Re: New rheumy/pain meds

[Guest guest]

I'm new to this group, diagnosed with PsA 8 months ago after years of assorted

bouts of pain. I also have had lumbar disc disease since the '80s. I hope not

to offend those folks who have had this disease much longer than I have. My

beliefs come from the fact that I have been a RN for 35 years and have dealt

with a lot of people in pain. I have to side with the MDs that are reluctant to

prescribe narcotics for people with chronic pain; pain meds only relieve the

symptom but don't address what is causing the pain. Narcotics should be

reserved for acute pain problems, chronic cancer pain and chronic pain after all

other ways to treat it have been exhausted. We must remember that pain is our

body's way to tell us that there is a problem. In our case it would do no good

to relieve our pain with narcotics and allow the inflammation to proceed

unchecked and progress to joint damage and disability. We know inflammation is

why NSAIDs are the first line drug of choice.

Let's face it folks, we are in this for the long haul. We have a chronic,

incurable disease that must be controlled to improve our quality of life.

Adding narcotic dependency to our list of woes will not help us. And the

tolerance that develops over time only causes the meds not to be effective when

we really need them. I'm sure there are folks out there on NSAIDs, DMARDs and

biologics that still have some pain. Local steroid injections into a joint are

also very helpful. If you need narcotics when other treatments have been tried

and have not given complete relief, use them. But unfortunately, too many people

in our society look for the quick/easy fix to problems.

I, also was terrified at the thoughts of starting MTX 6 months ago. I stated,

" I will never take biologics. " Now after minimal relief with various NSAIDs,

MTX(25 mg/wk) and sulfasalazine, I have come 360 and can't wait to start Enbrel.

BTW, I have had no ill effects from any of the meds. Never having been a heavy

drinker I still am able to enjoy 2 drinks/week.

So, I hope I haven't offended anyone in the group, but this is a forum to share

information, help, hope and feelings. I hope that we all have pain free days in

our future.

[Guest guest]

You know more often than not there is no other medical fix for the pain but to

treat it. Some of us have other medical issues that are going on and can not

take biologics or use the standard pain medications such as NSAIDs that are

called for. My only choice is to use opioids. And no I'm not someone who is

looking for a quick fix. I'm just looking for the ability to get on with a

somewhat normal life.

Obviously you have not experienced enough pain yet to have it negatively impact

your life that you can no longer function since you seem to think that those of

use who do use opioids just don't need them.

Until you walk in my shoes who are to judge.

Celeste

[Guest guest]

: I've only just run across your e-mail about narcotics and I would

probably agree that there are some doctors who too quickly dole them out; but

any good doctor will monitor a patient's use of such drugs. Additionally, there

are times when a patient could need pain meds to get through a particularly bad

flare or even at the beginning before finding the right DMARD.

I do think it interesting, though, that you seem to be so cautious about pain

meds when you state that you're not a heavy drinker but still have two drinks a

week while on MTX. That, according to my rheumy at least, is playing with fire

because of the threat of liver damage. She told me one drink a year on my

birthday and that was all!!!!

Hope the Enbrel works for you and gives you the relief you're seeking. It is a

bit scary but if it works, you'll thank your lucky stars you got over your fear.

Joanna Hoelscher