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New Chronic Pain Guide Focuses on Medications

By April 5, 2009

The latest edition of the American Chronic Pain Association Chronicle focuses on medications: myths, truths and the proper way to take your meds. This topic is near and dear to my heart, because so many of my patients struggle with managing their chronic pain medication.

My patients seem to have a love-hate relationship with pain meds. Either they love them too much and sleep through their rehabilitation session, or they are so afraid to take them that they cannot tolerate their therapy. It's hard to strike a balance. Add fears of addiction to the mix, such as when patients are presribed opioids for chronic pain, and medication management can quickly become a nightmare. What is a chronic pain sufferer to do?

If you have questions about medications, such as what is safe and why certain pills don't work for everybody, this guide is a good place to start.

Comments
April 8, 2009 at 2:30 pm
(1) Dewgeist says:

The article touches on the stigma chronic pain management places on people (not unlike that of those dealing with a mental disorder) of having to both justify treatment and defend against the common prejudices usually raised by said treatment.
It’s a sad truth that many health care workers still hold to the belief that chronic pain sufferers are either drug seeking addicts or emotionally dysfunctional, perhaps both.
Dr. Gregory House not withstanding…

April 13, 2009 at 6:28 pm
(2) Pam McGee says:

You are so right!!! I am actually online right now to divert my attention from the pain instead of taking an opiod. I am in the scared to take it unless I absolutely have to crowd for fear of addiction. I wish I knew the answer to, “Do I take the medicine and then work out, or skip the meds and dont work out.” I guess as with all things, there must be balance.

June 15, 2009 at 1:17 pm
(3) RedHen says:

“…some like their pain medication too much and sleep through rehabilitation…”

Your statement infers that sleepiness equals addiction. Such statements only serve to increase discrimination and mislead patients and non-patients about addiction.

Somnolence, i.e., sleepiness is a major side effect of pain medications and causes many chronic pain sufferers to stop taking medication.

Patients can and do fall asleep in the middle of an activity and do not know they are asleep. This is why they say do not operate machinery.

At the lowest dose, long acting pain medication makes me somnolent. I could not go to physical rehabilitation because it provides only minimal pain relief.

I stopped taking it for nine months. Unfortunately, the pain is so severe I have to take the medication. Now, I sleep all the time and I am miserable. At the lowest dose, I fall asleep in the middle of an activity.

Instead of labeling us as addicts why doesn’t someone find a solution to the severe sleepiness chronic pain patients experience.

June 15, 2009 at 6:37 pm
(4) pain says:

RedHen, I think perheps you misunderstood my statement. I am in no way implying that my patients are addicted to their meds. Most of them have only been newly prescribed medications, and none actually fit the criteria for a true addiction.

What I am referring to is the difficulty in striking a balance between working out pain medication side effects (such as drowsiness, also nausea and constipation) and people who are so worried about potential side effects that they try to go without any medication at all. When you work on a rehab unit, you see what a hard balance it is for many people to find.

This is why I was so happy that the American Chronic Pain Association brought this to the public’s attention. With so many negative perceptions of people who take pain medications long term, and with so many media celebrities giving everyone else a bad name, it can be hard to avoid the stigma.

August 22, 2009 at 10:32 am
(5) MICHAEL BOLT says:

I’ve endured acute chronic pain for 6 years due to a caevical bone spur operation & resulting pressure on a root nerve. It courses thru my body as does blood thru a vein. I’v tried varius pain medications the upper tier being oxycontin with no or short term relief. The next step is morphibe sulfate which I’vs tried on a test basis. It was amazing how all the phantom nerve pain totally disappeared but was denied an on-going regiman because the doctor was afraid of the DEA requiemnts, I have tons of medical records which support my impairment? People just don’t understand the amount of pain chronic patients deal with on a 24/7 basis. The addiction factor matters not to me if I can resume a normal life at age 59.
Thank You, Michael Bolt

August 22, 2009 at 10:35 am
(6) MICHAEL BOLT says:

Sorry about the spelling as it hrts tremendously in my fingers. Mike Bolt

October 28, 2009 at 1:44 pm
(7) Jeremy Blake says:

Friend I’m glad that you have recovered and constantly struggles against the pain, I also suffer this disease and really painful, but based on appropriate medicines’m doing to get ahead, this medication oxycontin is good for pain but it causes anxiety and is dangerous if you can not control it, visit a few months ago and in his article on oxycontin suggest it might be dangerous if not prescribed by a doctor and if one does not adequately control the sensations they produce, I really hope to have more news from you.

June 12, 2010 at 7:11 pm
(8) ron says:

i lost my right leg below the knee at 19 but i was able to work w/o taking any pain medication (all though painful) till 30 at which time i simply took one oxycontin 20 mg tablet in the evening to help with the phantom pain and sores that popped up during the day having to stand and walk 8 to 10 hrs a day, at 38 i developed a nasty lower left back pain which has put me on the edge of suicide at times, i continued to work and all they could do to comfort me was give more and more medication, now i am 43 and because of the costs i have had to take a combination of methadone and oxycodne that works well for the pain. unfortunately while working there doesnt seem to be enough pain medication in the world to do my job all though i continue to try. methadone really helps my chronic pain but unfortunately it is keeping employeers from hiring me because its thought to only be a medication for heroine and the opiate addicted. actually it is a pain medication first and one that a person can afford, its the only option i am afforded by my medical insurance, but its made me unemployable once i take a drug test.

June 17, 2010 at 12:13 am
(9) Nicole says:

In 1999 at age 18 i was diagnosed with SLE(Lupus). Then shortly after Chronic pain disorder and fibromyelgia. At first i refused any pain meds at all more due to denial. though as time went by the pain became evident enough that i could no longer function in everyday life. So i to started to take pain meds. After awhile it was just another pill added to the many i already took. Though sense i have taken them for so long now and my diseases have progressed a great deal so i take quiet a bit of meds for pain and i have been discriminated against not only by docs but pharmisist also cuz they dont know my history or what i go threw all they see is 30 year old with a face rash and wonder why in the world i would need that kind of meds. At first it realy bothered me and made me feel as though i was doing somthing wrong but now i just grin and bear it and tell myself that untill they have felt the pain i feel on a daily basis or deal with any chronic pain they have no right to judge me!

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