NFL Injuries Leading to Medication Abuse

By Richard Taite
dreamstime_s_36812629

NFL Injuries Leading to Medication Abuse

Many people addicted to prescription medications do not think that they have a problem. These addictions often begin as an injury. Few realize how quickly dependency can spiral out of control.

NFL injuries are treated with pain medications by team doctors. Are the players being responsibly medicated? Are they treated in ways that are for their benefit or in the team’s best interest?  Are the ways they are being treated for pain creating problems with addiction for which the NFL will not take responsibility?

Former Buffalo Bills linebacker Darryl Talley claims:

“When you’re done playing, you’re like a piece of meat. They treat you like, None of what you say is our fault. None of these injuries happened from playing football. They tell you whether or not you hurt. None of us playing this game is normal. To compare an NFL player’s pain threshold to the average person who’s never done it? They’re going to tell me I don’t hurt? But it’s just an unbelievable fight to deal with the pain.”

Due to accounts of irregularities in handling prescription painkillers, multiple NFL teams’ former players have entered into a class action lawsuit accusing NFL teams of misusing narcotics and other pain medications to keep players on the field despite injuries. Some blame the culture of football and the NFL.

According to law enforcement sources, investigators are focused less on individuals than on a broad range of alleged illegal dispensation practices in the NFL, which may facilitate addictions and pill trafficking. DEA spokesman Rusty Payne confirmed NFL physicians were being looked into after agents surprised at least five teams with spot checks of medical staffs at stadiums and airports following their Nov. 16 games.

Former NFL linebacker Scott Fujita said he still has a pill bottle, nearly the size of a soda can.

 “It was the craziest big pill bottle you’ve ever seen,” he said.

It was given to him by an NFL team physician to treat a single knee injury, yet it contained, he estimates, somewhere between 125 and 150 pills of Percocet, the addictive oxycodone-based painkiller. Another claim was that an assistant trainer passed out narcotic painkillers in unlabeled small manila envelopes before games to whoever raised a hand.

Doctors in the past too frequently handed out pain pills for a quick fix. These included many college and high school athletes. Parents should be aware of how their children are treated.

Change can be slow. Recently the law changed to require opioid prescriptions to be written monthly because they are no longer refillable electronically or over the phone. Time will tell how effective this will be.

We live in a fast paced world and no longer take the time that we should to heal from injuries. This puts many competitive individuals such as CEOs, celebrities, business owners and other professionals at risk for drug use that could lead to misuse or even addiction. Good long term health requires time and effort, but is well worth the investment.

 

 

http://www.buffalonews.com/sports/bills-nfl/broke-and-broken-20141126

http://www.washingtonpost.com/sports/two-former-nfl-players-decribe-prescription-drug-practices/2014/11/27/6cfb8768-768c-11e4-bd1b-03009bd3e984_story.html

 

 

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Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

 



Medicating When It Is not Needed

By Richard Taite
dreamstime_s_25690866

Medicating When It Is not Needed                       

Creativity is a complex and vast construct that has been vital to the progress of human civilization and the development of human reasoning processes. Indeed, the immense array of creative endeavors encompasses the works of such disparate activities as those undertaken by painters, sculptors, nuclear engineers, landscape architects, graphic designers, and software developers.

Sadly, many of the brightest, most creative children are misdiagnosed with behavioral and emotional disorders such as ADHD, Oppositional-Defiant Disorder, Bipolar Disorder or OCD. As a result, many often receive medication needlessly along with inappropriate and ineffective counseling.

Behavioral descriptions of Attention Deficit Hyperactive Disorder (ADHD), including higher levels of spontaneous idea generation, mind wandering, daydreaming, sensation seeking, high energy, and impulsivity overlap many traits of creative personalities. Physicians, psychologist, counselors and parents are often unaware of characteristics of gifted children and adults that can mimic pathological diagnoses.

Research has supported the notion that people with ADHD characteristics are more likely to reach higher levels of creative thought and achievement than people are without these characteristics. Results indicated that adults with ADHD showed higher levels of original creative thinking on the verbal task of tests and higher levels of real-world creative achievement, compared to adults without ADHD. In addition, comparison of creative styles found that preference for idea generation was higher among ADHD participants, whereas preference for problem clarification and idea development was greater among non-ADHD participants. These findings have implications for real-world application of the creative styles of adults with and without ADHD.

