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Overprescribed opioids

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SAN FRANSICO. (Ivanhoe) — Pain experts say in the last decade, there’s an alarming trend of doctors overprescribing opioids for patients with chronic pain. This year, the CDC handed down guidelines urging doctors to limit those prescriptions. So what’s a patient to do? Pain management clinics are an effective alternative to drugs.

Jim Weil suffered from debilitating, chronic migraines for more than 15 years.

Weil told Ivanhoe, “It wasn’t a question of how frequent or the duration, it was a question of the intensity.”

The list of drugs Weil tried to dull his migraines is pages long. Nothing worked. When his doctor urged him to take hydrocodone, Weil decided it was time to try something new and went to Beth Darnall, PhD, a clinical associate professor at Stanford University’s Pain Management Clinic.

Darnell detailed, “You can actually control how much you suffer from your medical condition.”

Darnall helps patients like Weil to focus on the mind-body connection to conquer pain. She teaches techniques like meditation, relaxation, and mindfulness and emphasizes the importance of sleep and exercise.

Darnell explained, “It helps give all of us a critical level of control over our pain, because we’re learning how to dampen pain processing in our own nervous systems.”

Weil said techniques he’s learned have considerably lowered the intensity of his migraines.

“It allows me to cope with it in a non-medicated way and get on with my life and make it as normal as possible,” said Weil.

Weil said it took two or three months to start working. Now it’s a part of his life every day.

Pain phycology was one part of an integrated treatment Weil received at the Stanford Pain Management Center which included physical therapy, biofeedback, peer support, group cognitive behavioral therapy, and medication support. Darnall said the best chronic pain treatment involves a comprehensive approach.

Contributors to this news report include: Wendy Chioji, Field Producer; Roque Correa, Editor; Rusty Reed, Videographer.

  

OVERPRESCRIBED OPIOIDS
REPORT #2378


BACKGROUND:
Opioid is a type of drug that is usually prescribed in order to relieve pain. Opioids work by attaching to a protein called opioid receptor.  When these attach to the receptor, they reduce the intensity of pain signals that reach areas of the brain that control emotion, which diminishes the sensation of pain. Because opioids also affect the part of the brain related to reward, when some people consume this drug, they may experience a euphoric response. This is why the prescription of this drug is very sensitive. Approximately 80% of the global opioid supply is consumed in the U.S. 

(Source: http://www.mayoclinic.org/diseases-conditions/migraine-headache/home/ovc-20202432 & https://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/how-do-opioids-affect-brain-body)

CONSEQUENCES OF OPIOIDS: If opioids are consumed with extreme care, they can alleviate pain safely and they rarely cause any type of addiction.  However, if they are abused, they can lead to physical dependence, and sometimes, addiction. Having an addiction to opioids can lead to severe respiratory depression and even death. If this drug is suddenly reduced or stopped it can cause:

  • Restlessness
  • Muscle and bone pain
  • Insomnia
  • Diarrhea
  • Cold flashes
  • Involuntary leg movements

(Source: https://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/what-are-possible-consequences-opioid-use-abuse)

NEW TREATMENT: Dr. Beth Darnall is a psychologist at the Stanford Pain Management Center, where she allows patients to deal with chronic pain without the additional use of medications. She treats her clients individually and in group settings in order to allow her patients to:

  • Understand the mind-body connection and how to use it to their advantage
  • Understand how pain and stress are connected
  • Learn about pain catastrophizing and how to stop it
  • Learn why focusing only on pain medication for pain relief can lead to worse pain and other problems
  • Learn how improving psychological factors can help them gain a better result from all medical treatments

These techniques performed by Dr. Darnall and the Center allow patients to have better control of their life and to be more tolerant to pain. She says “We help people learn to regulate thoughts – attention to pain, interpretation of pain, distress about pain – as a pathway to reduce pain intensity.”

(Source: http://bethdarnall.com/patient-care/)

PATIENT JAMES WEIL SAYS:  “The Botox medication, now not as effective now as it used to be, lowers the overall pain level but the Pain Management Clinic techniques help me deal with migraine flares, without additional medication and give me much better control of my life. It allows the pain to be much less debilitating and increases my pain threshold – i.e. allows me to be more tolerant of pain. What I have also learned during this time at Stanford is that I will most likely suffer from migraines for the rest of my life. I also possess the tools to manage them within me. The Pain Management Clinic has taught me to accept these facts and embrace them. It also has convinced me, if there were any doubts, that opioids are NOT the solution for chronic pain.”

* For More Information, Contact:

Ashley Gomez, Administrative Associate

Stanford Department of Anesthesiology, Perioperative and Pain Medicine

Division of Pain Medicine

ashgo@stanford.edu

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