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xofromdanielle14 karma

Is it 9-10 with pain medication on board or without it? We’re going to have to agree to disagree, but the research is very much against the idea that chronic pain is best managed with opiates.

As I explain in another post here chronic pain and acute pain are two different things.

Like I said, there’s a reason the Mayo Clinic’s chronic pain program doesn’t support the use of pain medication.

My screaming into a pillow suggestion is only for temporary relief. Different things will work at different times.

The ultimate relief comes to acknowledging the root of your pain problems and learning to live with it as a part of you vs. something you have to fight against.

I once was very adamant about my pain being 15+ after all, I get pancreatitis regularly, had a feeding tube for three full years and have spinal problems to the point where I have endured two major neck surgeries. I’m only 32.

I am not saying it is easy, all I’m saying is it is possible to learn to manage your pain. I’m not gonna say if I can do it you can do it too, because we’re all different. I will tell you if I can do it you at least have a chance. (Using you in the general audience sense)

Does pain medication work because you believe it does? What if you truly believed that other methods worked too?

I personally do not believe in daily opiates. I do believe they should be used acutely or for flare ups that are above and beyond normal. IE: I’m just now recovering from a hospitalization where my pancreatic enzymes were sky high. I chose not to use opiates in that situation. Personally, because I know it would trigger me into a worse situation than I already was in. However, I have no problem acknowledging that when needed opiates do serve a purpose ACUTELY and SHORT TERM.

Hyperalgesia is a very real thing and this narrative that opiates are the only way is very harmful.

If your skin is falling off or if your bones break at the slightest touch chances are you have a terminal illness and I’ll be very loud and clear when I say terminally ill think cancer, sickle cell, etc. patients should have access to pain medication regularly. At that point the benefits outweigh the risks but hEDS is not terminal and neither is my pancreatitis or degenerative disc’s disease. Or fibromyalgia, or endometriosis etc. etc.

I will agree that opiates do need to be destigmatized as does addiction. Addiction is not a moral failing. It is a disorder just like diabetes and like any other disorder it needs to treated appropriately.

xofromdanielle8 karma

I’m a chronic pain patient that was once like you. I saw the benefit of opioids and thought opioids were necessary.

I have a rare pancreatic condition that causes extreme problems. I do not use any opiates anymore and firmly believe that chronic pain is rooted in the brain differently than acute pain.

At its most simplified form chronic pain occurs because brain wires get crisscrossed and the body is overly sensitive to the experience of pain. Chronic pain is also more closely rooted to your emotions because of where it originates in the brain.

Whereas acute pain indicates there’s an actual injury that needs your attention. Immediately. It originates in a different part of the brain than chronic pain. Closer to your primal instincts vs. memories in the brain.

There is a lot of research indicating that acute pain is best treated with opioids whereas chronic pain (other than end of life chronic pain) is best treated through cognitive behavioral therapy modules.

What are your thoughts on this?

Speaking as a chronic pain patient in recovery from addiction I can say there’s a lot of science that is proving opioids on a daily basis are ineffective for chronic pain and I found by doing hard emotional work I was able to learn how to manage my chronic pain in a much healthier manner.

I can talk more about how I did that and how long it took before I saw any benefits, if you’d like to hear/learn more, but I know it is possible and the freedom from opioids has been life changing for me.

I do agree that opiate use and substance abuse disorder/how we handle addiction needs to be addressed and destigmatized, but I think this narrative that opiates are appropriate for long term chronic pain is harmful.

Post edit to include sources:

Sources for chronic pain/neuropathways and the brain:

Vogt, B. A. “Pain and emotion interactions in subregions of the cingulated gyrus.” Nature Reviews Neuroscience 6 (July 2005): 533–544.

Baliki, M. N., Geha, P. Y., Apkarian, A. V., and Chialvo, D. R. “Beyond feeling: Chronic pain hurts the brain, disrupting the default-mode network dynamics.” The Journal of Neuroscience 28, no. 6 (2008): 1398-1403

Mackey, S. “The strain in pain lies mainly in the brain.” Stanford School of Medicine, Pain Management Center.

National Institutes of Health. The Brain: Our Sense of Self. Colorado Springs: BSCS, 2005.

Richeimer, S. “Understanding neuropathic pain.” USC Pain Management. http://spineuniverse.com/displayarticle.php/article1614.html

How we can change our brain (in general) simply by changing our thoughts:

Begley, S. “The lotus and the synapse.” Newsweek, March 25, 2008. http://www.newsweek.com/blogs/lab-notes/2008/03/25/the-lotus-and-the-synapse.html

How truly believing something can change your pain is extremely effective:

Scientific Blogging. “Nucleus accumbens and the placebo effect.” http://www.science20.com/news/nucleus_accumbens_and_the_placebo_effect

I can provide more, if anyone wants it. I highly recommend the following books on the matter:

  1. A Day Without Pain by Mel Pohl
  2. Neuroplasticity: Your Brain's Superpower: Change Your Brain and Change Your Life by Philippe Douyon MD
  3. Pain: Its anatomy, physiology and treatment: Third Edition by Aage R. Moller PhD

xofromdanielle1 karma

Please see my post edit for sources.

xofromdanielle1 karma

I find it very interesting that OP is allowed tell their story in an anecdotal manner with no sources, yet someone with a conflicting opinion is required to provide them. Anywho, I did go ahead and post a few of my sources in the above comment because it is an important topic and something that I'm not just making up.

Thank you for going ahead and providing that link for me. I appreciate it.

xofromdanielle1 karma

Please see my post edit.