Smorgasbord Health Column – Painkillers – Prescribed and Over the Counter – Side Effects and Addiction.

Over the last twenty years, the USA has been on a downward spiral with regard to opioid addiction.

In 2002, 5,000 people died from overdosing with prescription opioids such as extra strength Oxycontin – Pure Oxycodone  ( a semi-synthetic opioid loosely related to morphine and originally based on elements of the opium poppy) and from others such as Percocet, Percodan which are usually oxycodone mixed with Tylenol or Ibuprofen. Other opioid drugs include Fentanyl, Hydrocodone and codeine in various strengths and mixed with NSAIDs or paracetamol.

In 2015 these deaths caused by opioid overdose had increased to 52,000 per annum.

The UK has also seen an increase in addiction. However some of those who are afflicted go unreported, such as when associated with the very elderly. I have personal experience of this with the prescription of Tramadol in excessive doses, and also Oramorph which is a liquid opioid, to my mother in her late 80 and early 90s. And then with the safe withdrawal from those drugs over several months after taking issue with the prescription.

It is hard not to be cynical when our elderly are being given addictive opioids, that can severely impact breathing, and who may be only interested in the pain relief they offer, rather than the very small print on the leaflet enclosed.

The UK has a public health system which is far more regulated than in the US, and the pharmaceutical companies do not have such a lucrative market place. However, we have still managed to become a nation of pill-poppers at a cost of around £16 billion per year to the NHS.

In the USA, the prescriptions for Oxycontin had risen to 6 million a year by 2009 but the use of the pills became big business on street corners and became part of the overall drug problem facing the nation. Also there is often a transition to the use of illegal drugs such as heroin, when the prescribed source of the painkiller dries up. It is no longer the stereotypical junkie who is on the front pages of newspapers, but young mums and sometimes both parents passed out in cars with children in the back seat.

Here is an interesting statistic that caught my eye when reading various reports on opioid addiction.

“Other developed countries, including the UK, have been grappling with a rise in opioid addiction, too, although Britain’s public health system means the issue of massive over-prescription is less acute.

But the US is the epicentre and the origin of the crisis, consuming more than 80% of global opioid pills even though it has less than 5% of the world’s population and no monopoly on pain.”

Read more of this very informative article: https://www.theguardian.com/us-news/2017/oct/25/americas-opioid-crisis-how-prescription-drugs-sparked-a-national-trauma

There is no doubt that there are life saving drugs developed that are beneficial to mankind, and that for short term relief of extreme pain, opioids are one of the few options. But unfortunately once the body is no longer in pain, and the drugs are continued to be taken, the neurotransmission in the brain is disrupted.

This is the way that neurons (nerve cells) communicate in the brain and they determine the way we feel, think and behave.

Each of our neurons produces one or more neurotransmitters such as serotonin or dopamine. For example, dopamine is mostly found in areas of the brain that determine feelings of reward. Prescription opioids produce effects similar to the neurotransmitters such as dopamine as well as endorphins (creating the feel good factor) effecting pain relief but when production of the neurotransmitters is disrupted, it can also result in lack of focus, lack of inhibition and become life threatening by inhibiting the ability to breathe.

Withdrawal from these addictive prescribed painkillers after long term use, is not easy at all, and can be dangerous. It takes professional intervention and help to rid the body of the toxins and to also normalise the functionality of the neurotransmitters in the brain.

What about over the counter painkillers.

It is easy to assume that if a drug or painkiller is available over the counter then it cannot be harmful. Unfortunately this is not always the case, especially with the class of drugs known as NSAIDs or Non-steroidal anti-inflammatory drugs which includes Ibuprofen and Aspirin (Disprin).

Millions of us will walk into a pharmacy and buy both these painkillers to reduce the inflammation of certain common conditions such as arthritis. However, there is increasing concern about the long-term use for chronic conditions.

Even the low-dose aspirin taken as a preventative against heart conditions, can contribute to some of the side effects that have been recorded.

Increased risk of Heart Failure.

NSAIDs encourage the body to retain sodium. The body then hangs on to water to dilute the concentration. You then have more fluid around individual cells and additional volume of blood in the cardiovascular system. This results in a lot of additional work and pressure on blood vessels which can harden, which in turn leads to high blood pressure, heart attack or a stroke. If you find yourself becoming breathless easily, developing puffy ankles, suffer from indigestion more frequently, tight feeling in the chest, nausea and sweating and a persistent cough, please go to the doctor immediately.

Kidney damage.

The anti-inflammatory and sodium retention properties of these drugs can lead to damage to the kidneys, and if after prolonged use of Aspirin of other NSAIDs you notice that you have poor energy levels, dry itchy skin, pain both sides of your lower back, frequent urination or blood in your urine, you should go to a doctor immediately.

Internal bleeding from stomach ulcers and gastrointestinal damage.

Although the 75mg preventative dose of aspirin has been thought to be less of a risk in relation to internal bleeding, there is growing evidence that in some people it can still result in damage throughout the digestive tract including the esophagus. Taking full strength aspirin for extended periods has been associated with stomach ulcers and intestinal bleeding. If you smoke, have a family history of ulcers of have other medical problems you should seek medical advice before taking this painkiller.

