Chronic Pain

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by Dennis Townsend                                                                                                                                                                                                                                                                Chronic pain, the pain that just doesn’t go away, it’s there when you wake in the morning, and it’s your constant companion when you try to go to sleep at night. The causes are many but the cure sometimes is nowhere to be seen. Some chronic conditions like cancer requires constantly controlling the symptoms which often includes controlling the pain. Oh sure, you take your pain medicines but it only last so long and before you know it you’re reaching for another pill or two. And if you’ve been taking them for a long time, they are not as effective as they were before and you find yourself doubling the doses just to get acceptable pain relief. The instructions on your medicine bottle start to mean nothing, and the pharmacy warns you of the dangers of a possible overdose, but when you are in severe pain you don’t give it a second thought. We are all aware of the heroin epidemic that has gripped the country and it has been linked to opiate abuse which some say is the real gateway for heroin. But  I believe that the root of that problem is really chronic pain.

The biggest health problem in America is chronic pain, it affects 100 million adults, more than heart disease, cancer, and diabetes combined according to a 2011 Institute of Medicine report. It’s the primary reason Americans receive disability benefits and it’s one of the least understood afflictions in the medical field. Medical schools teach hardly anything about handling chronic pain, spending maybe 9 hours on the subject over 4 years. One reason is that there is no objective way to confirm that the pain actually exist. Many patients with chronic pain are mistakenly seen by society at large as drug seekers or hypochondriacs. That leads to trial and error treatments, fighting skeptics who believe that the pain is imaginary. In America, 44 people die every day from overdosing on prescription medications, and three times as many die from heroin overdoses. With the heroin epidemic getting out of control and the government desperate to bring a halt to it, the decision is made to put the brakes on doctors prescribing opiates for pain. While that may be a solution for some, it’s a nightmare for those who are really suffering from chronic pain. In an effort to control the flow of opiates to patients, hospitals across the country are now opening up pain management centers where your pain medicines are closely monitored and refills are based on your ability to follow your doctors orders on when and how many to take. If you take more than what is prescribed on the bottle, you will run short before your next refill, and that could mean days without any pain medicines at all. A horrible prospect.

The normal prescription for pain medicines last for 30 days, and then you must get your primary care physician to approve another 30 days. I live in the great state of Ohio with a Republican governor who just signed a law that doctors can only give you a 7 day supply of opiates for pain unless you suffer from a chronic terminal condition that causes pain like cancer. The law is a double edged sword because if someone is actually suffering from chronic pain, and if that person can’t get pain medicines legally, then they will be drawn to the people the government is most afraid of, the street drug dealer. I can tell you that illegal pharmaceuticals of all kinds are on the streets everywhere, no script needed. The cost may be a little high as far as money is concerned, but for those who suffer with chronic pain, no cost is too high. for pain relief. There are millions of people who are living with chronic pain and while some are hypochondriacs and drug seekers, there are millions more who actually are suffering. And yes sadly, there will also be those who become addicted and move on to heroin, and lives will be lost. But is it any different than alcohol or tobacco? Both are addicting and both cost lives, and for now, opiates is just another chemical concoction to blame on a country’s lack of morals and unnecessary deaths.

Being able to determine the existence of chronic pain in a patient seems to be the problem but there is finally some good news on that subject. Scientist at Boston’s Massachusetts General Hospital has a new brain-scanning method that allows doctors to see chronic pain in detail for the first time. The technique, a merger of PET (positron emissions topography) and MRI (magnetic resonance imaging), clearly identifies that a patient is hurting and now gives doctors a way to diagnose chronic pain. Now that we can see the activation of chronic pain pharmaceutical companies should pursue new treatments for chronic pain. Trouble is, it will more than likely require taking another pill.

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