NEWS Sufferers find relief from pain, fear of addiction

[Guest guest]

Sufferers find relief from pain, fear of addiction

Connie Midey

The Arizona Republic

Sept. 21, 2004 12:00 AM

When severe pain makes every move too excruciating to bear, you probably

want just one thing: a pill to make it go away. Quickly.

Then the pain subsides and you begin to worry about becoming addicted to the

chemical that brings such blessed relief.

That fear never materialized for back-pain sufferers Dagmar Nuruddin of

Goodyear and Bill Sauro, a longtime Arizonan now living near San Francisco.

That was in large part because their need for relief was genuine and because

they worked closely with their doctor to reduce the pain as well as find its

cause and treat it.

" Some people are against the whole idea of using pain pills because they

think we'll have a nation of weaklings, " says surgeon T. Yeung,

founder of the Arizona Institute for Minimally Invasive Spine Care in

Phoenix. " And a lot of doctors are afraid of getting in trouble (legally) if

they treat their patients' pain with opiates. "

Undertreatment can be the unfortunate result, Yeung says, and a document

released in August by the Drug Enforcement Administration and national pain

experts agrees. It calls drug abuse and undertreatment of pain intertwined

and " serious societal problems. "

Uncontrolled pain affects sufferers' physical, emotional, social and

economic well-being, and accounts for " many tens of billions of dollars " in

health-care costs and lost productivity, the DEA report says.

The report, Prescription Pain Medications: Frequently Asked Questions and

Answers for Health Care Professionals and Law Enforcement Personnel

(www.stoppain.org), addresses the need to provide adequate treatment safely

while preventing patients from abusing their medication or sharing it with

or selling it to others.

In what he calls " ethical pain management, " Yeung asks patients to sign a

drug contract with him as he searches for and treats the source of their

pain. They must agree not to seek pain relievers from anyone else or share

them with others. They also must take the medication only as prescribed,

consulting with him if they need higher dosages. Random drug tests may be

administered.

Then he helps them stop taking the medication.

" All opiates can be addictive, " Yeung says. " Plus, when you give a patient

pain pills, you're affecting the liver and the kidneys. And you don't want

to hide something that you could cure.

" All that comes with responsibility. You have to know the patients, see them

regularly and know what you're treating. You have to be very meticulous with

your records. "

Opiates, also called opioids, are potent pain relievers made from the opium

poppy plant or produced synthetically, the DEA report says. They include

codeine, morphine, oxycodone and fentanyl, and are marketed under brand

names such as Vicodin, OxyContin, Percocet and Demerol.

Sauro, 58, who ran an advertising business in Arizona, says he " tried to

white-knuckle it " when pain from calcified disks made it impossible to

stand, walk or sit. If air travel was necessary, he bought three seats so he

could stretch out in hopes of finding a bearable position.

He tried physical therapy, acupuncture, yoga and other remedies to no avail.

When he found himself turning to pain pills, he decided surgery was the only

remaining answer. He wanted to tie his shoes without hurting, but he didn't

want to become addicted to the pills that made that possible.

" I had the surgery, " Sauro says, " got up the next day and never took another

pill. "

His experience confirms what Yeung has observed: that patients using opiates

properly and under medical supervision are unlikely to have serious problems

discontinuing them after their pain goes away.

" Studies have been done on people with severe burns, who were on narcotics

for a year or two, " Yeung says. " The studies concluded that if you have real

pain, you don't get truly addicted. "

Dagmar Nuruddin, 60, is determined to control her aches as harmlessly as

possible. Yeung said surgery for a slipped disk would be too risky for her.

Instead, she turns occasionally to a muscle relaxant and pain reliever for

the back trouble she has had since her youth.

" It has given me quite some problems, that little disk, " Nuruddin says, " but

Dr. Yeung said I should take the medication only as needed, and that's what

I do. We're trying to treat it simply and safely. "

http://www.azcentral.com/arizonarepublic/arizonaliving/articles/0921painkill

ers21.html