Nine percent of children aged 5-17 years old are labeled ADHD on average per year, and placed in special education programs. However, data from The National Center for Learning Disabilities shows:

•Only 1 percent of students who receive IDEA (Individuals With Disabilities Act) services are in gifted and talented education programs, compared to 7 percent of general education students.

•Students who receive IDEA services make up 12 percent of all high school students but are only 2 percent of students enrolled in an AP course.

The report concludes, students with learning and attention issues are shut out of gifted and AP programs, held back in grade level and suspended from school at higher rates than other students.

Every student deserves the room, the space, the opportunity to excel, the metaphorical equivalent of a desk of his or her own. Assessments of creativity are notably absent from most gifted and talented programs in this country. Instead of automatically putting children with ADHD characteristics in special education, a broader assessment should be conducted. Some of these children are talented kids who need room to be creative in order to excel in their studies.

Assessment could also allow students with ADHD characteristics to display their creative strengths, including divergent thinking, imagination, and hyperfocus (when interested). People with ADHD often are able to focus better when they are deeply engaged in an activity that is personally meaningful to them. This too would allow those who have ADHD to excel in particular areas, a chance to be the “smart one,” instead of being labeled as in need of special services.

Medicating a child is a serious matter with far reaching consequences. Our contemporary society often wants a quick fix, which is not necessarily the best choice for a children, but an easier solution for an overburdened school system and frustrated parents. Talk to a health care professional about concerns you may have about your child’s health. Never hesitate to get a second opinion when it comes to a diagnosis of ADHD in children.

 

 

 

http://www.sciencedirect.com/science/article/pii/S019188691000601X

http://www.alternet.org/adhd-brains-are-most-creative-why-do-we-treat-it-disability?page=0%2C0&paging=off&current_page=1#bookmark

 



Alcohol Abuse during the Holidays

By Richard Taite
Can you have just one drink?

Alcohol Abuse during the Holidays

The holiday season is upon us and alcohol is frequently more visible and free flowing during this time.  Exactly where the line is between heavy drinking and clinical alcoholism can be vague.

new study conducted by the Centers for Disease Control and Prevention (CDC) found a distinction between drinking too much and being alcohol dependent. The researchers say 9 in 10 Americans who drink too much should not be classified as alcoholics, but this does not mean they are not doing real damage to themselves both physically and socially. In recent years binge drinking has been a growing concern, especially among young adults. Researchers say it is important to distinguish between binge drinking and alcoholism, the latter being a chronic disorder.

Binge drinking is defined as four or more drinks on an occasion for women, five or more drinks on an occasion for men. Consuming eight or more drinks a week for women or 15 or more drinks a week for men also falls within the binge drinking definition. It turns out millions of Americans fall into the category of binge drinkers. The study found that nearly 1 in 3 adults is an excessive drinker, and most of them binge drink, usually on multiple occasions.

The researchers say excessive drinking is responsible for 88,000 deaths in the U.S. each year; 3,700 of those deaths were linked to alcohol dependence. There were also serious health effects from drinking too much in a short time period, such as violence, alcohol poisoning, and car accidents.

Here is some practical advice for the holidays. Think about how much alcohol you will consume before arriving at a party, then stick to your decision. If you find it difficult or uncomfortable to stick to your alcohol consumption plan, that is a red flag of a potentially more serious alcohol issue. If you are the host, offer a wide selection of non-alcohol beverages along with a variety of food to snack on. Never push someone to have a drink. Furthermore, if someone is intoxicated, try to discourage him or her from another drink or trying to drive by offering an alternative. The inconvenience of driving a friend home is better than living with only a memory during the holiday season.

http://www.cdc.gov/media/releases/2014/p1120-exessive-driniking.html

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Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also coauthor with Constance Scharff of the book Ending Addiction for Good.

 



Who’s Smoking Marijuana and How Much?

