Why Chronic Pain Patients Feel Targeted By Opioid Crackdowns

pain pill overdoseAs opioid overdoses continue to rise in the US, the government, lawmakers and medical personnel are all trying to figure out the best way to reduce these unnecessary deaths. Obviously restricting access to opioids would reduce the number of people who can get their hands on them, and in turn reduce overdose deaths, but it would also unfairly target people who need the pills. People like those suffering from chronic pain. So it’s understandable to see why when lawmakers propose strict rules for who can access these medications that chronic pain sufferers feel like they are being targeted and singled out.

It’s a tough balance to strike, and unfortunately it seems that as a nation we are more focused on what is easy and cheap instead of what will really address the root problem. Putting a band-aid over a large gash might stop some bleeding, but the wound won’t close correctly without stitches. Simply restricting access opioids and painkillers might stop some abusers from getting the pills, but it won’t solve the whole problem. We need to put some stitches in place.

Solving The Opioid Crisis

We’re not going to sit here and pretend we have all the answers for solving the problem of opioid addiction and overdose, but like we said above, simply restricting access is not going to solve the problem, and many innocent people who rely on those medications may no longer be able to access them. Instead, here are some steps that will help address the root problem.

1. Doctor Education – The vast majority of doctors understand that opioids do not address the root problem, but sometimes they are confused by a diagnosis or have seen other treatments fail and they fall back on them. Other doctors cut corners and prescribe pills freely and dangerously. We need to provide better understanding at the top level of how these drugs should be used, how to spot signs of abuse and how to ensure patients are safely taking their medications so that overdoses don’t occur.

2. Systemic Pressure – This problem will be harder to solve, but in many cases doctors are told to see as many patients as possible. If a doctor is feeling overwhelmed or rushed to see a number of patients, they can sometimes fall back on easy solutions like opioids. Doctors need to take their time with each and every patient and ensure they are giving them the best care possible. It’s possible the best care will involve opioids, but it should also involve therapy, exercise and regular abuse checks.

3. Patient Education – Patients also lack understanding of opioids and their abuse potential. Opioids are not a magic pill that will cure your pain, but they can provide temporary relief so other rehab techniques like exercise, swimming or physical therapy are more bearable. Opioids are a passive treatment, and they need to be paired with an active treatment option for best results. Patients also need to learn the warning signs of abuse for themselves and for loved ones who may have access to their pills.

4. Pill Technology – Medical researchers are looking into new abuse-deterrent opioids. They are creating pills that can’t be crushed or that become gooey if a user tries to extract the solution for injection. Other pills come in an extended release form and can’t be manipulated to give an elevated or intense high. More research into abuse deterrent options could prove useful.

Simply saying we need to restrict access to opioids will not solve the problem, and many chronic pain sufferers will be affected instead of those who are actually abusing the pills. That’s why so many patients feel targeted by these proposals. It won’t be easy to reverse this trend, but if we put in the time and money, it can be done.

Do Daith Piercings Work? Let’s Hear What Patients Have To Say

Daith Piercing MinnesotaThe daith piercing is without a doubt the most talked about subject on my site, which is ironic because I do not perform the procedure myself. My goal as a pain management specialist is to analyze a person’s pain and come up with a variety of solutions to help manage and treat that pain.

I referenced how some people have experienced headache relief by having their daith pierced and, although I’ve mentioned that there is no hard science behind the piercing, I’ve explained how some of the pain pathways may be affected by stimulation.

We’ve been referenced, praised and lambasted on other sites for talking up the piercing, but people continue to ask us questions about the daith piercing. So instead of giving some general answers about why it may or may not work, we though we’d let people who have already undergone the piercing speak about their experience. We’ve collected a bunch of comments from people who have shared their story on our site, and we want to put them in one easy to read place. So below, you can read what people who have undergone the piercing are saying about their experience. We hope you find it enlightening.

People Who Have Had The Daith Piercing

Here is a sample of some of the most recent comments we’ve received about the daith piercing.

I had a daith piercing done (left side) on 9/30/2016. I have not had a migraine since getting this done. I used to have one every day, with several trips to the ER a month. I had tried every medication possible they could prescribe me for them and the only thing that ever really worked for me was going to the ER and doing the IV cocktail thing, which unfortunately there is no script that can be given that works like it. When I got my piercing done I was experiencing a migraine almost to the point of debilitation, the second he preformed the piercing the pressure was relieved, similar effect to pushing the pin in the stem of a tire to let the air out and my vision was no where near as blurry. the next day it was gone with no meds at all. I do still get small headaches but OTC meds knock them right out. My only caution for it is please strictly follow the after care instructions and do your research on the shops that are doing them. Be 100% comfortable with the person doing it for you. Many shops say “oh yes I can do that for you, I have done tons of them” but just because they have done them does not mean they have done them correctly. – D.A.

