Tag: painkillers

Favorites, News & Research, Society, Treatment

“Potheads and Sudafed,” a New York Times Editorial

Kerrie Smyres

“Potheads and Sudafed,” a NY Times editorial that ran yesterday, caught the attention (and raised the ire) of About.com’s headache page guide, Teri Robert. The article addresses issues raised by the FDA’s denial of medicinal marjiuana’s efficacy. Columnist John Tierney writes of the conundrum:

Officially, the D.E.A. says it wants patients to get the best medicine. But look at what it’s done to scientists trying to study medical marijuana. They’ve gotten approval for their experiments from the F.D.A., but they can’t get the high-quality marijuana they need because the D.E.A. won’t allow it to be grown. The F.D.A. actually wants to know if the drug works, but the D.E.A. is following the just-say-know-nothing strategy: as long as researchers can’t study marijuana, they can’t come up with evidence that it’s effective.

And as long as there’s no conclusive evidence that medical marijuana works, the D.E.A. and its allies on Capitol Hill can go on blindly fighting it. Representative Mark Souder, the Indiana Republican who’s the most rabid drug warrior in Congress, has been pressuring the F.D.A. to crack down on medical marijuana. Last week the agency finally relented: in return for not having to start busting anyone, it issued a statement stressing the potential dangers and lack of extensive clinical trials establishing medical marijuana’s effectiveness.

For more information about the DEA’s stance, see this post.

FYI: The article is only available on the Times site if you have a paid subscription, but you can probably use your public library card to read it in a full-text newspaper database online. (The database I used is called ProQuest and I accessed it trhough the magazine and newspaper section of the library’s databases. These specific details are only applicable through my library, of course, but I hope they help you navigate your library’s website.)

Society, Treatment

DEA’s Stance on Pain Explained

Kerrie Smyres

Anyone with pain that requires opioid treatment must read this article on the DEA’s stance on painkillers. In fact, I think everyone who lives in the US should read the article.

Entitled “Treating Doctors as Drug Dealers: The Drug Enforcement Administration’s War on Prescription Painkillers,” this 35-page journal article overflows with illustrative information. Print it out and grab your highlighter. The time investment is well worthwhile.

Here’s the abstract:

Since 2001, the federal government has accelerated its pursuit of physicians it alleges are contributing to an increase of prescription-drug addiction. These highly publicized indictments and prosecutions have frightened many physicians out of the field of pain management, exacerbating an already serious health crisis—the widespread undertreatment of severe chronic pain.

[via Kevin, MD]

News & Research, Treatment

Toxicity of Tylenol

Kerrie Smyres

Before I was diagnosed with migraine and CDH, OTC painkillers were my constant companion. It was in the pockets of my jeans, buried in the bottom of my backpack and in little plastic bags strewn about my car. I’d find pills nestled in the carpet and in my bed. You get the point.

Even though my drug of choice was sold OTC, I knew that I shouldn’t take as much as I did as often as I did. But the risks were vague enough for me to ignore them. I’m not nice enough to let you ignore them too.

Get this: Overdoses of products that contain acetaminophen account for 40 to 50% of all acute liver failure cases each year in the United States. A recent study in the University of Michigan Health System showed that about half of these overdoses were the unintentional side effect of treating an ailment, like headaches. The researchers deemed these cases “therapeutic misadventures.” (Isn’t that a perfect description? It conveys the situation so clearly.)

Even if someone is careful to stay within the prescribed daily dosage of Tylenol, there’s a risk of accidentally combining it with any one of a number of other drugs that have acetaminophen as one component of many. More than 150 OTC drugs, from cold treatments to sleep aids to fever reducers, contain acetaminophen. Midrin, a prescription migraine abortive, has acetaminophen in it, as do many other prescription drugs, including painkillers.

You aren’t doomed to liver damage or failure if you take Tylenol. The University of Michigan offers these guidelines to keep yourself safe while taking acetaminophen:

  • Before taking acetaminophen, tell your doctor if you have ever had liver disease or if you drink alcohol daily or on a chronic basis
  • Carefully read the labels on all medications so you are aware of their acetaminophen content (both prescription and OTC)
  • Acetaminophen is found in Tylenol-brand products, some varieties of Excedrin, FeverAll, Genapap, Percocet and more
  • It is included in combination products, such as Midol Teen Menstrual Formula Caplets containing Acetaminophen and Pamabrom
  • Many prescription pain relievers also contain acetaminophen, such as Lorcet Plus, Darvocet and Vicodin
  • In case of an overdose, call your local poison control center at (800) 222-1222
  • Keep medications locked up or out of reach of children.
  • Do not take the full day’s dose of acetaminophen at one time; space it out over the course of the day

All that said, if you are taking enough Tylenol or any OTC painkiller to be worried about liver damage, you’d probably be best off seeing a doctor about your headaches. You could be having rebound headaches or you could be treating yourself for the wrong problem . It can take a lot of time and energy to find a healthcare provider that you like and a course of treatment that’s effective for you, but you’ll feel best in the long run if you make this commitment.

11/4/08: I’ve closed comments on this post because of excessive spam.

Meds & Supplements, News & Research, Society, Treatment

Sunday’s 60 Minutes: Pain & Desperation

Kerrie Smyres

Richard Paey, a chronic pain patient who is serving 25 years in prison for his frequent refills of pain meds will be interviewed on Sunday’s 60 Minutes. He was charged with prescription forgery, unlawful possession of a controlled substance and drug trafficking.

Ironically, the same judicial system that prosecuted Paey is now supplying him with more pain medication than he took before his prison term.

The show airs at 7 p.m. EST on Sunday, January 29.

Meds & Supplements, Treatment

Balancing Compassion and Cynicism in the ER

Kerrie Smyres

Unless a migraine is intolerable, a migraineur won’t go to the loud, bright, frenzied ER. Who would willingly subject themselves to that without desperately needing pain relief? But for most migraineurs, the visit is a harrowing back-and-forth between patient and staff. They don’t get their pain treated adequately and they leave furious with doctors and nurses who question the legitimacy of their complaints.

While patients know what their own pain is like, ER staff don’t know the individual, but the patterns of many people. Some of these patients are truly in pain and others are looking for a fix. The patterns leave an imprint so that even the most compassionate doctors and nurses struggle to be caring, not naive, and cautious, not cynical.

Using migraine patients as an example, Kim from Emergiblog, who has been a nurse for 27 years, fights to balance this contradiction. Although she is sympathetic to chronic pain patients, she can’t forget the times that she’s been fooled. She illustrates the dilemma eloquently and has terrific tips for chronic pain patients to get better care in the ER.

[from Jessica via Migrainepage]