Re: Risk Of Addiction To Pain Relief Is Small, Expert Says

[Guest guest]

Thanks Kat,

It's funny how much I (and I am sure others) avoid meds that might help me

feel better because I don't want to become dependent on them.

But then I have a sister who overdosed on Tylenol over a long period of time

and ended up being hospitalized as a result...

Ruth

>From: KathleenLS@...

>Reply-To: CMTUS (AT) onelist (DOT) com

>To: CMTUS (AT) onelist (DOT) com

>Subject: Risk Of Addiction To Pain Relief Is Small, Expert Says

>Date: Tue, 7 Mar 2000 00:07:19 EST

>

>From: KathleenLS@...

>

>DG DISPATCH - AAEM: Risk Of Addiction To Pain Relief Is Small, Expert Says

>02/21/00

>http://www.pslgroup.com/dg/16cc16.htm

>

>By Carlson

>Special to DG News

>SAN ANTONIO, TX -- February 21, 2000 -- Most pain experts say the public's

>concern about inadvertently becoming addicted to narcotics while being

>treated for pain is unfounded. Unfortunately, some physicians share that

>concern, and some patients are not getting the pain relief they need.

>

> " You will not make any patient an addict if you give them drugs to treat

>their pain, " says Henry Farkas, MD, MPH, Medical Director of the Northern

>Chesapeake Hospice and a staff physician at Union Hospital, in Elkton, MD.

>He

>pointed to the results of a very large study done in the 1980s, which found

>that only four patients became addicted out of 12,000 treated with opiates

>for pain. " It's just not a problem for more than 99 percent of people, " he

>said.

>

>Dr. Farkas discussed the topic at the 6th annual scientific assembly of the

>American Academy of Emergency Medicine (AAEM), held over the weekend (Feb.

>19-20) in San , TX.

>

>Even patients with a history of drug abuse who legitimately need pain

>treatmen

>t can be given opioids, he said, if they genuinely want to stay off drugs.

>

> " Assuming they are motivated to stay clean, most times their pain can be

>treated safely, " Dr. Farkas said. " I've seen patients in the Emergency

>Department who I knew were drug addicts because I treated them before, but

>now they came in with a broken arm or dislocated shoulder and were in pain.

>You treat their pain and get them better, and they don't go back to drug

>abuse. "

>

>Then there are patients who need pain medication but are so afraid of

>becoming addicted that they refuse drugs. " I tell them I know how to treat

>pain without opiates but it will not be as effective, " he said. " Then I

>treat

>them as best I can with adjunctive therapies.

>

> " But I also assure them that, at any time, if they want to try the stronger

>medication, it will not make them an addict, it will only make them feel

>better. Many eventually come around and agree to try a low dose of an

>opioid.

>Then they feel better, and we take it from there. "

>

>Pseudo addiction is a case in which the patient complains that the pain has

>returned and wants another dose of narcotics in less than four hours.

>

> " That person may look like a drug addict, " Dr. Farkas said, " but their dose

>may actually be too low. The peak drug level gets into the therapeutic

>range,

>but drops below the therapeutic range in less than four hours. "

>

>Here is the difference: if the dose is increased and the patient's

>functionality improves, that's a good indication; if the increased dose

>makes

>them drowsy and sleepy, that's an indication it should be cut back. " But

>that

>doesn't mean you should stop pain treatment completely, " Dr. Farkas said.

> " You might try something in addition to the normal opioid therapy, another

>medication for the particular kind of pain they are having. "

>

>He said there are several time-release opioids available which keep the

>drug

>level at a steady state in the therapeutic range.

>

>

>Kat in Seattle

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