As the treatment for chronic pain morphs into more opiate prescriptions, the rate of addiction and its consequences continues to climb. This doesn’t mean we should stop treating pain or that everyone prescribed opiates will become addicted. But it should give us pause and make us realize that just taking a pill doesn’t fix chronic pain – and doing so cause harm us in the long run.
Like many of us these days, doctors are feeling the pressure of being asked to do more work in less time. This burnout is a big problem for both doctors and their patients, and it has big consequences — some obvious, some less so. In this post, Dr. Adelman explores the relationship between physician burnout and another big problem facing the country — the opioid epidemic.
When a patient calls a new doctor begging for a refill on their pain medication, what should the doctor do? Denying medication to someone in significant pain seems unethical — but denying it to someone who’s suspected to be reselling it is a whole different story. Doctors now have systems in place to help them make the right call. But even these systems can’t replace the most critical piece of the puzzle — empathy.
If you’ve looked up from your phone recently — or even if you haven’t! — you may have noticed that many children and teens are glued to their devices. While experts aren’t quite ready to call this an “addiction,” a new survey of parents and teens confirms that many of them suspect they’re too dependent on their devices. We’ve discussed the potential implications of this, plus suggested some “ground rules” for when to ignore those devices.
Many people cite a lack of “motivation” or “willpower” as the reason that overweight people can’t control their eating habits. But a wealth of evidence has come to light that obesity is linked to insufficient sleep. Most recently, an experimental study has found that restricted sleep can increase the levels of brain chemicals that make eating pleasurable. Could it be that insufficient sleep makes the brain addicted to the act of eating?
Several long-term treatments can help people overcome opioid addiction. One of them, naltrexone, may help people who have trouble sticking with taking a pill every day. Naltrexone can be offered as a monthly injection called Vivitrol, which has been shown to help more people stay on treatment as compared to the pill form. However, it’s not for everyone, and like all treatments for opioid addiction, it must be used very carefully.
Ninety percent of smokers had their first cigarette before turning 18. A movement to raise the legal age to buy tobacco in the United States to 21 hopes that making it more difficult for young people to start smoking may lead to a healthier population overall.
A look into the “brain science” behind substance use disorders highlights the fact that for many people with addictions, “just say no” just doesn’t work. The biological underpinnings of addiction teach the brain to react unusually strongly if deprived of drugs, which can make recovering from an addiction incredibly difficult. Fortunately, it’s possible to teach the brain to rediscover healthier sources of joy and reward.
A recent study of nearly 3,000 patients who had an overdose during long-term opioid treatment found that more than 90% of these patients continued to receive opioids — even after their overdose. Poor communication between emergency rooms and prescribing doctors is likely the culprit. What’s more, doctors receive little training in recognizing patients at high risk for overdose, or in treating addiction when they do spot it. An important strategy to address the current opioid crisis is to improve how doctors are educated about opioids.
When it comes to pain management, focusing only on reducing the intensity of pain may lead to treatments that do as much harm as good. Ideally, pain-management plans should be tailored to each patient and include a range of therapies that not only reduce pain but also help improve pain-related quality-of-life problems.