By Richard Taite
dreamstime_s_11983875

Who’s Smoking Marijuana and How Much?

Statistics on cannabis users skew perceptions of cannabis use. Most statistical surveys of marijuana focus on a single quantitative measurement, “How many people are using?” However, there is a problem; more marijuana use does not necessarily translate into more marijuana users. The greatest amount of marijuana consumption comes from the heaviest smokers. How many people are using does not give us a clear picture of levels of misuse or abuse.

Examining frequency of use over time provides a picture of not only changes in who is using, but also how individuals are using. Researchers were able to draw some conclusions about the growth in marijuana usage from 2002 through 2011, based on data gathered. After exploring the demographics of this 10-year record of use, they found that “consumption grew primarily because of an increase in the average frequency of use, not just because of an increase in the overall number of users.” The driver of consumption turns out to be greater consumption, and that increased consumption is coming from older adults. Those older adults, it turns out, are smoking more pot.

There is also concern over a rise in the concentration of active ingredients in available drugs. In 2012, THC concentrations in marijuana averaged close to 15 percent, compared to around 4 percent in the 1980s, according to the data from police records. For a new user, this may mean exposure to higher concentrations of THC, with a greater chance of an adverse or unpredictable reaction. For frequent users, it may mean a greater risk for addiction if they are exposing themselves to high doses on a regular basis.

However, the full range of consequences associated with marijuana’s higher potency is not well understood. For example, experienced users may adjust their intake in accordance with the potency or they may be exposing their brains to higher levels overall, or both. Increases in potency may account for the rise in emergency department visits involving marijuana use.

Although the federal government considers marijuana a Schedule I substance and it is therefore illegal on a federal level, several states have already legalized medical marijuana or allowed social use. Regardless of public opinion, research shows marijuana may cause problems in daily life or make a person’s existing problems worse. Heavy marijuana users generally report lower life satisfaction, poorer mental and physical health and more relationship problems compared to non-marijuana-using peers.

If you smoke marijuana, perhaps it is time to considering quitting and looking at replacing marijuana use with healthier life choices. The amount of money and time wasted on this habit could probably be better used doing more productive activities. Consider seeking professional advice on private treatments available for substance abuse and help developing a personal plan to quit. Success is possible with a little effort and help.

http://journal.frontiersin.org/Journal/10.3389/fpsyt.2013.00138/abstract

http://www.drugabuse.gov/publications/drugfacts/marijuana

 



Regular Pot Use Changes the Brain

By Richard Taite

shutterstock_70950535The existing literature on the long-term effects of marijuana on the brain is confusing, mostly due to methodological differences across studies. However, in a new study of cannabis users, scientists investigated the drug’s long term impact through brain scans, hoping to overcome methodological problems in previous studies. They found that marijuana use changes the brain.

The team studied 48 adult cannabis users aged 20 to 36 and compared data with a group of matched non-users. Researchers collected multimodal measures of chronic marijuana using adults with a wide age range that allows for characterization of changes across lifespan without developmental or maturational biases as in other studies.

Compared with controls, marijuana users had significantly less bilateral orbitofrontal gyri volume, higher functional connectivity in the orbitofrontal cortex (OFC) network, and higher structural connectivity in tracts that innervate the OFC (forceps minor) as measured by fractional anisotropy (FA). Increased OFC functional connectivity in marijuana users was associated with earlier age of onset. Lastly, a quadratic trend was observed suggesting that the FA of the forceps minor tract initially increased following regular marijuana use but decreased with protracted regular use.

The findings suggest that chronic marijuana use is associated with complex neuro-adaptive processes and that onset and duration of use have unique effects on these processes. In other words, if you start using marijuana at a young age and use it often, it affects the way your brain works, and not for the good.

Regular cannabis use shrinks the brain, but increases the complexity of its wiring. The loss of brain volume is balanced to some extent by more connections between neurons. This seems to be the brain’s way of trying to compensate for the changes made by marijuana use. Tests showed that regular users also had lower IQs than non-users and this did not appear related to abnormalities of the brain.

