Banchory Chiropractic Clinic

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Painkillers – Do the Risks Outweigh the Benefits?

types_of_painkillers

A recent article in the daily telegraph regarding opioids has prompted me to write a piece about painkiller use.

Many of today’s painkillers like codeine, hydrocodone, oxycodone and tramadol are based on the opioid narcotics of the past. Opium and heroin made popular years ago are today regarded as highly addictive, dangerous and illegal.

However – today hundreds of thousands of people are dependent, addicted and stuck on these dangerous, ineffective painkillers.

Opioids painkillers were pushed through government regulations in order to give people with chronic pain from incurable cancers a form of relief. Some people believe that like many other dangerous medications these drugs were pushed through quickly by pharmaceutical companies trying to maximise profits and are today used treat various other conditions like neck pain, headaches, low back pain, fibromyalgia and arthritis.

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A recent review (1) of the available research regarding the safety and effectiveness of commonly prescribed opioids suggests that “the use of opioids chronically for most routine conditions, such as chronic low back pain, chronic headaches, or fibromyalgia, will not prove to be worth the risk”

Neurologists say the drugs have sparked an “epidemic” of deaths among vulnerable young and middle-aged people, as well as increasing numbers of overdoses and addiction. They also trigger other serious side effects, according to the report.

Codeine is the most widely used strong pain relief medication in the world and is available on prescription and over the counter in many products including Nurofen Plus and Solpadeine.

Previous research has shown codeine is not effective for the most common types of headache – “Opioids are not recommended for use in treating tension-type headaches, and fewer than 20% of patients with daily headache improve in sustained reduced pain and function” (2)

Around 27 million pills containing codeine are sold in Britain every year in a market worth £500 million.

Perhaps, one might think, that taking medication like this is appropriate if used on a temporary basis.  However it has been shown that it once you start taking such strong drugs you are unlikely to stop .  American Academy of Neurology says studies have shown half of patients taking opioids for at least three months are still on them five years later.

So why would this be a concern?

These drugs have of course been given the go-ahead to be used in prescriptive and over the counter medications, however what a lot of people might not be aware of is that there is a high level of mortality when it comes to the long term use of these drugs.  Professor Gary Franklin, of Washington University who wrote the study “More than 100,000 people have died from prescription opioid use since policies changed in the late 1990s to allow much more liberal long-term use.  In the US there have been more deaths from prescription opioids in the most vulnerable young to middle-aged groups (age 35–54 years) than from firearms and car accidents.”

Official figures show more than 30,000 people in the UK have become addicted to drugs containing codeine, which led to warnings being put on packets in 2009.

Packet sizes for over-the-counter products were also limited that year to just 32 tablets – with larger packs available only by prescription. Consumers are told not to take them for more than three days at a time because of fears of misuse.

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We are very sympathetic to those who suffer with chronic, severe pain regularly.  However, we strongly recommend that individuals explore every other possible method of pain relief before taking these strong and risky drugs.  Many people find just as effective pain relief from other approaches, without the side effects and serious risks associated with opioids.

Here are 7 other options that may help with pain relief:

