Chronic Opioid therapy- A Misunderstood Class of Drugs
First and foremost, it's important to recognize that opioids are neither "good" or "bad." They, like all drugs, are tools. And tools are just that: things we use to perform certain tasks. In this case, opioids can be used carefully, to reduce pain and improve life, or carelessly, to destroy health and ruin life.
It's up to both the doctor and the patient to control how these extremely powerful chemical tools are prescribed and implemented to help manage chronic pain. Tools only do what we tell them to do. Nothing more, nothing less. So...the thing to remember is that if you have chronic pain that's so intense it's adversely affecting your life, and your pain management physician suggests that you try a certain drug or drugs in combination, and one (or more) of these pharmaceuticals are opioids, don't rule them out simply because of fear or suspicion that you'll become, an “addict."
Which brings us to our next important issue, and that's the difference between an "addict" and somebody who may be dependent on opioid therapy or other narcotic pain medications in order to enjoy their life pursuit.
Addiction is marked by a continuous uncontrollable craving which results in compulsive opioid use. Patients are unable to take opioids as prescribed, continue to use despite doing harm to their (or other's) quality of life. It's a dangerous decision to carelessly use intoxicating drugs not for their pain relieving properties, but for an altering effect. Addicts seek drugs to alter their mood. They seek their psychiatric effects not their therapeutic properties. Addiction is a disorder and affects different parts of the brain than physical dependence.
Dependence on an opioid in order to live your life more normally with reduced pain is no different than the diabetic who must take daily insulin to keep blood sugar under control. Would you regard such a person as an addict? We sure wouldn't. If you have severe pain because of an injury or illness, and your physician believes that your life would improve under careful administration of opioid-type medication, you're being treated for an ailment, not seeking amusement or mood alteration. Patients receiving such drugs are taking them for their therapeutic properties not for their psychiatric effects.
That said, never alter the way you take such drugs beyond the directions given to you by your physician. Never take a pill "early" or "double up" because you're feeling bad that day, or take more than you've been prescribed. Because they can make you feel much better it's easy to take opioids lightly. Don't make this awful mistake.
Opioids are powerful drugs that must be taken exactly as directed, with no allowance for the patient to "cheat." Not even a little bit. Unless the prescribing doctor says it's allowed to add a pill, or take two, you should never do it. When taken as directed, opioids can provide profoundly life-improving relief from chronic pain. When used otherwise, you've taken your first step on a very slippery slope. Carefully follow what the doctor tells you to do and you'll be glad you did. Your pain should improve, and you'll have used a powerful medical tool with full and complete control.
At CareFirst we understand pain is a personal and private experience. I have personally taken an interest in chronic pain patients and have extensive post doctorate training managing this difficult and most often misunderstood patient population. If you think you may need opioid management for chronic pain, you may have your doctor refer you for a consultation.
In better health,
Randall W. Rodgers, D.O.
Certified-American Board of Interventional Pain Physicians
Controlled Substance Management
Certified Medical Review Officer