Word: opioids
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...even his or her personality. "A patient's psychological preference for treating pain can be more important than the amount of medication," Palmer says. She cites the case of an elderly woman with arthritis in her back who preferred taking the oral narcotic Vicodin to using a more potent opioid drug delivered through a patch. "The Vicodin wasn't nearly as powerful as the opioid patch," says Palmer, "yet it gave her more pain relief. That tells you this is a patient who wants control. In some patients the psychological impact of being able to open a pill bottle, pull...
...true even for patients in extreme agony. After knee-replacement surgery, Donna Jaeger, 56, of Auburn, Calif., developed a neurological condition that caused excruciating pain that she rated a "17 on a 1-to-10 scale." Pain-management experts at U.C. Davis prescribed a multifaceted treatment that included powerful opioid drugs and a spinal implant--all of which helped. But Jaeger regards psychologist Symreng as "my saving angel." Breathing techniques and soothing relaxation tapes help Jaeger reduce her pain level from 17 to 4 or 5 on a good day. "But really," she says, "it is just the talking...
Although high-profile cases of addiction to OxyContin and other opioid pain-killers have scared off many doctors and patients, such drugs have an important role to play in chronic pain. They are particularly useful, says Palmer, for elderly patients, many of whom can't tolerate the side effects of anti-inflammatories. Younger people develop tolerances to opiates more quickly than the elderly, says Palmer, which means the young wind up needing ever higher doses. That is not a big problem in older patients. "I like to use low-dose opioids in the elderly because there aren't any liver...
...Opioid painkillers, which include morphine and heroin as well as prescription products like Percocet, Percodan and Vicodin, are so dangerous because they are so seductive. They work by throwing up roadblocks all along the pain pathway from the nerve endings in the skin to the spinal cord to the brain. In the brain these drugs open the floodgates for the chemical dopamine, which triggers sensations of well-being. Dopamine rewires the brain to become accustomed to those benign feelings. When an addicted person stops taking the drug, the body craves the dopamine again...
...them when taken under appropriate supervision [DRUGS, Jan. 8]. Because of OxyContin's time-release formulation, patients with pain who take the drug do not experience the heroin-like euphoria you mentioned. Wrong perceptions about addiction--and mislabeling legitimate patients as abusers--can result in the unnecessary withholding of opioid medications from patients in need. You stated that Purdue Pharma is facing pressure from prosecutors to minimize forged prescriptions. In fact, the company took the initiative six months ago to meet with officials to assist efforts to stop illegal drug trafficking. You also suggested that several deaths in Maine were...