I just recently had this piercing. I had researched this for several months before deciding and talked to several people that had it done and have had great success. It was really not as painful as everyone makes it sound and took less than 60 seconds. I am very hopeful about this helping with my migraines. – C.S.

I’ve had headaches all day everyday for a long time, so I heard about this piercing and I went and got it done right away, went in with a headache and left pain free, literally! It’s been 3 days now still no pain or headache The piercing site bled a little because I slept on it. Cleaned it up and it’s healing, so very thankful I had it done, I love being pain free. – S. W.

I’ve had headaches for over 20 yrs. Its hurt pretty much every day for years now. Most days its a dull ache but other days they can become quite unbearable. Meds don’t help. I just got my daith piercing today. Before doing it I spent a few weeks massaging the general area so I know that pressure seemed to help, but only while pressure was being applied. I can say this much, I had a pretty bad headache before getting it done, my headache went away, but my ear is quite sore right now. It was quite painful for me, but everyone is different. – R.T.

I had the piercing in both ears it’s been a week now. I’ve not had the headaches but the pain I’m experiencing in my jaw is really bad what did you suggest that I do for the pain. I’m think of taking them out. – B. P.

I suffered chronic migraines and was in my 11th headache day when going in to get this piercing. Immediately upon the needle going through there was a HUGE release. I was getting migraines regularly during my menstral cycle my last cycle passed with NO migraine for the FIRST time in YEARS! I have only had one migraine since the piercing and it could hardly be called a migraine compared to what I was used to. I get them if I eat eggs or chocolate on an empty stomach.. if I skip meals or stay up too late. The last migraine I had was triggered by eggs and the pain was 50% less to 70% less than what i was used to and it only lasted a day and a half compared to the usual 3 days. This piercing helps tremendously and perhaps the acupuncture community could learn something. Also acupuncture does not pierce all the way through the skin.. there are a bundle of nerves penetrated that are deeper into the skin than acupuncture goes. Acupuncture may help some for me it stimulated my headaches and made them worse. The Daith was so helpful and so healing. There are SO many people being helped by this and Thank GOD for whoever noticed the correlation. Hope this helped! Bless! – K.E.

So as you can see, the piercing has worked for some, and not for others. There’s no guarantee that it will work for you, but for individuals who have failed to experience relief from other treatments, it may be an option worth exploring.

The Benefits and Drawbacks Of Medical Marijuana

Minnesota Medical Marijuana BenefitsRecently, the National Academies of Sciences, Engineering, and Medicine did a comprehensive review of the information available on the use of marijuana. The study looked at research published since 1999, and they came up with a number of conclusions. One of the most important findings is the current lack of good scientific information on marijuana. There is a clear need for good scientific research to guide healthcare professionals on the risks and benefits associated with marijuana use. Currently, to study marijuana or any of its derivatives, the federal bureaucratic hoops one must go through makes it extremely difficult to perform. The information available and the quality of the research at this point are limited. The conclusions are based mostly upon case report studies with limited controls.

The Complexity of THC and Marijuana

In Minnesota, medical marijuana is available to treat several specific conditions, and this year chronic pain was added to the list of approved conditions. The recent study also supports the idea that marijuana may be helpful to treat some people with chronic pain. For some it seems the non-THC (THC is the component that is responsible for the “high”) may help for pain. Since there are multiple causes of pain, it definitely is not indicated for everyone. Further, no studies have been done to determine what types of pain may be helped by components of marijuana, and it is not clear which of the 80 or more different compounds in marijuana are helpful. It is also known to be helpful for nausea from chemotherapy, and spasticity in multiple sclerosis. Marijuana may help in appetite with HIV, and there is limited evidence for help with bowel disorders, epilepsy, and Parkinson’s disease.

Potential Drawbacks

There are multiple potential harms that may be caused by marijuana. There is strong evidence that its use can lead to schizophrenia and psychosis, especially among young and frequent users. It may also lead to depressive disorders. The claim that it can make you a better driver is simply false, as statistics have shown that it leads to inattentive driving, a main contributor to traffic accidents. In pregnancy, use can lead to low birth weight in infants. Smoking pot can also cause and worsen any respiratory condition. There is weak evidence that smoking marijuana can increase the risk of heart attacks. One can also develop an addiction to marijuana. Conclusions cannot be drawn with regards to school achievement, unemployment, or social function and marijuana use.

Understanding It All

The overall scientific conclusion so far is that marijuana may have some reasonable medical uses. However, the scientific research on the compound is extremely limited at the moment. In the United States, it has been classified as a compound with no medical value and harmful to society. What needs to happen is that national legislation is needed to reclassify marijuana as a controlled substance, then good medical research can be done to determine what compounds in this plant are helpful or harmful. Once good research is done, then the use of compounds can occur with everyone understanding appropriate risks and benefits like with any other drug now available.