Brain scans disclosed that smoking cannabis every day was associated with shrinkage in the region of the brain involved in mental processing and decision making. Marijuana smokers who started taking the drug at a young age showed greater structural and functional connections between their brain neurons, the research showed. After six to eight years of continually smoking cannabis, the increases in structural wiring in the brain declined, but users continued to display higher connectivity than non-users. Again, this seems to show that the brain is trying to compensate for the damage being done to it by the marijuana use.

Dr Sina Aslan, from the University of Texas, Dallas, who co-led the research, said:

“The results suggest increases in connectivity … that may be compensating for grey matter losses. Eventually, however, the structural connectivity or ‘wiring’ of the brain starts degrading with prolonged marijuana use.”

Although the study does not conclusively address whether any or all of the brain changes are a direct consequence of marijuana use, the long-term effects on brain structure do suggest that these changes are related to age of onset and duration of use.  The younger you start using marijuana and the more often you use it, the worse off your brain will be.

Further work is needed to determine whether stopping cannabis use reverses the changes and if occasional users suffer similar effects. The best advice is not to use marijuana until your brain is fully developed, around the age of 25. The changes in the brain caused by early and prolonged marijuana use are serious and not worth the short term pleasure of the high.

http://www.pnas.org/content/early/2014/11/05/1415297111.abstract?sid=04b2b519-7a82-4da5-9aa3-1d9da67ee8ef

http://www.cnn.com/2014/11/10/health/pot-and-your-brain/index.html

Second, this goes on the bottom of all Rich’s external blogs:

 

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Richard Taite is founder and CEO of Cliffside Malibu, offering evidence-based, individualized addiction treatment based on the Stages of Change model. He is also co-author with Constance Scharff of the book Ending Addiction for Good.

Pot smoker image available from Shutterstock.



Veteran’s Day Message from Cliffside Malibu

By Richard Taite
dreamstime_s_41335983

Veteran’s Day Message from Cliffside Malibu

There are many things I’m proud of in this world. One is that I live in a nation with a volunteer military. Men and women from across our great land give their time, leave their families, and put themselves in harm’s way all so that we can live the lives we lead at home with relative safety and ease. Some don’t return. We remember them on Memorial Day. Most do come back, though sometimes they are damaged physically and emotionally by their service. They deserve our help.

Although not specifically a veteran’s service, Cliffside Malibu honors America’s veterans. Whenever we can, we help veterans find access to quality, evidence-based treatment for addiction and co-occurring psychological disorders, when benefits do not allow veterans to use VA services. We do our best to match veterans with services and treatment centers that are capable of meeting their specific needs, particularly those who have combat related psychological issues and require specialized treatment. Most often, we are able to secure low cost beds at nonprofit treatment facilities we respect. This is our way of paying it forward and supporting those who serve.

We believe that everyone deserves access to quality care for addiction and co-occurring disorders such as PTSD, depression, anxiety, and suicidal ideation. Please – if you or someone you love is suffering, do not wait to seek help. It can take months or years for VA benefits to come through. Meanwhile, our veterans are losing their lives. Call us. Call another treatment center. Call a 24 hour call center like (951) 676-2589 for a referral. Call the Wounded Warriors Project. Just call someone. We are losing too many good people. Get help now.

- See more at: http://www.cliffsidemalibu.com/richard-taite/veterans-day-message-cliffside-malibu/#sthash.PTn22iy3.dpuf



Prescription Opioid Abuse: A Gateway to Heroin and Overdose

By Richard Taite
dreamstime_s_38964914

Prescription Opioid Abuse: A Gateway to Heroin and Overdose

Opioid-involved overdoses in the United States have dramatically increased in the last 15 years, largely due to a rise in prescription opioid (PO) use. Emerging evidence suggests the increase is linked to unintentional PO misuse that easily turns into addiction.

Individuals who regularly use opioid analgesic medications do not often recognize that they are using a medication that can be a gateway to heroin use.

“According to the National Survey on Drug Use and Health, the number of individuals reporting past year heroin use almost doubled between 2007 (373,000) and 2012 (669,000). Emerging evidence suggests the increase may be linked to prescription opioid (PO) users who transition from oral and/or intranasal PO use to heroin use, with POs providing the entryway to regular opioid use, and ultimately, heroin injection.”

