Pain, Chronic Pain, and Opioids

Pain: What is it and how do you treat it?

Chronic pain is recognized by the World Health Organization as a leading medical issue, worldwide.

Pain also has been called a first possible step on the road to opioid addiction. A slip, a broken limb followed by a prescription to oxycontin or other powerful opioid, misuse of that prescription, and the path to heroin or fentanyl abuse can easily start.

Learn about the brain. Click here.

Pain is an unpleasant sensation and emotional experience linked to tissue damage. Its purpose is to allow the body to react and prevent further tissue damage.

We feel pain when a signal is sent through nerve fibers to the brain for interpretation.

The experience of pain is different for everyone, and there are different ways of feeling and describing pain. This can makes it difficult to define and treat.

Pain can be short-term or long-term, it can stay in one place, or it can spread around the body.

Fast facts on pain:

--Pain results from tissue damage.
--It is a part of the body's defense mechanism. --It warns us to take action to prevent further tissue damage.
--People experience and describe pain differently, and this makes it hard to diagnose.

--A range of medications and other treatments can help relieve pain, depending on the cause.

Pain chronic, acute

Pain can be chronic or acute and take a variety of forms and severities.


Pain is felt when special nerves that detect tissue damage send signals to transmit information about the damage along the spinal cord to the brain. These nerves are known as nociceptors.

The brain then decides what to do about the pain.

For example, if you touch a hot surface, a message will travel through a reflex arc in the spinal cord and cause an immediate contraction of the muscles. This contraction will pull your hand away from the hot surface.

This happens so fast that the message doesn't even reach the brain. However, the pain message will continue to the brain. Once there, it will cause an unpleasant sensation of pain to be felt.

How an individual's brain interprets these signals and the efficiency of the communication channel between the nociceptors and the brain dictate how people feel pain.

Source: Medical News Today

By Adam Felman   

Reviewed by Deborah Weatherspoon, PhD, RN, CRNA

Is pain treatment the root of the opioid crisis?

Check any obituary of a young person. It almost always lists heroin overdose as the cause. And going further, these heartbreaking obits describe the path to heroin beginning with treatment for an injury. 

Pain is a brain condition. Learn about your brain HERE!

As the number of U.S. prescriptions for opioids doubled over a 15-year period from 105 million in 1998 to 207 million in 2013, the number of fatal overdoses from the drugs soared almost five-fold, from 4,000 deaths a year in 1999 to nearly 19,000 in 2014. That includes people who illicitly used prescription opioids and those who overdosed on pills prescribed for them.

The problem has been building since the 1990s when a shift occurred in pain management. While traditionally medical professionals avoided opioids for any pain treatment, many doctors began using these medications a quick solution to a patient's pain.

"There was an entire movement and I was being told that we had an unrecognized epidemic of pain in America," Dr. Joseph Zebley told PBS NewsHour. "I think I, like many others, were fooled into at least partially believing that and starting to write prescriptions more liberally."

Amid the growing epidemic, many doctors also don't learn much about pain management while in medical school. A 2011 study found that during four years of training, a typical U.S. medical student spends only nine hours learning about pain.

In turn, some in the medical community, with increasing pressure from regulatory agencies and policymakers, are re-examining their approaches to pain management and how it's taught.

Comprehensive pain management is much more complex than just writing a prescription. The plan can include opioids when necessary. But the comprehensive approach also involves listening to patients, thinking creatively about treatment options, and working with doctors focused on different disciplines.

--Source: PBS NewsHour

Opioid crisis cuts U.S. life expectancy

Opioid crisis trims U.S. life expectancy

The opioid crisis is rippling through the U.S. healthcare system, causing a spike in rates of hepatitis C related to increased opioid injections and reducing overall life expectancy among Americans, which has fallen for the second year in a row, U.S. health officials said.

Addiction is a brain disease. Learn about it in clear language.

Heroin, an illegal opioid that is typically injected, accounted for around 15,500 deaths, and prescription painkillers were involved in about 14,500, the CDC reported.

