We’ve heard it, we’ve thought it, and occasionally we’ve even said it – “Life is a pain.” Some of us even decide to do something about it; so we get some pain pills.
“Life pain” is not exactly what opiate pain pills were designed for, but they do put you out of your misery for a while. Life pain is more often stress, anxiety, depression, exhaustion, disappointment, fear and perhaps a smidgeon of existential funk.
Those are a lot of symptoms to relieve with one pill, but we’ve tried. Valium was the 1970s answer for all of the above and more. In the ‘80s we tried Xanax, the ‘90s it was Prozac, and in the Millennium, it’s Vicodin.
Are we treating disease or just the misconception that life should be a soft drink commercial? Are we (doctors) not responsible for training our patients that there isn’t a pill for virtually everything?
Did the message get garbled and become “there is a pill for everything.” And who is in charge of the Unrealistic Expectations department – doctors, patients or both?
At least Valium, Xanax and Prozac have limited toxicity and addiction potential. Yet that’s not the case for Vicodin and other favorite opiates (narcotics).
Narcotic addiction made the cover of Consumer Reports last month. That’s a little strange because that publication is known for protecting the consumer from the evils of bad toasters or slow laptops. Dangerous narcotic medications have evidently raised the alarm in all quarters.
And there have recently been some very public deaths of some of our most celebrated citizens that involved prescription narcotics. That always helps to shine a bright light on a problem.
Pain is a strange phenomenon. I have had some unfortunate experience with pain, thanks to pushing my physical limits and the two resultant low-back surgeries. Pain is not measurable like blood pressure or BMI. In fact, you can list every characteristic you can think of, and you still won’t have a working model of pain.
Acute pain is easy. Break your arm in three places and it’s going to hurt. Pain will be the center of your universe for a week or so. It will be hard to do anything without some pain control. Narcotic pain pills are good in that instance, and blessedly the pain is short lived.
These same pain medication pills are a lousy candidate for pain that lingers, like the ache in my back from surgery 12 years ago. The wear and tear on our bodies is inevitable because we’re living in them for such a long time.
Most problematic is that you adapt to narcotic pain medication after just a few short weeks – it’s the nature of the beast – and that same dose of medication stops controlling your pain or putting you in a good mood.
An ever increasing dose will be required to chase those elusive targets. In the meantime, you will be dealing with some other narcotic side effects: constipation, lethargy and respiratory depression.
Get the dose high enough, or add some alcohol, or our old friends Valium/Xanax, and you may even stop breathing. Usually this is unplanned, and a paramedic team is not hanging out in the room with you, which dramatically decreases the survivability of respiratory arrest.
Human beings have been struggling with opiates since the poppy plant was discovered. And while narcotics offer the sweet promise of relief from all torments, like Ulysses’ Siren’s call, only darkness and death await.
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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