I still remember the day as if it were just yesterday. I was sitting in my office across from a patient who came in to see me for his intractable pain. I was covering for another physician, so this patient was new to me. He was wearing a heavy winter coat and sat at the edge of his chair. I asked him to sit back and take his coat off. He said he was in a hurry and wanted his prescription. As I wrote the prescription for methadone, a little voice in my head told me that this encounter was not the way medicine should be practiced. I wanted him to prove to me he needed this strong narcotic. Was he following the lifestyle changes I would typically recommend such as yoga and stress management? Had he taken time to even evaluate why he was in pain and the possible meaning behind it? In a flash, with the prescription in his hand, he was gone.
Today, the facts are jaw-dropping: 100 million Americans suffer with chronic pain, costing $600 billion per year with medical treatments and lost productivity at work combined. [1] If you're in that club, you know it costs nothing to join but you'd pay anything to get out. And whether you have back pain or a headache, you know it not only limits your ability to function, but it affects your mind and well-being over time.
We are blessed as a nation to have a thriving pharmaceutical industry that is continually researching new classes of medications for pain, mood disorders, insomnia, and many other chronic conditions. For a new drug to be developed, it requires an investment of time and effort, along with confidence that the drug is needed in our marketplace. Companies must be prepared to spend around $350 million before the medicine is available for sale. [2]
While the cost to manufacture drugs is high, many new drugs are entering the marketplace every year. With the seemingly endless choices of prescription medications at our disposal, chronic pain sufferers may be duly impressed by these offerings, but they want direct help for their pain. If a prescription medication is to be chosen, which medication will get the job done?
Recently, I learned that the No. 1 cause of accidental death in the U.S. now stems from misuse of prescription painkillers. This sent a shiver down my spine. The deaths amount to roughly 15,000 per year. [3] For many, these medications can be lifesavers and are the last resort to treat their pain, but for others, they can be a death sentence.
An occasional episode of pain may create some distress that limits your ability to function optimally. You may be able to handle occasional symptoms as long as they do not impair your functioning. But if this pain starts to occur more frequently, you may decide to seek out medical attention.
If first-line tests determine there is nothing serious to worry about, it's time to get serious about why the pain is happening. At this point, your physician may recommend a medication to soothe the pain. If you've been miserable, you probably can't get to the pharmacy fast enough with your prescription. That certainly was the case with my colleague's patient I saw years ago. But hold on -- there is a code to crack when it comes to treating pain.
3 Key Questions to Ask Yourself Before You Take a Pill
1. Are my pain symptoms severe enough to interfere with my ability to function?
To answer this, ask yourself if you have trouble functioning in your daily activities of work or childcare, for example.
Solution: Seek out a provider who can help you understand why the pain is so severe and consider a safe medication that you are able to tolerate. Short-acting pain medications such as narcotics and anti-inflammatories for pain and headache conditions can lead to rebound and habituation over time. [4] Also, remember that these medications can have a negative effect on your body such as digestive issues, liver detoxification problems, and impaired adrenal function. Further, symptoms such as nausea, constipation, fatigue, depression, and weight gain can occur depending on the medication chosen. [5]
2.Are my symptoms occurring multiple times per week? If so, ask what triggers them.
To answer this, evaluate your lifestyle. Have you been sleeping less, skipping meals, not drinking enough water, or "stressing out"?
Solution: Consider a daily preventive medication or supplement combination to decrease the frequency of your pain symptoms. For certain patients who suffer from chronic migraines, injections can be done (Botox Type A) to lessen the frequency of headaches and allow the system to rest and restore. [6] Combining daily prevention with stress-modifying techniques can be quite powerful long term in the management of pain. Journaling the triggers of your pain can be incredibly beneficial as well, since shifts in diet, sleep habits, or exposure to stress can lead to a profound decrease in pain.
3.What can I alter in my lifestyle to reduce the manifestation of these symptoms?
To answer this, you must sincerely ask yourself what you can try to do to change your lifestyle or diet to improve your health.
Solution: Realize that when symptoms occur, it is your body's way of communicating that it is out of balance. Use the symptoms to guide you. Understanding your authentic self can be quite helpful in your journey to health and healing your pain. Start learning about non-medication approaches so you can create a balanced, pain-free mind and body.
The journey to freedom from pain, both physical and emotional, starts with asking yourself some questions about the severity and frequency of the pain, and then understanding the root of the symptom. With the many medication options available, we need to be sure that having them onboard will not lead down a path of dependence and habituation. The long-term side effects of medications also need to be considered. We want to get rid of the pain, but not at the risk of harming our mind and body.
Each of us wants to live a life where we can be fully present and enjoy the beauty of what life has to offer. Suffering with symptoms such as pain can take us away from that harmonious place. I learned years ago that pain shouldn't just be treated with a paper prescription and fingers crossed. Pill or no pill, you and your doctor can be partners in treating your pain.
Be well everyone...
References:
1.WebMD. 100 Million Americans Have Chronic Pain: New Study Shows That Pain Costs Billions of Dollars a Year in U.S. http://www.webmd.com/pain-management/news/20110629/100-million-americans-have-chronic-pain.
2.Forbes. The Cost of Creating a New Drug Now $5 Billion, Pushing Big Pharma to Change. http://www.forbes.com/sites/matthewherper/2013/08/11/how-the-staggering-cost-of-inventing-new-drugs-is-shaping-the-future-of-medicine/.
Dr. Gokani is the Author of the upcoming "The Mysterious Mind: How to Use Ancient Science and Modern Wisdom to Heal Your Headaches and Reclaim Your Health"
Follow her on twitter: @Headachefix
"Like" her on Facebook: www.facebook.com/headacheandwellness
3.Centers for Disease Control and Prevention. Prescription Painkiller Overdoses in the U.S. http://www.cdc.gov/vitalsigns/painkilleroverdoses/.
4.Dan Hedrick, MD. Opiate Induced Pain. www.danheadrickmd.com/opiates/opiate-induced-pain/.
5.Rebound Behavioral Health. Causes, Signs & Effects Opiate Abuse. http://www.reboundbehavioralhealth.com/addiction/opiates/symptoms-signs-effects.
6.Allergan. www.botoxchronicmigraine.com.
Dr. Gokani is the author of "The Mysterious Mind: How To Use Ancient Wisdom and Modern Science to Heal Your Headaches and Reclaim Your Health"
Follow her on twitter: @Headachefix
"Like" her on Facebook: www.facebook.com/headacheandwellness
Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.