OxyContin: Pain Relief vs. Abuse
Are worries over abuse having an impact on the drug's legitimate use as a painkiller?
Treatment of Pain in Addicts
Is it inhumane, as some in pain management believe, to withhold opiates from
someone in pain who has a history of addiction? No, say two experts in chemical
dependency who talked with WebMD.
"Medical professionals need to be educated about addictions," says
Peter Provet, PhD, president of Odyssey House Inc., in New York City. "A
problem with addicts is they don't like pain of any kind. They've been
medicating their emotional pain, physical pain, or familial pain. The addict is
quick to ask for a pill, but sometimes we have to deal with our pain.
"All other kinds of treatment should be first considered before the
physician jumps to what is the easiest solution, a synthetic opiate," he
tells WebMD. "An addict or recovering addict suffering pain from cancer or
after a car accident should talk with a physician well-versed in addiction. On
occasion, someone who is in recovery may need a drug like OxyContin. It would
need to be done thoughtfully with full knowledge of addiction, and then the
treatment should be very carefully monitored."
Pinsky, author of When Painkillers Become Dangerous: What Everyone Needs
to Know About OxyContin and Other Prescription Drugs, says the risk of
addiction is so great, not only for addicts but for anyone genetically prone to
addiction, that any patient who comes forward with pain should first be asked
if there is a family history of alcoholism or addiction.
"How does the health care provider know who is genetically predisposed
to addiction? It may be hidden back three generations. The risk is triggering
opioid and opiate addiction, the addiction with the poorest prognosis."
Opioids and opiates act similarly on the brain and the terms are often used
interchangeably, but unlike opiates, opioids -- such as methadone -- are not
Pinsky admits to holding a minority view when he says no one should be
treated with opiates more than two weeks, particularly if there's a family
history of addiction. "If you have a history of addiction and have an
extraordinary need to go beyond two weeks, it needs to be monitored very
carefully by someone in the addiction field." He says there are many
non-narcotic pain medications, such as Toradol, and alternative therapies, such
as acupuncture, massage, and chiropractic treatment.