-- dtouch wrote:> People in chronic pain please be aware as many of you have found out > that out right to pain relief is being slowly taken away. We must ask > our lawmakers and other representatives to insist that a person has a > right to pain relief and that our doctors won't be afraid to give us > pain relief medication so that we can function to our full potential > free of pain and increase our quality of life. As someone who knows, > when my pain is at its peak, I feel so tired I can hardly go and if I > get pain relief, I become a different person with energy I didn't know > I had. Please do everything you can to stop these attacks on our > doctors who are caring and can seperate the junkie from the chronic > pain persons. > Thanks, Dolores in Louisiana dtouch@bellsouth.net > > "Frank B. Fisher, M.D." wrote: > >> Dolores, >> >> Just keep talking to people about the problem with pain management >> and law enforcement. When a critical mass of people become aware of >> it, it will change. Winning my case will have a large impact >> because it will reveal that law enforcement actually impedes pain >> management. Hardly anyone believes this yet. >> >> I have pasted on some basic information you might already know. It >> might be useful to circulate it. >> >> Frank >> >> Opioids >> Patient and Family Information >> >> Opioid analgesic pain medications are recognized by the Medical >> Board of California as the cornerstone of treatment for chronic >> pain. Their use is limited mainly by widely held beliefs about >> their dangers, most of which are false. What follows is basic >> information about these substances and their role in the treatment >> of chronic pain. This information is directed to patients and the >> people who associate with them. >> >> Addiction >> This is the bogeymman. It is generally feared that exposure to >> opioids will invariably lead to addiction and this would be so >> terrible that many terminal cancer patients refuse morphine and die >> in agony as a result. Large studies have repeatedly revealed that >> this is simply not the case, and that addiction to opioids in pain >> patients is actually rare. Addiction is defined as the combination >> of cravings for a substance combined with self destructive behaviors >> leading to harm, with continuing use in spite of the harm. >> >> Dependence - This term means the fact that if a patient has used >> opioids they are likely to have a flu-like withdrawal reaction if >> they stop the medication abruptly. This can prevented by gradually >> tapering the dose of the medication. Dependence does not signify >> addiction as it occurs in almost everyone who takes opioids. >> >> Respiratory Depression/Tolerance - When an individual unaccustomed >> to taking opioids takes too large a dose it can slow or even stop >> breathing. When a patient has had their dose of opioids gradually >> raised, they can and do take dosages that would kill an individual >> not accustomed to these doses. This is called respiratory >> tolerance. Pain also promotes respiration, making it doubly hard >> for opioids to harm a pain patient. >> >> Tolerance also quickly develops to the "high" caused by opioids. >> Within as couple of days to weeks the patient returns to feeling >> completely normal, although they may be taking enormous doses of >> medication. >> >> Titration - This term describe the process of gradually raising the >> dose of opioids until the patient reaches their best level of >> functioning. Fortunately, once this is established it is seldom >> necessary to keep raising the dose as not much tolerance to the pain >> relieving properties of opioids occurs. Most patients will require >> a variation is their dosage from day to day depending on their pain >> levels and activities. The range of possible doses needed to >> control pain varies from one patient to another more than with any >> other drug in the entire field of Medicine, which means that some >> patients will receive dose of a size that is staggering to the >> uninformed observer. >> >> Alcohol/Tranquilizers - It is dangerous to drink alcohol or overdose >> on tranquilizers such as Valium or Xanax while taking opioids >> because these substances reduce respiratory tolerance. The majority >> of deaths attributed to opioids actually occur in combination with >> these other central nervous system depressants. >> >> Security/Diversion- Opioids present a public health risk when they >> are diverted into the hands of non-patients who intend to abuse >> them. These individuals are often not protected by either tolerance >> of pain against the respiratory depressant effects of opioids and >> are likely to combine them with the depressants mentioned above. >> The results can be tragic. For these reasons the bulk of a >> patient's supply of opioids must be kept locked in a safe and never >> given, sold, or traded to anyone else. >> >> Toxicity/Side Effects - Opioids are not toxic to any organ system in >> the body. They do not do any damage even with long term use. While >> an array of different side effects is possible in a patient taking >> any given medication, the only side effect commonly observed is >> constipation, which is easily anticipated and treated. >> >> Pain Relief/Functioning - Opioids reliably reduce pain levels in >> chronic pain patients, however they seldom make the pain go >> completely away as they do in patients with acute pain who do not >> have a tolerance. Patients can live with this residual pain as long >> as their dose is titrated to a level where they can function. The >> way this works is that at higher levels opioids act as >> antidepressants in chronic pain patients, and although they can >> still feel the pain if they think about it, the depression cause by >> the pain is alleviated allowing them to carry on with the activities >> most of the rest of us take for granted. This is the major benefit >> of opioids in chronic pain. They allow the patient to function is >> spite of the pain. >> >