Thursday, August 25, 2011

Should Holistic Therapies Replace Narcotic Medications?

By David Greene, MD, CEO


Narcotics are the most popular method for treating chronic pain. In the decade 1997 to 2006, there was a narcotic usage percent increase of 347 percent in the US (Dartmouth Medicine Magazine). This has lead pain management doctors to begin asking the question "Is such a huge use of narcotics effective?" Narcotics are an easy option for doctors, but a better treatment option for increasing function is mixing in holistic treatments. One may not be able to eliminate pain, but the more important overall outcome is to improve function.

At this juncture, over one hundred million US individuals are living in chronic pain at a cost of over $530 billion a year. Have we reached epidemic proportions? Yes that point has been reached, and front and center with this problem are narcotic prescriptions. What makes them so popular? They end up being an easy answer for pain doctors, who can perform the easy option - the quick fix prescription. Narcotics may relieve pain, but the problem is not fixed.

Opiates often work well by dulling the nervous system, but they are highly addictive. Tolerance often sets in, where the patient requires more and more medication to achieve the same effect. Even if the anatomical problem is no different, the amount of pain medication necessary for the same relief may start to spiral out of control. In addition, there is a condition called opioid induced hyperalgesia (OIH) where a patient may experience increased pain with increased narcotic dosing.

Additional narcotic usage side effects can include depression, endocrine disorders, altered sleep, or immune system suppression.

With chronic pain, unfortunately there is no objective test to identify the amount of pain a person is experiencing. It is a subjective experience. It may cause inability to work, socialize, play with one's kids, or have fun with recreational activities.

Chronic pain is difficult to completely cure, and the focus should be increasing function rather than simply numbing the pain. Does this mean eliminating pain? Not necessarily. It may mean simply helping patients learn to live with their pain.

Non-narcotic methods of helping people function better with chronic pain include spinal decompression therapy, diet and exercise improvement, physical therapy, relaxation exercises, chiropractic treatment, acupuncture, and stress management.

These types of treatment may already exist in an integrated pain center, incorporating both alternative and traditional treatments. One of the primary issues is that the integrated treatments work, but are not covered by insurance plans all the time. In these recessionary times, individuals often rely on their insurance and do not routinely have the means to pursue alternative treatments, even if it would end up with a better outcome.




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