Switching from POs to heroin is only one problem. Overdose is another concern. New York University’s Center for Drug Use (CDUHR) and HIV Research and the NYC-based National Development Research Institutes (NDRI) published a recent study examining the overdose knowledge and experience of nonmedical PO users. Researchers found that people who abuse POs fail to educate themselves on the risks of overdose.  Dr. Pedro Mateu-Gelabert, lead investigator with CDUHR and NDRI, said in a statement:

We found that despite significant overdose experiences, nonmedical prescription opioid users were uninformed about overdose awareness, avoidance, and response strategies.”

Most of the users in this study were generally uniformed about the benefit of naloxone treatment for overdose recovery. Naloxone comes in pre-filled auto-injection devices and is used along with emergency medical treatment to reverse the life-threatening effects of opioid overdose. Having this medication on hand can save lives when PO or heroin users overdose.

PO users in the study tended to see themselves as distinct from traditional heroin users. Today the average PO abuser is more likely to be young, white and middle class. They are also unlikely to utilize harm reduction services that address drug users’ health and safety. This is because PO abusers don’t usually see themselves as substance abusers or addicts. PO misuse often leads to long-term opioid dependence, as well as transition to less costly heroin.

Nora D. Volkow, M.D. at a hearing of the US Senate Caucus on International Narcotics Control stated:

“To address the complex problem of prescription opioid and heroin abuse in this country, we must recognize and consider the special character of this phenomenon, for we are asked not only to confront the negative and growing impact of opioid abuse on health and mortality, but also to preserve the fundamental role played by prescription opioid pain relievers in healing and reducing human suffering. That is, scientific insight must strike the right balance between providing maximum relief from suffering while minimizing associated risks and adverse effects.”

The US is seeing an increase in the number of people who are dying from overdoses, predominantly after abuse of prescribed opioid analgesics. This disturbing trend appears to be associated with a growing number of prescriptions in and diversion from the legal market. People from all walks of life are being prescribed addictive painkillers.  This trend must stop.

 

 

 

http://www.ijdp.org/article/S0955-3959(14)00206-0/abstract

http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2014/americas-addiction-to-opioids-heroin-prescription-drug-abuse

http://www.samhsa.gov/data/sites/default/files/NSDUH-SR200-RecoveryMonth-2014/NSDUH-SR200-RecoveryMonth-2014.htm



Mindfulness and Meditation: Two Steps Toward Better Health

By Richard Taite
dreamstime_s_28835030

Regular meditation along with a mindful lifestyle path can help individuals control and recover from many mental health disorders. Meditation is a practice of training the mind to induce another state of consciousness or bring attention to a particular point. Mindfulness refers to a psychological quality that involves bringing one’s complete attention to present experience on a moment-to-moment basis, in a specific way and nonjudgmentally.

A recent study examined associations of mindfulness with mental health and the mechanisms of mindfulness in experienced meditators practicing various meditation styles. Researchers wanted to know if mindfulness and meditation helped people overcome anxiety and/or depression. This was a well-done study. All psychometric and structural analyses of mindfulness on depression and anxiety were based on two large, independent meditator sample groups. Results were cross-validated and allowed for cross-cultural comparisons, further broadening the generalizability of the results.

Researchers found that meditation and mindfulness did help individuals manage anxiety and depression. The success of decentering and nonattachment were the most important mechanisms of mindfulness and consistent with neuroscientific evidence on the same subject. Aspects of emotion regulation and awareness along with nonattachment helped explain the effects of mindfulness on depression and anxiety. In particular, positive effects on the ability to cope with stress were observed and described from a physiological point of view.

This research tells us that we can change the way the brain works by practicing mindfulness and meditation, for positive impact(s) on our mental health. Modifications of cerebral networks and neurobiological functioning are possible in relation to expertise in meditation practice. Published evidence on the neurobiological effects of meditation include information on:

(1) The deactivation of the default mode network that generates spontaneous thoughts and contributes to the maintenance of the autobiographical self and is associated with anxiety and depression;

 (2) Changes to the posterior cingulate cortex that helps to understand the context from which a stimulus emerges;

 (3) Improvement in the temporoparietal junction that assumes a central role in empathy and compassion;

 (4) Changed responses by the amygdala, which is implicated in fear responses.