“These are not simply numbers - these are actual lives,” said Benjamin F. Miller, chief policy officer of Well Being Trust, a non-profit foundation focused on mental health issues. “Seeing the loss of life at this dramatic rate calls for more immediate action.”

President Donald Trump in October declared the opioid crisis a public health emergency, which senior administration officials said would redirect federal resources and loosen regulations to combat abuse of the drugs. However, he stopped short of declaring a national emergency, a move he had promised months before and which would have freed up more federal money.

Overdose rates rose in 40 states and in Washington, D.C., between 2015 and 2016, with 17 states seeing increases of 25 percent or more, according to the TFAH analysis.

“Every community has been impacted by this crisis,” Auerbach said, adding that the government was not making the investments needed to “turn the tide.”

The surge in overdose deaths has depressed recent gains in U.S. life expectancy, which fell to an average age of 78.6, down 0.1 year from 2015 and marking the first two-year drop since 1962-1963.

In a separate report, the CDC linked the recent steep increases in hepatitis C infections to increases in opioid injection.

Researchers used a national database that tracks substance abuse admissions to treatment facilities in all 50 U.S. states. They found a 133 percent increase in acute hepatitis C cases that coincided with a 93 percent increase in admissions for opioid injection between 2004 to 2014.

“Hepatitis C is a deadly, common, and often invisible result of America’s opioid crisis,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Mermin urged testing people who inject drugs for hepatitis C infection to prevent new transmissions.

As the opioid epidemic has worsened, many state attorneys general have sued makers of these drugs as they investigate whether manufacturers and distributors engaged in unlawful marketing behavior.

Reuters, Inc.

Join our conversation on the drug epidemic and families

The amount of drug that can kill. Fentanyl threatens to greatly worsen our addiction crisis.

A social worker in a small upstate New York town told me that in order to shoot up with meth, teens in his town used the only private space they could find: their family car. They shot up in the most secluded place they could find--empty downtown areas, WHILE DRIVING.

A mental health worker in Vermont told me that they're on the verge of giving up on today's youth and trying to prevent children from becoming the next generation of addicts.

Doctors in emergency rooms give families devastating news about their children, anywhere from the limited, compromised futures they face to the crushing news of their deaths.
 
Former President Bill Clinton gave a speech recently saying that the opioid epidemic will destroy this country.

WHAT WE'RE DOING

A Thousand Moms, which has produced a series of books entitled "Healing the Brain," will hold a four-week conference-call series entitled "Network of Support: Addiction and Our Families." 

Made possible by a donation from a concerned supporter, A Thousand Moms’ four-part information series for educators, parents, social workers, other concerned individuals is now free of charge. Dates for Network of Support: The Addiction Crisis are Tuesdays, July 18/19, July 25/26, August 1/2 and August 8/9. (Original presentations are repeated on the following day for the convenience of participants. Times: Tuesdays at 11:00 am EDT., Wednesdays at 7:00 pm EDT. 

Calls last one hour. CONF CALL #: 605 475-6333  ACCESS CODE: 2456474

Presented in clear, non-complicated language

To empower participants, coverage in this series will include a basic understanding of how addiction works in the brain and body. Each session will combine addiction facts with practical strategies for coping with current or potential substance abuse by a loved one. Substance abuse topics include: How the brain works; Why is addiction a brain disease? Opioids/heroin;  Methamphetamines, cocaine; and Alcohol and marijuana. Support topics include: Positive parenting as a prevention tool for drug abuse; Communication, encouragement,and negotiations; Setting limits; supervision, and knowing your child's friends. 

The conference call programs are presented by Fred Elia, MS, president of A Thousand Moms, and David Balog, author, Dana Foundation’s Sourcebook of Brain Science and Healing the Brain: Stress, Trauma and Development.

First call: Tuesday, July 18, 11:00 AM EDT

CONF CALL #: 605 475-6333  ACCESS CODE: 2456474