Posts Tagged Pain Management
Understanding your bodies response to opioid medication
Posted by Dr. Epstein in News/Press Releases, Opioid Dependence, Pain Management on June 3rd, 2009
A correct defining of terms is essential to understanding the use of opioid type medications. Prolonged or chronic use of opioid medication will cause one of four types of responses by your body. These 4 responses are dependence; tolerance; addiction or pseudo addiction.
Dependence is a physiological response of the body to medication. This means the physiology of the body gets used to seeing this particular, whatever it maybe, drug in the blood stream and adjusts to it. Therefore, the sudden cessation of the medication will cause the beginning of a withdrawal syndrome as the levels of the drug decrease.
Tolerance is similar to dependence in that both are physiologic body responses. Tolerance just means that the body once again gets used to, and adjusts to, a certain consistent blood level of a medication in the bloodstream. Since this level of medication is consistent the body adjusts to it and then more medication is needed to achieve the same effect as a smaller dose once did. This not only happens with opioid medication but can happen with insulin or blood pressure medication.
Addiction is a drug craving and its continued use even though the person realizes the continuing use of the drug may, or many times, has already hurt them. The drug controls their life and they will do anything to obtain it no matter the consequences. This is a biological physiological and genetic response to the drug. The important thing to remember is that a drug maybe addicting yet may cause dependence. Remember dependence will cause a withdrawal syndrome as it is suddenly removed. Well cocaine is one of the most addictive drugs available, yet it does not cause dependence. I find that very interesting.
The last thing that may happen is called pseudo-addiction? The person will demonstrate all the characteristics of an addict, control; craving; consequences; and continued use in spite of harm, but is not addicted to the medication. What happens here is that the patient starts on a dose of medication that is too low or tolerance develops quickly and the pain is not adequately controlled. So in an attempt to control his or her pain the patient displays addictive behavior. The interesting and satisfying aspect of pseudo addiction is that once the pain medication level, usually an opioid, is raised to adequate blood levels all the addictive characteristics leave the patient and they maintain productive lives at that point.
Are you fitting into any of these categories? If you feel you maybe, or just have uncontrolled pain or an already developed opioid dependency problem please contact Health and Pain Management of Florida at your earliest time. Remember that “Pain is inevitable; suffering is optional!”
Advances coming for pain management!
Posted by Dr. Epstein in News/Press Releases, Pain Management on April 30th, 2009
Patients in pain have major changes to look forward to over the coming months. There are two major companies that supposedly have new products ready for release.
The makers of Oxycontin, Purdue Pharmaceuticals, told me that two new major developments are right around the corner. I would suppose that one would be a better delivery system of the long acting medication making diversion and abuse more difficult. If that is the case, it would ease the availability for the real patients in need of aid. In my humble estimation, easier since division and abuse would be harder.
The other major new development is a new drug for treating pain. This new drug is generically called tapentadol. It will be a short acting medication taken 3 to 4 times a day or every 6 to 8 hours. It is the first entirely new chemical molecule for the treatment of pain since 1984.
I anticipate all these changes to male pain management more exciting than ever before!
Truthfulness is supreme!
Posted by Dr. Epstein in News/Press Releases, Opioid Dependence, Pain Management on April 15th, 2009
Truthfulness is supreme!
In a pain management medical practice mutual trust must be established between patient and the physician. On occasion patients feel that their answering questions about past behavior honestly will exclude them from a physician’s care. In our practice it works just the opposite.
We at Health and Pain Management of Florida live by two mottos: the first is “pain is inevitable, but suffering is optional”; the second is “today is the first day of the rest of your life”. I need to feel that I can trust the patient with medications that may potentially cause the loss of life. Of course any medication, including aspirin, can cause the loss of life, it is just the prescribed opioid medications that may do that quicker. And the patient must have complete trust in me because I am prescribing potent and potentially lethal forms of medications. So you can understand that this trust and confidence issue is one that runs from patient to physician and the physician to patient.
So please remember whatever the past, whatever the problems, tell your physician. A patient may have something in their past such as misdemeanor; a felony drug charge; a short or long prison confinement; etcetera tell the physician. Those problems may require the physician the monitor you more closely when you start medication but they should not keep the physician from treating your pain. Honesty is always the best policy! That is because when we as physicians find questionable activities in your past, via computer searches or previous medical records, instead of directly from you as our patient, we are less likely to be understanding and more likely to discharge you from our practice since the bond of trust has now been violated.
Thank you and remember “pain is inevitable; suffering is optional!”
Is Pain Medication the Answer?
Posted by Dr. Epstein in Opioid Dependence, Pain Management on March 18th, 2009
Is Pain Medication the Answer?
Daily, people come into our office and say they “do not want to start taking narcotics” out of a fear of addiction. We explain that there is a possibly of addiction, dependency, or tolerance to the medication. That is not our goal and that is why we monitor so closely for such behavior. Pseudo addiction is when a patient displays all the criteria of someone being addicted to opioid medication, but their behavior is not an addiction problem. Their problems exist due their physician under prescribing the medication necessary to control their pain, which in turn makes them portray behavior of an addict seeking pain medication. As soon as the medication is raised to the necessary level to control their pain, the patient’s addiction characteristics disappear. These aberrant behavioral characteristics will not disappear with increased doses in a truly addicted person.
After I explain the different possible conditions and the inherent dangers of the medications, I then explain to the patient that our goal is to achieve the highest quality of life that their condition allows. Yes, a patient in their 20’s, 30’s or 40’s who starts on scheduled medication to control their pain may become dependent, tolerant, addicted or pseudo-addicted. However, if they do not utilize some available service or medication to control their pain they then become dependent, or addicted to their pain.
The question to be answered is;
-Are you better off taking medication to control your pain which improves your quality of life and enables you to live as normal as possible?
Or
-Are you better off not taking medication to ease your pain? Are you able to bear with the pain and enjoy family, friends, work, and recreation? One way or another people who suffer from chronic pain will be dependent on either pain medication or unfortunately pain itself.
At the least, your quality of life may improve and be more enjoyable with pain controlling medication. That is not to say all patients in pain are candidates for pain medication. Call your primary physician and discuss this matter or call our toll free number 866-723-9002 to set up a phone consultation appointment.
Remember: Pain is inevitable, but suffering is optional!