Narcotics are Not the Answer

Effective pain management has become increasingly difficult these days. There seems to be a lack of understanding of the dangers of narcotic pain medications among the general population and many of my patients and their family members. The biggest thing I want people to understand is that these medications CAN KILL YOU. That is right, they can kill you in multiple fashions. According to Sanjay Gupta's recent article on CNN.com  http://www.cnn.com/2014/08/29/health/gupta-unintended-consequences/index.html?hpt=he_c2

every 19 minutes someone in the United States dies of an accidental PRESCRIPTION drug overdose! This is now the leading cause of accidental death in America, even above car accidents. What the hell is going on? Not to mention that many of these people have been turning to heroin because it is cheaper than prescription pills; talk about a gateway drug. The next time you lecture your kids about smoking pot and then head into the bathroom and take a Percocet for your back pain, you may want to think twice about what you just said. 

I think what America is failing to understand is that pain is a part of life. If you come into the hospital and have a surgical procedure, there will be pain; you just had your body cut into with a scalpel and possibly had some organs removed, it's gonna hurt. Pain tells us that there is something wrong. We should not mask the pain with narcotics, how else are we going to know if you are getting better. Not to mention that being constantly sedated can lead to pneumonia, blood clots and other life threatening conditions. It is in your best interest in life and in the hospital to remain as awake and fully functional as possible, despite the pain. We will not let you lay there agonizing and miserable, nurses are extremely good at being able to take the edge off without killing you or sending you into respiratory failure. I think our society has created a "quick fix" mentality and people expect it everywhere they go. We have forgotten that there are alternatives to treating pain; narcotics should be the last resort. 

• If you are admitted into the hospital for any type of surgical procedure please ask your doctors and nurses what level of pain should be expected and how they expect to manage your pain. If you have surgery anywhere in your torso it will become increasingly important to focus on deep breathing and coughing to prevent yourself from getting pneumonia. The single most important thing you can do to prevent pain with these types of surgeries is to "splint" your incision with coughing and any type of movement. "Splinting" means that you hold pressure on the incision with a pillow or rolled blanket while you perform these activities. You can ask for non-narcotic pain medications as the first line of defense. If you still are having too much pain that prevents you from coughing and deep breathing then go ahead and ask for stronger pain meds. 
• People who take narcotics will be constipated. The narcotics slow down the motility in your intestines. The first thing you should do is cut down on the narcotics, the second thing you should do is drink more water and then exercise to increase your motility. The first thing I tell my surgical patients to do is get up and go for a walk. This also decreases the chances of getting a blood clot. 
• If you are having a lot of knee, ankle or back pain your first resort should not be to see a surgeon. Maybe it is time to lose some weight. People assume that because they have these pains and they have a hard time exercising, that they cannot lose weight; this is not true. You can lose weight by changing your diet alone with no exercise. 
• There has been a rise in the last few years in the incidence of arthritis and osteoporosis. There is much evidence to support that diets high in protein and animal products lead to inflammatory diseases such as arthritis, eczema, and even asthma and are also one of the leading causes of osteoporosis. Decreasing the amount of animal products and increasing the amount of vegetables, legumes and whole grains in your diet is enough to decrease the inflammatory process in your body and relieve pain. Weight bearing exercise, even in the elderly, have been shown to improve bone health. Annemarie Colibin's book The Whole Food Guide to Strong Bones is an excellent resource for those looking to increase their bone health. 
• People with chronic back pain should consider yoga,massage and acupuncture as an alternative pain management regimen to narcotics. These are not quick fixes, but they have virtually no side effects and will leave you conscious. Medical marijuana has become increasingly popular and proven effective in many conditions such as migraines, chronic pain, seizure disorders and improving appetite. I can honestly say that I have never taken care of someone who overdosed on marijuana. 
• If the pain you experience is of an emotional source, then I can tell you now that the road to recovery is not going to be a "quick fix." If you never get to experience depression at its fullest then you are denying yourself the opportunity to realize exactly what it is that needs to be changed to make your life better. Depression forces us to be alone and be stuck in our heads. Its purpose is to help you focus on yourself. If you use narcotics, alcohol or other drugs to numb your depression, you will never get better. The first step is to kick the substances with whatever help it takes. The second step is to seek long-term happiness through good social and family connections and find a purpose in your life outside of yourself; what can you do to improve the world that you live in?

There are many sources of pain in this world whether it be from a surgical, physical, or emotional origin. Pain is a part of life and it serves a vital purpose in reminding us that we are human and we are mortal. It is often a friendly reminder that life can be short and that we should savor what we have because you never know when it will be gone. Using narcotics to mask pain is a highly dangerous practice that medical professionals and the community should be aware of. Narcotics should be a last resort in pain management. It is important to protect yourself from the "quick fix" system by informing yourself and demanding pain management alternatives from your physician.