Allergic reaction.

My mother was allergic to aspirin and so am I. Possibly because we have the asthma gene from my grandmother. Asthma sufferers should be very careful about taking NSAIDs without medical advice and should be monitored carefully.. This is particularly important if you have children who have asthma, and in fact it is not recommended for under sixteens to take NSAIDs at all.

Paracetamol is generally considered safe as it does not have the same anti-inflammatory properties, select age appropriate dosages such as in children specific products, but again it is wise to ask the advice of the pharmacist.

You should also never give NSAIDs like aspirin to children with chickenpox or with influenza as it can result in damage to the liver and the brain.

What are the alternatives.

That is really tough because when it comes to acute short term pain such as following injury or post operative, it is difficult to beat NSAIDs, and in extreme cases opioids.

However, chronic pain management needs to be approached in a holistic way that maximises the effect on the pain, but minimises the damage to the whole body and its major organs.

Diet and exercise is very important as sitting all day and not using the body does not release natural endorphins that help with pain.

Eating sufficient good fats, vitamin C rich foods to help the production of collagen (for joint pain) and a wide range of anti-oxidants with a reduction in refined sugars.

Here is my basic nutritional shopping list and if you are eating these foods regularly you should see some benefit. Those with particular anti-inflammatory properties are tomatoes, green vegetables such as spinach, nuts, fatty fish and berries.

https://smorgasbordinvitation.wordpress.com/2014/05/19/a-basic-shopping-list-for-a-nutritionally-balanced-diet/

Sometimes diet and exercise is not sufficient, in which case it might be worth exploring acupuncture, which is a therapy that I have used for chronic knee pain successfully.

Physiotherapy can also help relieve muscle and join pain as can certain forms of exercise such as swimming.

Personally I use a daily turmeric spray as it has anti-inflammatory properties when used over an extended period of time.

Finally

At the end of the day, pain needs to be managed. If it is acute pain from an injury or post operative, then you may require prescribed medication in the short term. In which case you should work with your doctor to reduce the painkillers over a period of time as the pain becomes manageable with non-opiate alternatives.

If you suffer from chronic pain then also work with your doctor and pharmacist to manage with both physical therapies and the right pain medication that does not cause any serious side-effects. Do not be afraid to ask questions about any prescribed medication and read the leaflet carefully to maximise safe usage. For example taking with food to help prevent damage to the stomach or intestinal tract.

Also review your diet, lost weight if that might relieve joint pain in hips and knees and explore alternative health products that may work for you. Talk to a qualified assistant and check out online first. If you have any questions them please do not hesitate to ask. sally.cronin@moyhill.com.

For more information on Opioids and NSAIDs here are some links.

https://familydoctor.org/condition/opioid-addiction/

https://drugabuse.com/library/opiate-abuse/

https://www.health.harvard.edu/pain/pain-relief-taking-nsaids-safely

I hope you have found this of interest and I look forward to your feedback. Thanks Sally

 

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61 thoughts on “Smorgasbord Health Column – Painkillers – Prescribed and Over the Counter – Side Effects and Addiction.

  1. Pingback: Smorgasbord Health Column – OTC Painkillers – The Militant Negro™

  2. This is a growing epidemic in the United States and when the doctor’s cut them off, without weaning them down, they will turn to streets to the cheap drug heroin. That is when many overdoses occur. Also the drug that rehabs use to wean patients, saboxone or subutex, are highly addictive themselves.

    Liked by 1 person

  3. This is so needed, Sally. I’m so glad I made the choice NOT to succumb to prescription pain killers over 20 years ago. I can’t imagine having to deal with addiction as well as the auto-immune diseases that disrupt my life. I probably wouldn’t be here. I hope everyone reads this blog and passes it onto a friend.

    Liked by 2 people

  4. Thank you Sally for this excellent article. So informative and clear with good eating advice added. For what kind of pains are such heavy medications prescribed? As I live in Europe where laws are different this is a warning.
    Of course we need pain killers at times and chronic pain is tricky to handle.
    Your picture of all these colourful vegetables are inspiring and I am going to see if Tumeric spray is available here. Sounds intriguing.
    Miriam

    Liked by 1 person

    • Thank you Miriam.. usually they are designed for short term use following sports injuries for example, post-operative for joint replacements or any major invasive surgery. They are also of course used in palliative care where the pain is likely to be continuous and addiction is not an issue. The UK is regulated but my mother still ended up on far too high a dose of tramadol with the addition of pure morphine and I would bet that is the case with many elderly people who have chronic pain and it keeps them sedated effectively and out of the surgery! As I said I am a cynic when it comes to the health service having seen huge amounts of waste despite some amazing medical interventions. Glad you found interesting.

