Wednesday, January 25, 2012 at 5:00 AM
Vicodin. Percocet. OxyContin. You might recognize these names: they're all narcotic painkillers. They have a ”chilling effect” on pain signals in the brain. They bring welcome relief for many, minimizing what otherwise could be an excruciating existence. But they are powerful drugs, and can lead to abuse and addiction. This creates a fine line for doctors who treat pain. In our next report in the series Body in Pain, ideastream's Anne Glausser looks at the benefits and risks of prescription painkillers.
SOUND OF PAIN SUPPORT GROUP
SANDY ROZELMAN: Ok, welcome, hi everybody. We have some new people.
I met Deborah Tepley at a chronic pain support group in the Euclid Library.
She’s got severe neck pain--it’s arthritis and a bulging disk--as well as constant headaches.
She’s tried everything to get rid of the pain: surgeries, electric stimulation, relaxation tapes, even belly-dancing for core strength.
But she says without pain meds she’d be in dire straits:
TEPLEY: I am on pain medication. I don’t like it. But otherwise, I would have stepped in front of a bus.
Prescription painkillers are under greater scrutiny these days.
On the one hand, they relive the agony of pain.
When given after surgery, pain pills – analgesics or narcotics – can promote healing. They allow the patient to move around more. Movement can reduce complications and promote recovery. Patients who “tough it out” without medication may take longer to heal.
On the other, abuse of painkillers is a major problem.
The rate of deaths from painkiller overdoses has tripled in the last decade.
The Centers for Disease Control call these overdoses a “public health epidemic.”
SOUND OF CLASSICAL MUSIC COMING FROM TABBAA’s OFFICE COMPUTER
Dr. Kutaiba Tabbaa is the director of pain management at MetroHealth. He starts his day with meditation and classical music.
Tabbaa was an accomplished heart surgeon. But he switched because he says he wanted to be part of a field in its infancy.
TABBAA: We are still in the beginning of discovering pain management.
TABBAA: Many people think pain management is principally the prescription of pills. Let me get the Vicodin, let me get the Percocet, that’s what pain management is. Pain management is a science. It’s an approach for the whole patient.
Tabbaa tries things like nerve blocks and spinal implants for chronic pain sufferers.
One of his favorite therapies is water exercise, things like aerobics or simply walking in pools.
TABBAA: All my patients they become like a fish.
Tabbaa does prescribe painkillers, but only after careful consideration, and almost always in conjunction with other treatments. They can bring relief, he says…
TABBAA: If the patient and the physician use it properly; they understand the risk of it; they understand it’s a sword with two-edges, that it could help you significantly and it could harm you significantly.
Painkillers are addictive drugs. But this doesn’t mean everyone who takes them becomes hooked.
In fact, a recent review of the scientific literature found that less than 3 percent of chronic pain patients taking prescription drugs became addicted.
Tabbaa and other experts say we need to keep painkillers available to those who need them.
But many times the drugs get in the hands of people just interested in the high.
The CDC estimates that 1 in 20 people in the U.S. use prescription painkillers recreationally--that is, non-medically.
Halting this abuse will take some work.
KATHY: Frankly, if you know who to call, and there are plenty of people, then it’s easier than ordering a pizza.
Kathy lives in Southwest Ohio, and her teenage son is addicted to prescription painkillers.
She asked we withhold her last name to protect her son’s privacy.
KATHY: My son is wonderful. He has everything going for him. He is a very attractive boy, he is very smart, he is physically gifted, has always been very athletic. So it shocks us to find ourselves in this situation.
In 8th grade, he took an old bottle of Vicodin from their medicine cabinet.
He was a kid, experimenting. But it led to addiction.
Things came to a head when Kathy and her husband had him take a polygraph test, after a rash of stolen money, bad grades, and erratic behavior.
KATHY: That perhaps was the beginning of him recognizing that this had gone beyond his control.
One way people like Kathy’s son find access to these drugs is by going to so-called “pill mills” which are medical practices that dole out painkillers regardless of a patient’s health history, often for financial gain.
MetroHealth’s Kutaiba Tabbaa says pill mills are giving pain management a bad reputation.
TABBAA: It’s unbelievable. I mean this is drug dealing; it’s not pain management.
Ohio is among several states starting to crack down on these pill mills.
Governor John Kasich signed into law last year a bill that requires doctors to rigorously track and document all aspects of their pain prescriptions.
It also implements a patient tracking system to cut down on “doctor shopping,” a practice where people visit multiple physicians to get new prescriptions.
Legal and appropriate use of painkillers, however, remains vital to the care of people in pain.
Wellness Support Group (for chronic pain): Meets at the Euclid Public Library once a month at noon on Tuesdays. Upcoming meetings for 2012: February 14th, March 13th, April 17th, May 15th, June 19th, July 17th. Contact Sandy Rozelman at 216-481-9633 or firstname.lastname@example.org for more information.
Centers for Disease Control on the problem of painkiller overdoses: http://www.cdc.gov/vitalsigns/PainkillerOverdoses/index.html
Cochrane review of prescription painkillers: http://summaries.cochrane.org/CD006605/opioids-for-long-term-treatment-of-noncancer-pain
Information on Ohio’s “Pill Mill Bill”: http://www.dispatch.com/content/stories/local/2011/06/21/kasich-signs-pill-mill-order.html
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