Pain exists for a reason. When it is a physical pain, it tells us when something is wrong and can even help doctors narrow in on what is wrong. Over the past half century, how doctors help patients cope with pain has changed. This is due in part to a variety of pharmaceutical advancements and the idea that pain for an extended period is detrimental to your overall health. However, the downside of these advancements is that
there is a prescription opioid epidemic in the United States.
This epidemic is not only due to doctors’ desire to treat pain and reduce your chances of developing PTSD from the pain. The other factors are an undereducated patient population and the failing medical system in the United States which may have you waiting a long time to see specialists and receive necessary treatment to determine the cause of the pain. For these reasons, consider taking the following steps to protect yourself from becoming part of the statistics of the opioid epidemic.
1. Become Your Own Advocate
The quality of health care you receive is only as good as the information you provide. Creating a cheat sheet of all the vitamins and over the counter and prescription drugs you are taking is the first step you should take to protect yourself. This can then easily be given to medical personnel in the event of an emergency, or you can reference it quickly to make sure you fully inform medical staff of everything you are taking. Other things you may want to list on such a cheat sheet include known allergies as well as any medical conditions and prior surgeries as these are factors that should be taken into account when deciding which painkiller is right for you.
In addition to this cheat sheet, you should consider requesting copies of your medical files depending on the duration of your treatment as well as the number of doctors you visit. Although physicians’ offices can easily obtain records from each other, there is value to having everything already in one place – especially if you find yourself switching primary care doctors at some point during treatment. With the advent of digital records, you can aid your health care providers by bringing your own digital copies of important exams such as x-rays, MRIs, and CT scans to your appointments. While doctors can easily request the interpretations of these tests, nothing is better than actually seeing the images.
2. Get to know Your Primary Care Physician
If you don’t already have a primary care doctor, you should get one. You should also not be hesitant to see your primary care doctor more than once a year. Depending on the severity of an emergency room or urgent care visit, you should follow up with your primary care doctor. A primary care doctor is meant to be your advocate in the medical community. When you discuss your most recent emergency room and urgent care visits with your primary care doctor make sure you cover what tests were run, the results of the tests, and what drugs they prescribed. Your primary care doctor can then become your second opinion. Moreover, since they should theoretically know you better than a physician who has seen you once – they may have a better course of treatment and a better idea on how to treat the pain long term.
3. Educate Yourself
The only way you can become a health care advocate for yourself is to educate yourself. Mistakes happen, and the drugs physicians and their assistants prescribe are no exceptions. The only protection you have is to know what is best for yourself. The first step to this is to understand the four divisions of pain killers available, their differences, their adverse reactions and when they should not be taken.
Common paracetamol include: acetaminophen (Tylenol).
This class of drugs is typically found in cold medications due to their excellent ability to reduce fevers and pain without the complications of thinning the blood. This class of pain killers only has mild anti-inflammatory benefits, which is why they are not as potent as other classes of pain killers. Although paracetamols can contribute to liver damage, they are viewed as safer pain killer on the market.
NSAIDS (non-steroidal anti-inflammatory drugs)
Common NSAIDS include aspirin, celecoxib (Celebrex), etodolac, ibuprofen (Advil, Motrin), ketorolac, naproxen (Aleve), piroxicam, sulindac, and much more.
NSAIDS work by blocking cyclo-oxygenase (COX) enzymes, which then inhibit production of prostaglandins and thromboxanes which cause inflammation. There are two classes of COX enzymes inhibitors, so depending on which enzyme is causing the inflammation, certain NSAIDS may work better under certain conditions. The most common side effects of long-term NSAID use include gastrointestinal and kidney issues. If you have any digestive issues, heart issues, recent surgeries, or may be pregnant – you should discuss these circumstances with your pharmacist or doctor before using NSAIDS.
Common corticosteroids include cortisone, dexamethasone, hydrocortisone, hydrocortisone, methylprednisolone, prednisolone, and prednisone.
Steroids are hormones which can be used to treat pain, especially when the pain is caused by inflammation and abnormal reactions from the immune system. Unlike some other painkillers, they do not block the pain receptors. Steroids have an extensive list of possible side effects, which increased when they are used for an extended period of time. Some of the more serious side effects with long-term use can include decreased bone density, gastrointestinal bleeding, and increased risk of infection and heart disease. For these reasons, you should consider discussing optimal diet and exercise lifestyle choices and calcium and vitamin D supplements with your doctor if you need to use steroids long term.
Common opioids include codeine, fentanyl, hydrocodone, hydrocodone/acetaminophen
(Vicodin), morphine, hydromorphone (Dilaudid), meperidine (Demerol) methadone, oxycodone, oxycodone/acetaminophen (Percocet), and more.
The side effects of opioids are typically not as severe as the organ toxicity that can happen with NSAIDS, however, gastrointestinal issues such as constipation to more serious depressed respiratory rates can occur. The biggest problem with long-term opioid use is the body’s ability to build up a tolerance to the drug, which can then lead to dose increases, dependence, and possibly even addiction.
Many states have already passed laws or are in the process of passing legislation that makes obtaining naloxone HCl (Narcan) easier for individuals at risk for opioid overdoses. The drug can be easily administered via a nasal spray or auto-intramuscular injection to reverse an opioid overdose. While the drug does not have serious side effects, use of it can complicate pain management after it is administered and thus should only be used in a life or death scenario. If you or a loved one uses opioids, you may want to consider talking to your doctor about obtaining Narcan.
4. Don’t Be Afraid to Speak Up & Ask Questions
Do you have a horrible side effect to a drug your doctor prescribed? You will want to say something. If you have acquired the knowledge to know that you should not be on a painkiller that is also a blood thinner – Say something. Similarly, if you have any questions or concerns about a new drug, do not be afraid to ask questions. Also, don’t be scared to ask for clarification if you do not fully understand the answer that was given to you. Good doctors will listen to your concerns and make sure you are educated about your health.
* This article is only meant to be informative in nature. In no way should this be viewed as a substitute for medical advice from a licensed practitioner. The author and XoFaith.com, encourage you to discuss your pain treatment with qualified physicians to decide the best course of action for your particular situation.