Understanding Opioids, Addiction and Naloxone

opioids safety drugsChronic pain patients have a multitude of possible treatments available for the management of symptoms. Strategies often include exercise, physical therapy, chiropractic care, massage, injections and medications. One of the more frowned upon treatments is opioids, but sometimes they are used successfully. With the current opioid crisis, many pain patients fear using them and want to be safe if they have them in their possession.

Opioid Safety

The most important rule with regards to use of any medication, especially opioids, is to never take more than what has been prescribed. Opioids can build up in the body and suddenly become deadly if too much is taken. Running out early can cause opioid withdrawal syndrome and while it is uncomfortable, it is not dangerous to your health. If you are taking opioids, expect your doctor to closely monitor your medication and behavior while taking these drugs. Since they are highly addictive and abused, most doctors will tightly control prescriptions and refills. Drug testing, opioid contracts, behavior screenings, depression screenings and monitoring of other medications are standard. Mixing of medications like sedatives, anti-anxiety treatments like benzodiazepines, and using any street drugs often will lead to ending a prescriptions for opioids, and often there is zero tolerance of any safety rules due to the extreme danger inherent with opioid misuse.

Mixing Street Drugs and Opioids

The latest step in opioid safety is the prescribing of naloxone in addition to the opioid. Naloxone is a drug that can block the opioid receptors for most opioid-type drugs, and it can prevent an accidental or purposeful overdose. In Minnesota it can be obtained at most pharmacies even without a prescription, and can be given effectively as either an injection or as an intranasal spray. Anyone who is routinely taking an opioid or has opioid medications in the home should likely have naloxone too, in case they accidentally or purposefully take too much, or someone else takes their medications. If you are on these medications, ask your doctor about having a safety prescription for naloxone.

Using street drugs for an addiction to opioids or for pain is high-risk behavior. The singer Prince was using Percocet obtained from street sources to control his hip joint pain. The Percocet he obtained had allegedly been mixed with fentanyl, which is an extremely potent opioid and caused his overdose death. If you are addicted to opioids, are using them to get high, use heroin, or have family or friends that is misusing opioids, you can obtain naloxone and this may save someone from an overdose death.

Successful Opioid Treatment

Opioids can be helpful in treating pain, but they are extremely difficult to use due their limited safety. More physicians are very reluctant to prescribe these medications and their long-term efficacy and safety is limited. More information has become available on how opioids actually tend to increase pain over time versus being helpful. Pain management specialists will work with patients to find alternative strategies to these dangerous medications.  

One last issue with regards to all medications, especially opioids, is how to dispose of unused or outdated prescriptions. In the past, medications were often flushed down the toilet or thrown out in the trash. The environment does not do well with those methods, and it tends to lead to contamination of our waterways and ground water. Freshwater fish are starting to show significant levels of some commonly disposed medications. The best way to get rid of unwanted medications is to bring them to your local police or sheriff’s department where they have disposal lock boxes. These medications then are handled as hazardous waste and usually incinerated at high temperatures to completely destroy them and turn it to relatively safe ash.

If you’re struggling with an opioid addiction or want a doctor to help get to the bottom of your pain, contact Dr. Cohn today.

The Next Generation of Fitness Trackers

New Fitness TrackersThe next generation of fitness trackers and wearable wellness devices are coming, and with them are several new trends and capabilities. The most common feature is the ability to monitor more items related to your health. The second trend will be sharing your personal statistics with others, especially your health insurance carrier and if you meet various goals, insurance costs may be lowered.

The Future of Fitness

Fitness trackers all have miniature computer chips and circuits inside them. Currently, they can easily monitor steps taken, and relative changes in altitude to measure stairs climbed. Based on secondary data in an external program, they can estimate calories burned and distance traveled. The next level already performed in many trackers includes monitoring heart rate, and providing rough measures of sleep based on body motion. The increased level of monitoring provides a measure of fitness in most people. Some of the units are also including GPS receivers such that distance and time can be more closely estimated.

Future fitness trackers are looking at tracking other aspects of health. Other parameters that are likely to be added are blood oxygen saturation, possibly CO2 levels in the blood, and blood glucose. For runners and high level athletes, lactate levels in the body, and some are looking at measuring electrolytes in the sweat to improve performance. Other possible health monitors that may be incorporated somehow will be more sophisticated heart beat evaluation and brain wave analysis at night to check sleep patterns.

Although these devices are improving, they are not necessarily as accurate as those used in the medical office setting and likely will not be considered medical devices. They will be useful to give a person more immediate information about their overall health status, but they certainly shouldn’t replace regular checkups with your doctor.

Fitness Trackers and Insurance

Some employers and at least one major insurance carrier are now starting programs using fitness trackers to motivate employees to work on healthier lifestyles. One measure of health is the amount of activity a person performs, and this is measured by the number of steps taken during the day and the frequency during the day of increased activity. By meeting certain goals of activity, health insurance costs may be fractionally lowered. The one fact this all hinges upon is those who exercise regularly tend to be in better health and thus have lower health care costs.

Everyone knows the importance of exercise. For those with pain, it is even more important. Pain may limit what they can do for exercise but it is still essential and in most cases improves the quality of health and diminishes pain. Exercise needs to include overall activity for cardiovascular health and increase endorphins, and stretching and strengthening routines. All three components of exercise are necessary, and fitness trackers can help motivate a person to be consistent. The reward will be personal with better health and improved functional activity.

