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Reporting on Narcotics & Headache: What a Mess

ABC World News Tonight’s three-part series on migraine is raising awareness, but now all I can think is, be careful what you ask for. Really, what’s worse, a lack of understanding of the seriousness of headache or a feature story on the bad patients who take narcotics, thus worsening their pain?

The story, entitled Warning About Using Narcotics to Treat Migraines, looks more like a warning about treating undiagnosed headache with narcotics or using them as an early line of defense. According to the article, people who go to their doctors and complain about headache get prescriptions for narcotics about 70% of the time.

Triptans are offered up as the better alternative. But triptans, although they can be used to treat other episodic headaches, are primarily thought of as migraine drugs. I don’t have quantifiable evidence of this, but I doubt most GPs would consider treating non-migraine headache with triptans. Since half of migraineurs are undiagnosed or misdiagnosed, it’s clear why so many people with migraine aren’t treated with triptans.

There are probably a lot of people with headache who are given narcotics too early in their treatment. That doesn’t mean that no one with headache should use opioids to treat pain. Even though the story sets up a pain specialist and a headache specialist as representing opposing opinions on this, they both say basically the same thing: If no other treatment works, narcotics can make life bearable.

I think that ABC’s story was based on an analysis from the March issue of The Journal of Headache and Pain that highlights all these important issues without making us all look like drug addicts. Medical News Today summarizes:

“. . . of the patients diagnosed with migraines, only 50 percent received a prescription medication commonly used to treat headaches; of those, 59 percent received narcotics/opioids while only 41 percent received triptans. . . .”

“The analysis also suggests a high incidence of under-diagnosis and/or misdiagnosis of migraine. Nationally, approximately 12 percent of people suffer from migraines; however, in this data set, only 3 percent of subjects had a diagnosis of migraine, much lower than the national prevalence level. Therefore, the analysis confirms that there is a need for greater education and awareness of migraine.”

6 Responses to Reporting on Narcotics & Headache: What a Mess

  1. Diana says:

    I think they did us a *huge* disservice. They completely distorted the issues facing migraineurs and made us look like a bunch of morons who take the wrong drugs for no apparent reason. Thanks, ABC.

  2. katy says:

    Thank You for posting this article! I’ve been wondering what on earth went down on that day, but I missed it. Some people in an online migraine community I’m in are quite upset about this but I was really confused as to what the issue was. Not anymore! Thanks again! 🙂

  3. Kerrie says:

    And it seemed so promising. Today I’m up in arms about this one: http://abcnews.go.com/GMA/Health/story?id=1710002&page=1

    K

  4. katy says:

    A simple nasal surgery…that is neither named or defined! And look!! It changed all of her blood vessels too! Lordy.

    “I couldn’t drink wine,” she said. “I couldn’t eat chocolate and, you know, I’ve done both with no ill effects since the surgery.”

    I started a blog the other day finally because I am just so tired of the stigma about opioids. I am on long-acting opioid therapy and that story was sort of a last straw…and now I can’t even tell if they are on any level knowingly contributing to the propaganda and the stigma, or if these people at ABC are simply DENSE. wow.

    ************
    I like the way you think! Your blog looks great. I’m looking forward to reading more and have added it to my blogroll so others can enjoy it too.

    K

  5. Sarah says:

    Keep in mind, these are people who base their whole argument on the study of some few who had problems “eating chocolate” or “drinking wine”. If those two things constituted the majority of my problems when I have a headache…well, I would count myself pretty lucky wouldn’t I? Maybe they should try to interview some one else, like me, when I’m lying on the floor sobbing and contemplating using a drill bit on my temple to alleviate some pain. To withhold Narcotics from someone in the state that I’m in is cruelty, a cruelty I know too well. There is another option though, for those doctors and reporters who think that narcs are never the answer: Tramadol. It’s synthetic, attaches itself chemically to to same pain relieving opi receptors in your brain, and although its not always AS effective as say, a straight shot in the rear, it can help me to function well enough to get into the shower on bad days. Not much else though.

  6. CP says:

    I have had H/A over 20 yrs. I have been tried on over 50 meds to no avail.. Narcptics are the last line of defense. To withhold these is ‘cruel and unusual’ punishment, especially after all the meds I’ve been on. The ppl who say narcotics should not be used for HA should be drawn and qaurtered, or at least be made to deal with these with a pain level of 6-10 on a daily basis like me… maybe then they would understand taht it’s not 100% wrong!

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