Thursday, November 24, 2011

Taking Chances with Narcotic Painkillers

A recovering addict must avoid taking narcotic painkillers to treat chronic pain (if they wish to stay in recovery). However, what about the non-addict? Better yet, what about a person who is not an addict, but has the potential to become one?

For many recovering addicts, the idea of surgery causes a heightened sense of anxiety.

Aside from the slicing, bleeding and unique set of risks associated with any surgery, addicts have to wonder about the ensuing pain of going under the knife---and debate whether taking prescribed narcotic painkillers will affect their sobriety or bring about a relapse.

Narcotic painkillers serve a very useful purpose. A non-addict can and often should take narcotics like Oxycontin and Vicodin when they are prescribed by a doctor, especially if he or she will endure extreme pain following the procedure. Rather than lying in bed in misery, a person can pop a narcotic painkiller to make life bearable, even if it means sleeping or nursing banana popsicles until they can be semi-functional (and lucid again).
For the recovering addict, though, narcotics are rarely ever a viable option. Treatment centers (e.g. Ridgeview Institute) teach people that narcotics of any kind threaten an addict’s sobriety---and simply being prescribed something for pain is not reason enough to take it.
“Earth people” (as non-addicts are called in recovery circles) have the ability to take narcotics responsibly. After a knee surgery, many (if not most) people can simply take pills to relieve pain, as prescribed, and stop taking them when the medicine is rendered unnecessary. A non-addict will normally complain that the medicine makes them feel loopy or tired, and will stop taking them as soon as possible.

But for a recovering addict, pills like Oxycontin and Valium are the very drugs that threatened to bring them to premature deaths, prison, or suicide. An addict has difficulty comprehending why someone would complain about the buzz they might feel from a painkiller [Isn’t that the point?]. Narcotics can make an addict feel invincible, relaxed, and at peace again. Narcotics---while just another occasional drug for an Earth person to deal with---can get an addict high, and can compromise his or her very sanity and health.
After exhausting all other alternatives, some people in recovery will inevitably have to take a narcotic painkiller. Still, there are ways of managing the consumption to avoid relapse. A sponsor or trusted family member can secure the medicine, and administer it as prescribed.
An addict should tell a therapist, a doctor, and/or a substance abuse disorder specialist about the predicament, to ensure that his or her sobriety is not compromised by the intake of drugs to deal with temporary pain. Also, there are 12-step meetings to deal with pain, and many other options to feel better without narcotics, like physical therapy and holistic medicine. Not to mention, there are plenty of extremely powerful non-narcotic pain relievers on the market today.
Narcotics simply aren’t an option for an addict dealing with chronic-pain. Once an addict, always an addict, and it’s just unrealistic (if not delusional) to expect an addict to be able to responsibly manage narcotics to cope with pain in the long-term. But what about the non-addict?
Narcotic painkillers are some of the most commonly used drugs in the United States, with as many as 244 million prescriptions dispensed in 2010. The potent drugs help ease pain for millions of people each year, and most of these people’s lives are not derailed by the drugs. The non-addict can take the medicine as medicine, and appreciate it for its pain-relieving qualities---and that’s all.
Still, most people become addicts by accident; they took drugs as prescribed and ended up getting physically and psychologically hooked. The only way a person can truly know that they are a drug addict, unfortunately, is to become an addict themselves.
Some prominent doctors are questioning the use of narcotics to treat chronic pain, alluding to a lack of evidence for the practice and serious problems associated with abuse.
A recent study conducted by NPR and Thompson Reuters Health Poll asked Americans about their experience with narcotic painkillers and their views about drugs. About half of the respondents had been prescribed a narcotic painkiller. More than three-quarters said the drugs are linked to addiction.
More than a third of respondents who have used prescription narcotics said they had concerns about them. The top fears were side effects (45 percent) and fear of addiction (27 percent).
Roughly 30 percent of those who said they had not used painkillers said they had concerns about them. Fear of addiction was the top worry at 38 percent, while 31 percent of people claimed to have refused or questioned a doctor’s recommendation of painkillers.
Prescription narcotics have sparked a fierce debate since their inception.  Dr. Gregory Terman (Professor of anesthesiology at the University Of Washington School Of Medicine) told NPR that people are normally split into two radically different ways of thinking about painkillers: one is terrified of narcotics, while the other sees them as a panacea.
He told NPR that while addiction is a legitimate concern, it is a side effect that affects only a small percentage of people who have a predisposition for abuse or who take a liking to recreational drug use. He stressed that doctors must keep the “medications in the hand of patients who are doing better” to minimize the diversion of the drugs for misuse and abuse.
How exactly is a doctor supposed to determine a patient who is “doing better?” Also, that “small percentage” of people with a predisposition for abuse is quite high; some experts estimate it’s as high as one in ten American with a substance abuse disorder.
Dr. Terman’s ambivalence about drug addiction is frightening, but extremely commonplace in the medical community. Despite being highly educated and respected, many doctors are willfully ignorant of the realities of drug addiction. Thus, those in recovery must research and question everything that they are prescribed, especially narcotics.
Alas, a person can only know that they are drug addict after the fact. There’s no correct way to avoid becoming an addict, but by only taking narcotics as prescribed (and needed), a non-addict is significantly less likely to wind up a drug addict.

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