The converging evidence shows that mindfulness-based interventions are effective in the treatment of psychological disorders, the reduction of stress, and for improving overall well-being.

Several of the proven therapies based on mindfulness meditation are:

  • Acceptance and Commitment Therapy
  • Functional Analytic Therapy
  • Behavioral Activation
  • Metacognitive Therapy
  • Mindful Based Cognitive Therapy
  • Dialectic Behavior Therapy
  • Integrative Behavioral Couples Therapy
  • Compassionate Mind Training      

All therapy models may be use alone or combined in a personal plan developed to meet individual needs.

These treatments offer concepts and techniques that may enhance therapeutic efficacy by teaching individuals a new way to focus attention in order to diminish cognitive reactivity and to enhance psychological flexibility. Mindfulness can be learned by anyone to foster clear thinking and open-heartedness. It requires no particular fitness level, age, religious or cultural belief system, but only the desire and effort required to practice regularly. Give it a try. Meditation and mindfulness practice are easy to learn, free to use and can make a great positive impact on overall mental health.

http://www.ncbi.nlm.nih.gov/pubmed/25330072

http://www.ncbi.nlm.nih.gov/pubmed/25261599

http://www.ncbi.nlm.nih.gov/pubmed/24719001

- See more at: http://www.cliffsidemalibu.com/richard-taite/mindfulness-meditation-two-steps-toward-better-health/#sthash.HvsCHkxD.dpuf



As Seen on TV: Advertising’s Influence on Alcohol Abuse

By Richard Taite
dreamstime_s_26292306

As Seen on TV: Advertising’s Influence on Alcohol Abuse

Excessive alcohol consumption is a leading cause of premature death in the U.S. and responsible for one in every 10 deaths. The statistics that describe the ways in which we drink ourselves to death are staggering. A study published in the journal Preventing Chronic Disease found that nearly 70% of deaths due to excessive drinking involved working-age adults. The study also found that about 5% of the deaths involved people younger than age 21.  Moreover, excessive alcohol use shortened the lives of those who died by about 30 years. Yes, 30 years.

One strong factor that reinforces the popular culture surrounding drinking is the glamour of advertising. Researchers at the Johns Hopkins Bloomberg School of Public Health examined alcohol-advertising placements to determine whether the alcohol industry had kept its word to refrain from advertising targeting young people. This included television programs for which more than 30% of the viewing audience is likely to be younger than 21 years, the legal drinking age in every state.

The study found that alcohol related advertising increased by 71% in the last decade; this is largely attributed to exposure on cable television. That increase coincided with a reported upsurge of alcohol consumption by high school students. In conclusion, the study suggested that if the National Research Council/Institute of Medicine’s proposed threshold of 15% exposure to advertising was implemented, young viewers would see 54% fewer alcohol ads and society would see a correlating decrease in alcohol related deaths.

What about those “drink responsibly” admonitions on so many commercials? Federal regulations do not require responsibility statements in alcohol advertising. The alcohol industry’s voluntary codes for marketing and promotion emphasize responsibility, but they provide no definition for responsible drinking. So when you see the admonition to “drink responsibly” at the end of an alcohol-related television commercial, there is no idea given as to exactly what that may mean, particularly to someone under the legal drinking age.

David Jernigan, PhD, director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health said:

“The contradiction between appearing to promote responsible drinking and the actual use of ‘drink responsibly’ messages to reinforce product promotion suggests that these messages can be deceptive and misleading.”

Youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years according to the Centers for Disease Control and Prevention.

Alcohol advertising influences many people across a wide range of demographics. Regardless of the warning labels on alcohol containers, community prevention programs and general public knowledge of the risks of excessive alcohol consumption, people continue to drink in health-damaging ways. Drinking in public, at sporting events, in parks, during celebrations, etc., is firmly embedded in society as acceptable behavior. At the same time, the large number of alcohol related deaths among all age groups is a concern, especially when this drinking behavior is generally developed while individuals are underage.

