Chronic pain is a progressive disease of the nervous system, caused by failure of the body's internal pain control systems.The disease is accompanied by changes in the chemical and anatomical makeup of the spinal cord. Chronic pain is a malignancy, in the sense that when it goes untreated, it increases in intensity and spreads to areas that weren't previously affected, damaging the sufferer's health and functioning.
Opioids are substances naturally produced within the body to regulate
pain. They are commonly known as endorphins, and recognized as producing the state of euphoria known as the runner�s high. Chronic pain victims, who can�t produce enough opioids on their own, often benefit from supplementation with pharmaceutical opioids
When taken as prescribed by your doctor, opioids are among the safest
drugs available.
Oxycontin, like other opioids, is safe for patients who take their medicine as prescribed. �Oxycontin deaths� occur in habitual substance abusers, not patients, and are usually the result of combining the drug with overdoses of alcohol and other drugs. These are deaths associated with Oxycontin, not caused by it, and they are not occurring in patients.
Opioids can be discontinued whenever they are no longer needed. Patients often recover from chronic pain, and return to active lives.
Opioid addiction in pain patients is extremely rare. Addiction is defined by the American Society of Addiction Medicine as, continued use in spite of harm. If opioids make your life better by controlling pain, you are a pain patient. If they make your life worse, and you continue to use them, you are an addict.
For most patients, their dose remains stable over long periods of time.
When opioids are taken on a regular schedule, tolerance quickly develops, and the psychological �high� goes away, leaving the user feeling completely normal. Long-term opioid users, as a group, have driving records for accidents and violations that are the same as everyone else�s.
No. Opioids improve functioning by reducing pain levels. They don�t remove all the pain, or the ability to perceive new pain.
You may. Dependence means that if opioids are abruptly discontinued you will have a physical withdrawal reaction, similar to having the flu. This reaction can be prevented by gradually tapering off the medication. Dependence is a physical phenomenon, not a sign of addiction.
This should not prevent a trial of opioids. Studies at Harvard Medical School and the University of Washington indicate that a past history of substance abuse has little predictive value for failure of opioid treatment. If you have current behavioral or substance abuse problems, you may have trouble with opioid treatment.
Constipation, nausea, itching, insomnia, and drowsiness commonly occur. All of these side effects can be successfully managed
No. Opioids occur naturally in the body, and are not harmful to any organ system. They can be taken safely for a lifetime, if necessary. Anti-inflammatory non-opioid medications such as Motrin, Naprosyn, and Vioxx, on the other hand, kill 16,500 patients each year through bleeding from the stomach, and are toxic to the liver and kidneys.
The amount that allows optimal functioning is the correct dose. There is no upper limit to the dose of opioids that can be safely used, when the medicine is increased gradually.
The idea that one opioid is more addictive than another is a misconception. The prevalence of opioid addiction runs far below that for other common drugs of abuse, such as tobacco, and alcohol. This is not for lack of exposure either, because 23,000,000 people have surgery each year, and most receive opioids afterwards. The fact is, most people don't like opioids, and this is borne out by experiments at NIDA, and mentioned in textbooks.
There are clearly differences in preferences expressed by people who pursue opioids for the psychological reward they experience. So far, this is not borne out by the scientific literature, but anecdotal evidence really leaves little doubt.
The mistake often made, is using this preference observation to jump to the conclusion that one opioid, such as Oxycontin, is more addictive than another. The flaw in this reasoning is the extrapolation that because there are preferences for specific opioids within the population of abusers, this means that certain opioids can cast some sort of evil spell over the rest of us. This simply isn't the case. The fact remains that most human beings still aren't inclined to abuse opioids.
I agree with your observation that oxycodone is more effective in the treatment of pain than many other opioids. It seems to be the case, that the more effective opiods are also those preferred for their psychological effects. For the reasons discussed above, this would not be a problem for the field of pain management, except that doctors are blamed for not preventing abusers, who would find a source of opioids anyway, from getting what they prefer.
The phenomenon of tolerance prevents chronic pain sufferers from experiencing the psychological rewards that abusers pursue. Paradoxically, they take too much, to be able to get high.
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