By the time you finish reading this newsletter, another American will have died from an overdose of opioid painkillers like morphine, Vicodin, or OxyContin.
It’s become an epidemic. In 2014, nearly 30,000 people died from opioid overdoses, half of whom had legitimate prescriptions. Prescribing statistics in the UK show a similar rate of rise in opioid use, so it is no surprise to read a growing number of reports warning about the storm of misuse and opioid-related deaths that is predicted to hit us. An article in the British
Journal of Pain reports that if we don’t take action, then the UK could end up in the undoubted opioid chaos seen in the US at the moment.
Now, the US Food and Drug Administration (FDA) is trying to get control of the problem with some very serious changes. They instituted stricter guidelines to deter doctors from liberally and haphazardly prescribing these addicting medications to patients with pain problems.
They make it very clear that opioid-based pain drugs should be used as a ‘last resort’ – and only for short periods of time. And they’re insisting on some new – and pretty bizarre – testing requirements for both doctors and patients.
On one hand, you have to give the FDA some credit for finally acknowledging how serious this issue has become in America. But… and this is a big ‘but’… the US government has botched these regulations pretty badly.
For chronic pain sufferers, these new rules could leave them – and their doctors – in the lurch. It is important that the UK medical authorities and government pay close attention to what is taking place across the pond right now with regards to opioid prescriptions, so UK patients and doctors aren’t also left in the lurch if lessons aren’t learnt.
Refusing to treat pain won’t make it go away
Under the new regulations, doctors who prescribe pain medications must operate under what’s called an ‘assumption of suspicion’. In other words, they have to conduct regular urine testing on their patients.
But it’s not to keep you from taking too much of the drugs – it’s to confirm that the drugs are actually in your system. Because if they’re not, the theory is that you must be selling these drugs on the black market.
And then, the drugs are taken away from you, despite the fact that you might have just been taking a couple of days off.
What kind of heath care system FORCES people to take a drug every day… or not at all?
In many ways, the new guidelines tie doctors’ hands behind their backs, imposing a system of bureaucracy that includes contracts, checkpoints, reports, and a whole lot of red tape – none of which do anything to LESSEN PAIN.
It’s no wonder that nearly half of doctors who were surveyed said that these new rules would force them to stop prescribing narcotics like opioids, or at least reduce the amount that they’re going to prescribe.
But there are millions of patients in chronic pain. And if primary care doctors are going to shy away from prescribing morphine-based medications, then we are on the verge of a crisis of massive proportions.
There’s about to be a huge problem – and there are going to be some very confused and cranky patients who are going to be in a lot of pain and have nowhere to turn.
Yes, there are doctors who specialize in pain, and these doctors provide some interesting treatments (mostly epidural injections of steroids in to the spine). But there aren’t many of these doctors around now, and most of them have been booked solid for weeks to months even BEFORE these new regulations were announced.
So, if nearly half of doctors are going to reduce or eliminate the number of pain medications they prescribe… and it’s very difficult to get an appointment with a pain doctor… what the heck are all these patients currently on painkillers going to do?
And what happens if you aren’t in pain now, but you are in the near future?
Caught between a rock and a hard place
While I applaud the FDA’s bold move in admitting that these prescription drugs are causing serious harm to patients, I’m saddened that they didn’t reach out to the alternative medical community first to get some other strategies for pain control that aren’t ‘medication-based’.
If only they would’ve just asked for our help!
In fact, I am shocked at their total lack of any backup plan. The new guidelines mention some alternatives for people in pain, but here’s where I really take issue. They want you to take other drugs – NSAIDs like ibuprofen or aspirin, paracetamol, antidepressants, or seizure drugs – that carry a host of their own risks!
NSAIDs like ibuprofen lead to thousands of deaths per year and countless hospital visits due to their obvious damage to the gut lining and kidneys. And as you know, aspirin has its risks and benefits, too – but when you take it for pain control (meaning higher than the ‘baby’ dose of 81mg.), you run a high risk of intestinal bleeding.
Paracetamol (acetaminophen) has less gastrointestinal side effects, but it stresses your liver and severely depletes the all-important glutathione levels in your body… which leads to a whole host of other severe medical issues.
Antidepressants and seizure drugs numb your pain receptors – but they also come with a laundry list of side effects and can actually leave you feeling numb all over!