      Like

  5. Pingback: Smorgasbord Health Column – Painkillers – Prescribed and Over the Counter – Side Effects and Addiction. | Smorgasbord – Variety is the spice of life

  6. Dad was on a painkillers for the pain in his arthritic hip. When the pain became worse the doctor was going to prescribe morphine. We asked about acupuncture instead and he said we could try but, of course, the NHS wouldn’t pay for it. We did try it and it really helped though the acupuncturist point out right from the start she could only help with pain relief – the damage to his hip couldn’t be put right.

    Liked by 2 people

  7. Husband was on co-codamol after his recent operation and couldn’t stay awake.We followed your suggestion on magnesium & calcium tablets and vit D spray, Sally – knocked the co-codamol on the head. Also he has beetroot juice and aloe vera every day. Next turmeric. Although still immobile (apart from a very funny double walk with me occasionally! ) he’s keeping his sense of humour. Thanks for all your help with these posts. x

    Liked by 2 people

  8. The drug companies marketed these opioid drugs feverishly and now when we are left with the ruins, they’ve disappeared. Several states, including Maine, are involved in a lawsuit trying to get them to anti up for the costs associated with this devastating epidemic. It is a huge problem in Maine and so sad to see lives lost and destroyed. Your suggestions are wonderful, Sally. Opioids should never be used for chronic pain and only worsen the physical and emotional pain.

    Liked by 1 person

    • It is tragic as you say Molly and not just individual’s lives being ruined but their families too. I have little faith in most of the large pharmaceutical companies. I appreciate that they have shareholders and want to pay back the cost of their R&D but when a drug is life-saving and they are making billions a year in profit, I find it unacceptable that they charge so much.

      Liked by 2 people

      • I have strong opinions about Big Pharma. I know they do a lot of good, and without many lifesaving drugs, people would die. But the incessant TV commercials make me sick. And half of the drugs they advertise are unnecessary or treating side effects of other drugs. I am a minimalist when it comes to taking prescriptions. At the current time, I’m happy to say I am not on any prescription drugs on a daily basis.

        Liked by 1 person

  9. I took dihydrocodeine for nearly 30 years for an autoimmune condition – I stopped taking it 4 years ago and now I don’t take any prescription meds. I’ve switched to acupuncture, yoga, meditation, diet and exercise, but even these don’t always keep the inflammation in check. I put turmeric in most of my food – would it be worth getting the spray as well?

    Liked by 1 person

  10. Having been on heavy duty painkillers for a long time after my accident and my husband being on even more heavy duty meds – I know what this feels like and how hard it is to come off them.

    Can I just say that despite not having any medical evidence, I found yoga immensely helpful in all sorts of ways. The stretching and balance helped movement but the breathing helped so much with managing pain. I would definitely reccomend it to anyone looking for an alternative to pills.

    Liked by 1 person

  11. A very good post with your usual good advice Sally but it is scary that these opioid drugs are still being prescribed and that no monitoring systems or alternatives are being promoted by the medical profession this can only get worse unless direct action is taken 🙂

    Liked by 1 person

      • Yes you are right and unfortunately many people still absolutely trust what the doctor tells them to take without question..me I have always asked questions my doctor used to just smile at me indulgently I will add thinking about it now..He was a handsome man … But yes old people that is a problem and a shame that they are not afforded more respect just pills to keep them quiet…I honestly can’t see an answer to that one as not everyone has family or family who care .A sad state of affairs xxx

        Liked by 1 person

  12. Pingback: Prescribed/OTC Painkillers: Side Effects & Addiction. – The Militant Negro™

  13. A very important topic that needs independent investigation. Although no one likes to see lives sacrificed needlessly, the pharmaceutical industry has had a past history of placing revenue and profit in front of safety and efficacy. I believe the solution lies in the public becoming more aware of pharmaceutical side effects, natural alternatives and a greater need for personal responsibility in making lifestyle decisions.

    Liked by 1 person

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  17. As a chronic, severe back pain sufferer, I worry about not receiving the medication I need, and I never once experienced a euphoric feeling from the drugs. In fact, I don’t understand how people get addicted to them. All it does for me is take the edge off of the agony.

    Liked by 1 person

    • Only about 10 to 15% if those taking opiates experience a high from the drugs, as their pain recedes they want to hang onto that feeling of eurphoria, happiness etc and so they start to lie about their pain levels to get more instead of tapering off. They become tolerant to the drug which means they begin to crave a bigger fix and then in extreme cases move onto other drugs such as heroin. When someone like yourself has chronic back pain that never goes away and it only takes the edge off without euphoria, it is unlikely that you would become addicted. Having said that it is possible to build up a tolerance over time meaning that if it is not relieving pain you may need to look at other forms of pain management. Which I am sure you doctor has explored. It is a tough thing you are having to cope with and I am sorry that you have so much pain.

      Liked by 1 person

      • Periodically, I endure spinal injections that do provide temporary relief, and during this period, I don’t take any pain meds. Quite frankly, the meds plug up the system which I find exasperating. Thanks for responding.

        Liked by 1 person

  18. Pingback: Smorgasbord Weekly Round Up – U2, Blog Challenges, Literary Column and Letters from America | Smorgasbord – Variety is the spice of life

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