Posted by shelliR on March 15, 2002, at 22:20:54
My father sent me the article an article on pain from a publication of an MS association (The Motivator). It's called "Pain Unnecessary With or Without MS.
These quotes are all from Dr. Ann Berger, chief of pain and palliative care services at the Clinc Center at NIH.
Given all our debates on opiates for depression, and what is addiction, I think Dr. Berger is quite clear about the difference. I was also really impressed that she addresses the issue of physical dependence, as being less harmful than pain. It really made me look at things in a different light. I am taking a partial opiate for my pain --depression that presses in my chest and makes me feel suicidal. Although I had already made the choice to stay on a partial opiate, until or if, something else works for my depression, I realize now that I have been putting way too much energy into whether I might need to go up in dose.
"Addiction implies improper, illegal, and non-medical use of a substance. The addict loses control over their use which becomes compulsive and harmful. The continue to take a drug in spite of the harm. They are not patients. They seek the drug for the sensation it gives them."That cannot be compared to taking a legitimate treatment, opioid or otherwise, under the control and administration of a physician. Taking codeine or morphine to relieve pain as part of a therapeutic regimen is no different from taking insulin to control diabetes.
"The use is managed. A specific dose in prescribed for a specific time. It can be increased or decreased according to need. It can be adapted to balance side effects.
"Physical dependence is misunderstood. Thre is nothing bad about it unless the managing substance, opioid or otherwise, is abruptly removed from the paitent which would precipitate a withdrawal symptom. This is a circumstance no practitioner would willingly allow. This can be avoided by tapering medications slowly before discontinuing them. Other than that, physical dependence is a safe, regulated byproduct of relief.
"No one has to live with pain. That’s the important message I want of impart. It’s one I think should have advocates all over the country. Physical dependence is minor compared to a lifetime of pain and the problems it can cause."
"Patients should be encouraged to ask questions about pain. Doctors can be pressured, even if they're not pleased to answer. With a team approach, the primary care physician, can refer a patient to a pain management specialist.
The article refers to two web sites that I found useful:www.ampainsoc.org
www.aapainmanage.orgShelli
poster:shelliR
thread:98244
URL: http://www.dr-bob.org/babble/20020313/msgs/98244.html