Alcohol use is a major public health problem that can lead to social, financial, and health related setbacks and premature death. Talk to health care professional if you or someone close to you is struggling with excessive alcohol consumption.

 

 

http://jama.jamanetwork.com/article.aspx?articleid=1810389&resultClick=3

http://www.cdc.gov/pcd/issues/2014/13_0293.htm

http://www.cdc.gov/features/alcohol-deaths/

 



The Ineffectiveness of Opioids for Chronic Pain

By Richard Taite
dreamstime_s_13564399

The Ineffectiveness of Opioids for Chronic Pain                                                                                      

Let me first say that I am not a medical doctor. However, as the founder and CEO of a leading addiction treatment center, I sit on the front-lines of the prescription painkiller epidemic. From this vantage point, by working with addicts and their families and the physicians who treat addiction, I have come to learn a great deal about opioids, both when they are useful and when they may cause more harm than good. In reading the recent research on the efficacy of opioids for treating non-cancer related pain, I am dismayed at the ease with which these medications are prescribed.

The use of opioids for chronic non-cancer pain has increased dramatically over the past several decades. This has been accompanied by a major increase in opioid addiction and overdose deaths. The evidence does not support the safety and effectiveness of opioids for chronic pain and is causing an epidemic of tragic drug overdoses. The consequences of this abuse have been devastating and are on the rise.

An estimated 2.1 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.

The high risks associated with long-term opioid use are clearly shown by the climbing numbers of reported overdoses. Over 100,000 individuals have died, directly or indirectly, from prescribed opioids in the United States since the late 1990s. People aged 35–54 years have higher poisoning death rates involving opioid analgesics as compared with those in other age groups. Furthermore, substance abuse rates in those over the age of 55 are predicted to double in the next few years according to research predicting future trends from past and current research data.

A major reason why opioids are over prescribed is the misinformed belief that addiction is a rare consequence of long-term opioid therapy. The limited data supporting this outdated belief is of poor quality. Dependence arises in virtually all patients who are treated with long-term opioid therapy, and serious addiction occurs in up to one-third of patients.

The long-term use of opioids may not be beneficial even in patients with more severe pain conditions, including sickle-cell disease, destructive rheumatoid arthritis and severe neuropathic pain. The American Academy of Neurologists in a newly released position statement claimed :

Studies show that roughly half of patients taking opioids for at least three months are still on opioids five years later. Research shows that in many cases, those patients’ doses have increased and their level of function has not improved. In addition, the premise that tolerance can be overcome by dose escalation is now seriously questioned.

A relationship between prescribed opioid dose and overdose events was verified in three separate high quality studies. A nine time increased risk of overdose was noted in amounts exceeding 100 mg/d compared to doses below 20 mg/d in patients. Unfortunately, prescribed doses are common at 120-200 mg/d. Many patients suffer serious opioid-related harm, including death, despite never misusing an opioid prescription.

Addiction withdrawals from opioids, when not treated by a detoxification specialist, are extremely unpleasant lasting several days, and sometimes compared to severe influenza, including abdominal pain, nausea, diarrhea, and generalized malaise. The emergence of these symptoms following abrupt reductions in the dose of opioids, and their resolution following re-administration of the drug is common. This makes it difficult for even highly motivated individuals who are dependent on opioids to reduce or eliminate use without careful medical oversight and support.

If a patient’s pain is not under control, they should seek the help of a pain specialist and consider more successful alternative therapies than opioid medication on its own. Evidence now supports several holistic treatment options that are effective to help alleviate pain. We are able to promote mental, physical and spiritual healing without the need for what are now being regarded as generally ineffective opioid medications. Talk to a medical professional specializing in pain management for help with a long-term personal plan for managing pain.

 

http://www.neurology.org/content/83/14/1277

http://www.samhsa.gov/data/2k13/DataReview/DR006/nonmedical-pain-reliever-use-2013.htm

http://link.springer.com/article/10.1007%2Fs13181-012-0269-4

http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2008.02411.x/abstract

 



 
 

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