Pain Supplements and Their Processes, Part 2

Pain SupplementsFor part 1 of “Pain Supplements and Their Processes,” click here. Below, we continue exploring some pain supplements, their dosages and their uses.

Turmeric is a plant and the main spice in curry. It is used for arthritis, headaches and fibromyalgia. The chemicals in it are thought to decrease inflammation. Caution is recommended if you are on a blood clotting medication, have diabetes, or have stomach irritability and heartburn problems. The recommended dosage to treat arthritis-related problems is 500 mg twice a day.

Boswellia, or Indian frankincense, is a tree native to India and Arabia. The sap or resin from the bark is extracted into this compound. It is used for osteoarthritis, rheumatoid arthritis, joint pain, tendonitis and bursitis. Boswellia is thought to decrease inflammation, and no significant side affects are known. The usual dose for joint pain is 100 to 250 mg a day.

Lastly, green tea is thought to be helpful for headaches and joint pain. This is tea or an extract made from the Camellia sinensis plant. Benefits are obtained from the polyphenols in the steamed fresh leaves. These compounds are thought to prevent inflammation and swelling, and protect and lessen joint cartilage degeneration. It also contains antioxidants that art protective to the heart. It should be noted that green tea does have small amounts of caffeine that could affect heart disease, blood pressure, diabetes, bleeding disorders and osteoporosis. The recommended dosing is about one to three cups of tea per day.

Taking natural supplements for pain may or may not be helpful. Above is a list of some of the compounds that have been recommended for treatment of painful joint conditions. Most have some sort of properties that affect inflammation, but the studies that prove their effectiveness have been somewhat limited. If you wish to try these remedies, and do not have other medical issues, they are likely to be mostly safe, but consult with your physician prior to starting any supplement regimen.

How to Deal With Pain After a Marathon

The Boston Marathon is underway, and although the winners have already crossed the finish line, thousands of other runners will soon complete their own 26.2 mile trek. Even if you’ve trained for months, running a marathon is sure to leave you feeling aches and pains in the coming days. To combat post-race pain, we’ve come up with a few tips to help prevent and alleviate pain after a long run.

Right After The Race

Although you’ll likely be looking for family and friends after you cross the finish line, there are also some steps you’ll want to take to within a few minutes of finishing. The first thing you’ll want to do is refuel, but it’s easier said than done. Your body isn’t going to be able to handle a big meal, but if you can get your hands on a banana, orange or energy bar, you’ll be able to help prevent post-race cramping. Once you’re back home, consider taking a cold bath to help destress your muscles. After that, you’re due for some much needed R and R, but try to get up and walk around a bit to keep your legs loose.

Marathon tips

The First Few Days After The Race

You’re going to be pretty sore in the first few days after your marathon. To keep your muscles loose, soak in a warm bath for 10-15 minutes every day, and do some light stretching once you’re out of the tub. Feel free to use a muscle roller to massage your muscles as well. As for nutrition, reach for fruits, proteins and a few carbs. The fruit will help boost your immune system, and the carbs and protein will help your muscles mend.

A Week After The Race

Now that you’re a week out, you’re probably itching to get back out there and go for a run. If you’ve followed the above tips, you’re probably feeling pretty good, but you’re not quite fully back. The first thing you’ll want to do a week after the race is to continue eating a healthy diet. Avoid a bunch of junk food and stick to fruits, veggies and a balanced diet. Get a lower body massage, pour yourself a warm bath, and soak for 15-20 minutes. Once that’s complete, do some stretches. If everything feels good, feel free to try a short 3-5 mile run.

Those are some good tips to follow, but if you know something is wrong after a race, swing on in to a doctor. A professional will be able to conduct a full examine and tailor a rehab plan to your exact injury.

Pain Care: The Benefits of Pain Management

Pain Care BenefitsPain is a complex problem with physical and emotional components. It can affect all aspects of a person’s life. When pain is treated early and aggressively, often it can be cured. Sometimes the injury that has caused the pain cannot be completely reversed and the damage needs to be managed on a long-term basis. Medically, we are always looking to find a diagnosis and treatment for every problem. Pain Care is aimed at finding the individualized, comprehensive diagnosis and management plan for a patient’s symptoms and problems.

Pain Care

Pain Care has been developed to take the next step in managing a patient’s symptoms. A new patient will undergo a comprehensive evaluation by a Board Certified specialist in Physical Medicine and Rehabilitation with a subspecialty in Pain Care. These physicians are medical doctors with extensive special training in the musculoskeletal, medical and neurologic systems, which allows them to better diagnose and treat almost any painful condition.  As Physical Medicine doctors, they are the “Family “ physicians coordinating and delivering care to those with pain.

Since pain often is a complex problem, Pain Care is designed to help the patient move forward with management. Every patient is unique with their own set of important problems. If all the answers were obvious, there would be no need for our services. Unfortunately, pain is the most common problem bringing a patient to the doctor’s office. When it does not resolve in short period of time, consulting a specialist is often extremely beneficial. There is not one solution, one medication, one shot, or one specific intervention that is right for every patient. Pain Care is designed to integrate and coordinate our skills into the community to treat these challenging patients with their current care team.

Pain management is not a new medical field, however there are not many providers with the Physical Medicine and Pain specialty skills. Pain is complex and Pain Care is designed to address these issues and bring a solution to the patient and community.