Pain Management and Medication

Specialties Pain

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Hey All,

Last night in my Communication class in college I was talking with my one of my classmates who was explaining to me about her chronic pain from a car wreck she had. She told me that a good pain medication will not make a hurting person loopy or high but merely help control the pain. But If the same medication is given to a non-hurting person it will make them loopy or high. She also told me it is a function of the loopy and high feeling from the drugs that leads to addiction.

She went on to say that in some cases to control her pain she has been prescribed to take doses for up to a 300 pound male, and they care givers (this was when she in the hospital after her wreck) were asking why she was not asleep or knocked out.

The extent of my pain med knowledge is how lortab 7.5 affects me. But I did not pain extremely attention to detail while I was on it. However I did notice that it did not knock me when I did have pain. But when I took one after pain was gone I did experience the loopy-ness and high that people have talked about.

I hope some of you all can shed some light on this. I really would like to understand more about these drugs.

Thanks.

Nick

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What she is saying is absolutely true.

When someone is on opioid therapy on a long term basis, physical tolerance, which is NOT addiction, will inevitably occur, and the dose will need to be titrated up.

It is very important to separate addiction from tolerance. Addiction is the abnormal craving for a narcotic for purposes that are not therapeutic. Seeking relief from pain is a valid medical reason for taking pain medication. Addiction is a complex issue that needs careful diagnosis.

I've taken care of pts with CA that were on phenomenal doses of opiods...you or I would have stopped breathing. The same holds true for chronic non-malignant pain.

Think of it like diabetes...insulin needs to be titrated based on the blood glucose. Pain needs to be titrated based on the pt self report of pain.

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What is CA? Also, is it true that if a person is in true pain that the pain meds will not give the person the loopy or high feeling?

Thanks.

Nick

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CA is cancer. And ditto everything fab4fan said.

But I'd be more worried about blood pressure meds if I were you Nick :D

Heather

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Check out this comprehensive article from PA Board of Medicine:

Principles of Highly Effective Pain Managers

http://www.dos.state.pa.us/bpoa/LIB/bpoa/20/10/medbd-newsletter.pdf

Harvard's Pain Management Service

Pain syndromes exist for which specific therapies are indicated and have been shown to have significant benefit in the literature. One of the major undertakings of our medical director, Dr. Edgar Ross, was to create extensive treatment algorithms for basically all painful conditions as listed by the International Association for the Study of Pain (IASP) diagnosis coding system. The purpose and long term goal of these algorithms is to hopefully standardize pain treatments, and enable outcomes to be tracked by diagnosis. Some of the more common specific pain syndromes seen in our pain management center are discussed below, as well as their treatments

http://www.hmcnet.harvard.edu/brighampain/therapy/

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I have had chronic myofascial pain since I tore a ligament in my lower back at work in 99. I can tell you that when I am in pain and take Lortab, I don't feel loopy at all. I feel relief. One of the things that you attempt to teach patients with chronic pain is that the medicine will improve quality of life because when a person is in pain, they withdraw and cannot concentrate on anything but the pain.

I had an anaphylactic reaction to Naproxen Sodium about 5 years ago. Had to be rushed to the ER and was flat out terrified. About 3 months later, I took a Motrin for discomfort and started having an "inflammatory" reaction, which I immediately went to the ER for. Was told that the entire drug class of NSAIDs was off limits, as well as ASA.

Now, I am very careful of what goes into my mouth, because ASA is in a lot of stuff as just another ingredient. I have also educated myself thoroughly on pain relief.

I tell my patients that the pain medication is a Sword, not a Crutch, and to use it to fight and hopefully defeat the pain.

Hope this answers your question.

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I tell my patients that the pain medication is a Sword, not a Crutch, and to use it to fight and hopefully defeat the pain.

AMEN!!!!!!!

And FAB, Totally correct! If that could be a perscription for proper knowledge and use of pain medication... I'd sure ask heck be writing it!

Dave

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