Percocet (what I'm shooting for).

"Different chronic noncancer pain syndromes can be treated with chronic opioid therapy. A patient should not be classified as unresponsive to an opioid until a trial of other opioids has been given. If it is necessary to change the opioid because of side effects or inadequate pain relief, with each new opioid tested, the number of patients in whom this new drug will be effective increases. Failure of one opioid is not a prediction of failure of another."

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1 comment:

Anonymous said...

Thank you so much. I have been screaming the same things to doctors for half my life. Not because of fibro, but because of other pain (teeth stuff) and telling them that 20 percocet were NOT going to make me an addict, but they rarely listened and so I suffered. Same thing is going on now, only I figured out that three shots of 180 proof does the same thing because of the way that opiates and alcohol affect the central nervous system. Heaven forbid anyone should find out I do this to get rid of the pain...I might become an alcoholic (I haven't)! Stupid white coat fiends. I think I'm going to learn to make my own opiates if the pain gets much worse.

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