So what kind of ultimatum have the US medical authorities given patients, then? They can:
- Continue to have thousands of people die each year due to opioid-related overdose and have many more addicted;
- Increase the number of NSAID related deaths and/or increase the long, slow death from the
use of paracetamol; or
- Just leave everyone ‘numb and tired’ from antidepressants and seizure drugs.
Come on! We’re talking about people on morphine and other opioids, dealing with serious pain.
Not one of these is a good short- OR long-term solution.
Quite frankly, I think these recommendations are laughable. If NSAID’s, paracetamol, antidepressants, and seizure drugs truly worked on that level of pain, doctors wouldn’t have had to turn to such powerful drugs.
Let’s face it: One of the reasons that we got in to this conundrum to begin with is that the conventional medical community hasn’t had any great pain options.
Pain is a physical problem that needs something WAY more than a plaster. But we can’t just pop these pills to make the pain go away unless we’re willing to accept these dire side effects and risks.
Don’t just clear the smoke – extinguish the fire
What’s amazing to me as an integrative doctor is the multitude of other options that exist that conventional doctors either don’t know about, don’t believe in, or don’t want to recommend.
Granted, some of these options aren’t as easy as popping a pill. But they ARE effective for a large percentage of people, and they’re actually ‘good for you’ – because first and foremost, this alternative approach to pain control is to find the ROOT CAUSE of the pain.
And there are four culprits that are often to blame.
- Food sensitivity: You’d be amazed at what certain foods can do to your joints! The most
common offenders are gluten and casein (the main proteins found in wheat and dairy), but sugar isn’t far behind.
Conventional doctors often miss food sensitivities as a cause of pain because they aren’t quite as obvious as food allergies. In the case of a sensitivity, the foods don’t cause an immediate response. Instead, they start wreaking their inflammatory havoc about two hours (or so) after you eat the offending food. It could even take up to 72 hours before you feel any effects! An integrative doctor like me can perform a food sensitivity test to find out which foods you should avoid.
- Toxins: Exposure to heavy metals such as mercury and lead can cause pain from a slow, insidious process of damage to your nervous system. And other toxins, like mould, can cause some unusually severe inflammatory reactions.
You can work with an integrative doctor to help determine your toxic load and work out a potential detoxification process. I’m a fan of oral detoxification supplements such as chlorella or PectaSol, as well as sauna therapy to sweat toxins out right through the skin.
- Chronic infections: If the pain and inflammation is infection-related, there are some amazing herbs (such as garlic and cat’s claw) with anti-inflammatory properties that can work really well.
- Misalignment of the body: You can take all the morphine you want to forget that your
body is out of whack, but the only way to actually get rid of the pain is to put everything back in its right place.
Easing pain shouldn’t lead to something worse
If you’ve been on opioids for weeks… or months… or even years, work with your doctor on addressing the root cause of your pain rather than covering it up.
Keep in mind that your body may be physically dependent on the drugs, so it’s important to wean off them slowly to minimize any symptoms of withdrawal (which can range from agitation to vomiting).
Now, addressing the root cause of pain isn’t a ‘quick fix’ – so while you’re healing, you’ll probably still experience some pain, at least for a while.
But you don’t have to just bite the bullet for the rest of your life… and you don’t need to take addictive drugs… or ones that might make your stomach bleed.
First of all, you could do what I call a ‘detox week’, when you eat only organic vegetables, fruits, and protein – basically, the Paleo Diet – for seven days. So many of my patients have seen their chronic pain turn around miraculously when they make this dietary change, which reduces foods you may be sensitive to AND your exposure to toxins.
As for straight pain control and anti-inflammatory treatments, I’m a fan of supplements like curcumin and boswellia, both of which are available at reasonable prices at your local health-food store.
And, as I shared with you in the April issue of Nutrition and Healing, I’ve been seeing some amazing success with a proprietary extract blend in the form of a medical food called Limbrel. It’s stood toe-to-toe with NSAIDs in clinical studies and come out equally as effective in alleviating pain.
I’ll admit that these alternatives aren’t as powerful as morphine – but they’re a LOT safer for you to take, without risk of addiction, overdose, or death.
And you can try different ways of combining these therapies to get the pain control that you need.
There’s a legion of other alternative and complementary therapies that you can try as well – and they go way beyond the ones your doctor may have suggested (like talk therapy or exercise).
I’ll explore those in depth in next month’s issue.
Dr. Glenn S. Rothfeld
Nutrition & Healing
Vol. 10, Issue 7 • July 2016
Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.