Pain touches all of us at one time or other, yet the medical community is just beginning to understand and address the many forms of pain. Acute pain has a beginning and end and is the result of injury or illness. Chronic pain lasts beyond the usual recovery period for an injury or illness. It can be continuous or it may come and go. Chronic pain can be very stressful physically and emotionally. It is the leading cause of adult disability. It is estimated that nearly 50 million Americans suffer some form of chronic pain. Lower back problems, arthritis, cancer, repetitive stress injuries, shingles, headaches, diabetic neuropathy, neuralgia, and fibromyalgia are common causes of chronic pain. Many issues need to be addressed to improve the effectiveness of chronic pain treatment while managing the risks of adverse effects.

One of the most important issues is that, in most cases, chronic pain is not curable. The goal of treatment is to make the pain manageable. The reasons for chronic pain are complicated but have to do with neurochemical changes in the nervous system that cause persistent pain long after the initial injury to tissue has occurred, such as in cases of postherpetic neuralgia after a severe case of shingles. Chronic pain management must be an ongoing process and should be directed toward managing the pain and reducing its intrusion into daily life.

Another issue is that chronic pain has complicated underlying causes and mechanisms. Treatment must be selected according to the pain's origin. Pain of the muscular or skeletal systems often responds to anti-inflammatory agents such as non-steroidal anti-inflammatory or steroid medications. These medications must be monitored for side effects of the GI, kidney, and liver systems. Pain of the nervous system often responds to anticonvulsants, topical anesthetics, and antidepressants. Oral medications in these classes have to be monitored for side effects and drug interactions with other medications. Abdominal pain is most responsive to opioid narcotics and, sometimes, hormonal or antidepressant therapies.

Opioid narcotics may provide relief for many patients suffering from chronic pain. These potent medications must be managed carefully. To be used responsibly, it is important to understand the distinctions between physical dependence, tolerance, and addiction. Physical dependence results in a reaction when the drug is abruptly withdrawn. This also occurs with other drugs. Physical dependence is an expected result of patients taking opioids for any length of time and is not a problem if a tapering schedule is used when discontinuing the drug. Tolerance is an adaptation of the body to the drug that requires a change in dose or a change in the medication itself. Tolerance occurs when receptors of the body systems become less sensitive to drug effects.

Addiction is a chronic disease characterized by craving and habitual use of a substance despite harm to self. It is estimated that addiction rates in the US are 10-15% for various chemicals. The statistical risk of opioid abuse by a person suffering from chronic pain is unknown but estimated at 3-19% of patients. Warning signs of addiction include seeking prescriptions from multiple prescribers; prescriptions for multiple habituating substances; forging or altering prescriptions; or selling, stealing or using other persons' medications. When prescribed and monitored properly, opioid drugs are valuable tools in the treatment of chronic pain.

THIS WEEK'S FEATURED PRODUCT IS AIRBORNE, TAKEN TO PREVENT GETTING COLDS. THIS PRODUCT HAS BEEN IN GREAT DEMAND, PLENTY IN STOCK AT TAOS PHARMACY TODAY!

[Return to Archive Index]

[PageTop]