  1. Eliminate or radically reduce most grains and sugars from your diet – Avoiding grains and sugars will lower your insulin and leptin levels and decrease insulin and leptin resistance, which is one of the most important reasons why inflammatory substances in your body are produced. A study from the National Institute for Health found a strong link between high pain levels and sugar intake in women suffering with fibromyalgia. (3)
  2. Take a high-quality, animal-based omega-3 fat – Omega-3 fats are also known as essential fatty acids.  These fatty acids are essential because they are involved in many processes within the body.  They have been shown (in many studies!) to be an effective tool in pain relief, especially for arthritic conditions. (4) As a side-note the same meta analysis study highlighted the effectiveness of omega-3 supplementation for irritable bowel disease (IBS)  and dysmenorrhea (painful periods).
  3. Chiropractic – Of Course!
  4. Acupuncture – Acupuncture has repeatedly been proven to be an effective adjunctive treatment in many chronic pain conditions (5).  It has even been suggested that acupuncture could replace analgesia in some minor surgeries!
  5. Massage therapy – For many years in many societies, a massage would be the first-line therapy for pain.  It is common in some eastern cultures to get a massage as often as weekly, regardless of pain levels.  In our clinic we quite frequently refer patients for a massage with our recommended therapists.  Here is some quick info about the benefits of regular massage.
  6. Yoga, meditation and mindfulness techniques – In a study performed in 1985 (so not new information!) ninety chronic pain sufferers were put through a 10 week yoga and mindfulness relaxation programme.  It was found that” Statistically significant reductions were observed in measures of present-moment pain, negative body image, inhibition of activity by pain, symptoms, mood disturbance, and psychological symptomatology, including anxiety and depression.” (6)
  7. Vitamin D – Vitamin D deficiency has been linked to chronic widespread pain in women particularly (7) and another study has shown that Vitamin D repletion resulted in a significant reduction in pain with patients suffering from neuropathic pain (8) (which is notoriously very difficult to deal with!!). This time of year we always have plenty of Vitamin D drops for sale! See why vit D is important HERE

 

A Final Note

Please don’t assume we are unsympathetic to those in chronic pain.  We are pain specialists and feel very strongly for long term pain sufferers.  Our outlook for patients is always positive as we see so many success stories in the clinic (still not convinced? look HERE.  If you would like our opinion on your condition please call 01330 824040.

References:

  1. Franklin, Gary M. Opioids for chronic non-cancer pain: A position paper of the American Academy of Neurology. Neurology 2014;83;1277-1284
  2. Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G, Schoenen J. EFNS guideline on the treatment of tension-type headache: report of an EFNS task force. Eur J Neurol 2010;17:1318–1325.
  3. Gayle M. Timmerman, Gayle M., Associate Professor, Nicolina A. Calfa, MC, Doctoral Candidate, Counseling Psychology, and Alexa K. Stuifbergen, PhD, RN, FAAN, Professor.  Correlates of Body Mass Index in Women with Fibromyalgia.  Orthop Nurs. 2013 Mar-Apr; 32(2): 113–119.
  4. Robert J. Goldberg, Joel Katz.   A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain.  PAIN Volume 129, Issue 1 , Pages 210-223, May 2007
  5. Andrew J. Vickers, DPhil; Angel M. Cronin, MS; Alexandra C. Maschino, BS; George Lewith, MD; Hugh MacPherson, PhD; Nadine E. Foster, DPhil; Karen J. Sherman, PhD; Claudia M. Witt, MD; Klaus Linde, MD.  Acupuncture for Chronic Pain – Individual Patient Data Meta-analysis.  Arch Intern Med. 2012;172(19):1444-1453.
  6. Jon Kabat-Zinn, Leslie Lipworth, Robert Burney.  The clinical use of mindfulness meditation for the self-regulation of chronic pain.  Journal of Behavioral Medicine.  June 1985, Volume 8, Issue 2, pp 163-190
  7. K Atherton, D J Berry, T Parsons,G J Macfarlane, C Power, E Hyppönen.  Vitamin D and chronic widespread pain in a white middle-aged British population: evidence from a cross-sectional population survey.  Ann Rheum Dis 2009;68:817-822 doi:10.1136/ard.2008.090456
  8. Paul Lee, MBBS (Hons); Roger Chen, MBBS (Hons), FRACP, PhD.  Vitamin D as an Analgesic for Patients With Type 2 Diabetes and Neuropathic Pain.  Arch Intern Med. 2008;168(7):771-772. doi:10.1001/archinte.168.7.771.

 

Felicity Rogers

Felicity graduated from the Welsh Institute of Chiropractic in 2007 upon completion of a BSC degree in Chiropractic and has been working as a Chiropractor in the UK for over 7 years.

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