FROM OUR EXPERTS
Researchers have discovered why many fibromyalgia patients complain that even strong narcotic pain medications fail to relieve their pain. A study at the University of Michigan Health System found that the mu-opioid receptors (MOR) in people with fibromyalgia had a reduced ability to bind to the drugs targeting them. The researchers did positron emission tomography (PET) scans of 17 women who had fibromyalgia and 17 women who did not. Results showed that the fibromyalgia patients had reduced MOR availability within regions of the brain that normally process and dampen pain signals –– specifically, the nucleus accumbens, the anterior cingulate and the amygdala. Opioid medications work by binding to opioid receptors in the brain and spinal cord. When those receptors have a lowered availability, the painkillers may not be able to bind to the receptors as well as they should, which means they cannot alleviate pain as effectively. Among the drugs that would be affected b...
There was an article in the New York Times recently about a couple away on a lovely vacation in Indonesia and the husband accidentally fractures his ankle. Not so lovely. Their cell phones turn out to be the most reliable tool they have. They make the decision not to have surgery in a foreign country and then have to figure out how to get him home.
It all sounded rather painful and unpleasant. His ankle fracture and subsequent pain reminded me that I still have 49 Percocet tablets in my cupboard.
Let me explain.
I had surgery in the early fall. As part of the post-op pain management plan they prescribed Percocet, 50 pills. The prescription reads: one or two, every three to four hours as needed, enough for days upon days upon days. Too many pills in my opinion, way too many.
I had taken one right after surgery in the recovery room for pain I didn't yet feel and one more when I got home. That evening, I had horrible withdrawal from all of the medication and certainl...
Migraineurs and other chronic pain patients who use narcotics (opioids) are often asked to sign narcotics contracts, or treatment agreements, with their doctors. These contracts establish the rules for the doctor’s prescribing narcotic pain medications. They require that the patient submit to random or scheduled drug testing to determine if they are taking the proper amount of the drug and that they are not taking any other pain medications or illicit drugs. If patients fail the test, these contracts allow the doctor to terminate care. Who do these contracts protect? Doctors can get into big trouble for over-prescribing controlled substances, or helping people with addiction or substance abuse issues get them. These contracts are an attempt to limit doctor’s exposure to prosecution for misuse of controlled narcotics. Research shows that it’s not usually chronic pain patients who abuse narcotics. Pain medication is widely under-prescribed, and pain u...
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