Pain management, pain pills, buyer beware says New York Times reporter Barry Meier A while ago, in a casual conversation with a primary care physician I am friendly with, she stated she did not trust pain management doctors since in her experience, they turned people in pain into junkies. In her experience, she has had numerous people as patient she had to send to rehab. Most people visit pain management doctors out of desperation, hoping to get relief and find a way to live with their pain. It has been my personal experience as a doctor who deals with people in pain that often, the painful problems people experience are due to a misunderstanding of why they are in pain, rather than where they are in pain. The other day, a new patient who was seen had reflex sympathetic dystrophy in her arm, and nobody has been able to tell her why. She visited us out of desperation after spending a year with injections, procedures, and drugs including fentanyl who did nothing to reduce the pain. She was now losing power in her last two fingers on that arm. Our evaluation indicated problems in her gait and lower back, with the arm being secondary. After about 10 minutes of work to her core and her right shoulder and forearm, her grip strength returned to mostly normal, as her neck also found relief. She wrongly believed her years of neck and shoulder discomfort was due to a stressful job, when it was her lower back that she never noticed until I worked on it was the reason. Was this also the reason she developed RSD? We will soon find out but the reason I bring this up is because she has been exposed to many narcotic drugs that are addictive and the more you take, the less they seem to work. This author does a great synopsis of the reasons you, as a consumer should be wary of pain management and the narcotics they offer. Apparently, there is a growing army of primary doctors who agree this is a bad approach which creates long term disabilities and a high cost to society, while not resolving the pain. Read more The Problem With Pain Pills By TARA PARKER-POPE In the new e-book “A World of Hurt: Fixing Pain Medicine’s Biggest Mistake,” the New York Times reporter Barry Meier explores the murky world of prescription pain medicine. He makes a strong case that opioid drugs used to treat chronic pain, like OxyContin, not only are addictive and deadly but often don’t work for many people who use them and lead to a range of additional health problems. It’s Mr. Meier’s second foray into the complicated world of pain relief. His first book, “Pain Killer: A ‘Wonder’ Drug’s Trail of Addiction and Death,” focused on the potential for abuse of OxyContin, particularly by teenagers. In the new, shorter e-book, Mr. Meier focuses on the long-term consequences of widespread use of opioid drugs to treat pain. I recently spoke with Mr. Meier about the problems associated with painkillers, why doctors and patients resist giving them up and some of the surprising side effects of these drugs. Here’s our conversation. Q. Why did you decide to revisit the topic of opioid painkillers? A. I wrote a book 10 years ago about the rise of OxyContin and the pain management industry. That book was focused on abuse. The prevailing medical notion was that there was this bright line involving the opioids — that they were great for patients but the problems happened when they went out on the streets and were abused by kids and others. But today it’s clear that the long-term use of these drugs can not only be ineffective for chronic pain, but they also create bad side effects for patients. Not just addiction but powerful psychological dependency, depression of hormone production, lethargy and listlessness and sleep apnea, among others. These drugs do work well for some patients, but for many other patients, they’re not working well at all. Q. What made you realize that more needed to be written about the consequences of these drugs? A. There were two powerful factors. The number of annual overdose deaths from narcotic painkillers has grown four times higher than it was a decade ago. The current statistic is that about 16,000 people a year die of overdoses involving prescription narcotics. The thing that was even more powerful for me was the growing realization that there are risks of these drugs for patients themselves, not just for people who are out-and-out abusing these drugs. People taking these drugs as directed have far more significant negative consequences than have been previously appreciated. It became of question of, “How are we treating chronic pain over the long term and are these drugs really the answer?” read more