Why Doctors Should Be Listening To Their Patients, Not Relying On Scans

doctor listeningThe world is a fast-paced environment. No one has time for anything anymore. In medicine, there is constant pressure to see more patients and do more electronic paperwork, and productivity is a key guidepost to life. However, slowing down and spending a few minutes listening to the world around you and to patients may actually be more rewarding, and solve more problems.

Listening To Your Patients

Being an older physician, technology was just beginning to influence medicine when I began training. CT scans were just starting to become available at the beginning of my training, and MRI scans were not available until I was in practice for a few years. The hallmark of a good physician was their ability to make a diagnosis based on a patient’s history, a physical exam, and some basic testing. The patient encounter was the critical event, as was at getting the story.

Most of the time, if one listens to the complaint of a patient closely, the diagnosis of the problem becomes much more clear. The physical exam is also critical; this is especially important since high technology studies like MRI scans often find problems that are not the cause of a patient’s symptoms. Going old school and using the technology as an assistant and not depending on it often leads to a better treatment plan for a patient.

Treatment and Listening

There are many different styles of physician practice. Being in the field of pain management, one can use multiple approaches to the same problem. One common approach for low back pain is that everyone needs to have every structure in the low back injected with steroid. Another style is that the only treatment that is needed is a course of extreme physical therapy. The approach that seems to be the most effective is take a good history, do an exam of the patient and then decide what is wrong and needed. Most of the time, it will yield a more precise course of action.

Multiple times I have found that an MRI may show multiple significant looking issues, but the history and exam show no correlated problems that would warrant treatment. The body can adapt to multiple things seen on a scan and not have any problems. Treating a scan versus treating a person can be the absolute wrong thing. Furthermore, most problems can be treated in a number of ways, and the choice is often dependent on the approach the patient wants once they understand the options available.

Listening and examining a patient may be considered old fashioned. As a new physician it is often hard to understand the subtle things a patient is trying to convey. Sending a patient for tests and treating the tests is far easier. As an older physician, a lot of the stories become very classic, as is the exam. For example, spinal stenosis in the elderly has a unique story of pain when walking a few feet and being just fine when sitting or lying down. The story tells more in a few words then the MRI and then the treatment is absolutely defined by what the patient desires. Being old fashioned and listening is not glamorous, but it often is a more effective way to get the job done right.

Shared Reading Helpful For Chronic Pain Patients

Shared Reading Chronic PainNew research suggests that shared reading may help ease discomfort and provide cognitive benefits for individuals battling chronic pain.

Shared reading, as the researchers defined, was the act of of gathering with others and reading short stories, poetry or other literature out loud. Researchers said by reading literature that triggers memories of experiences throughout life, like happy childhood memories or relationships, patients can experience benefits similar to or that outweigh the effectiveness of cognitive behavioral therapy for chronic pain.

Shared Reading And Chronic Pain

There are hundreds of different treatment options for chronic pain, because chronic pain is unique to the individual. Some people experience pulsing pain in their lower back, others battle waves and waves of headaches, while others have nerve damage that sends pain signals to the brain when their is no painful stimulus present. What works for one person will not always work for another, and unfortunately that’s the problem that many pain sufferers are running in to. In turn, they are looking into alternative options, one of which is shared reading.

For their study, researchers compared the benefits of shared reading to cognitive behavioral therapy, which is a technique that aims to change the way people think and behave in order to better manage physical and mental issues related to chronic pain. To do this, patients with severe chronic pain were asked to participate in either five weeks of CBT or 22 weeks of shared reading. At the conclusion of the five weeks of CBT, individuals in that group joined the shared reading group for the remainder of the 22 weeks. The shared reading sessions incorporated literature that was designed to prompt memories of family, relationship, work experiences or other happy memories throughout their lifetime. Participants were required to report their pain severity and emotions before and after each session, and they were asked to record their pain and emotions twice a day in a personal journal.

Study Results

At the end of the study, researchers wrote:

  • While CBT helped to manage a person’s emotions, shared reading appeared to help patients address the painful emotions that might be contributing to chronic pain.
  • Pain severity and mood improved for up to two days after shared reading sessions.

“Our study indicated that shared reading could potentially be an alternative to CBT in bringing into conscious awareness areas of emotional pain otherwise passively suffered by chronic pain patients,” researchers wrote. “The encouragement of greater confrontation and tolerance of emotional difficulty that sharing reading provides makes it valuable as a longer-term follow-up or adjunct to CBT’s concentration on short-term management of emotion.”

Researchers want to conduct future studies with larger sample sizes, but it’s an interesting approach to treating chronic pain. We’ll certainly keep tabs on shared reading as a potential treatment option.