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Using lousy drugs for chronic pain


August 21, 2014
Dear Jeff and Debra:

Our daughter was prescribed Vicodin for her migraine headaches about two years ago, and her father and I are quite concerned she has become addicted. She lives in another state, so we aren't privy to what goes on with her on a daily basis, but we have clues.

Our 15-year-old granddaughter told us her mother takes a lot of pills and sleeps most of the time. Her husband has moved out, calling it a trial separation. When we suggest coming for a visit, she comes up with excuses why it's not a good time. Over the phone, she often sounds as if she is drugged. One of her best friends called us with concerns about her pill use a few weeks ago. She's suffered from cluster migraines since she was a teenager and always used over-the-counter solutions.

We're frightened that getting on painkillers has grown into its own problem, much more serious to her wellbeing then headaches ever were.

–Concerned Parents

Dear Concerned:

The clues you describe raise a red flag of concern. Once someone has become addicted to narcotic pain medications, they build tolerance and need more and more pills to get the same effect. This can lead to stealing medications from other people's medicine cabinets, going to multiple doctors for additional prescriptions, buying pills online or on the street. Unable to get enough pills, many are forced to turn to heroin as an inexpensive alternative.

The over prescribing of pain medications has created a new class of heroin addict–people who never before fit the profile. Heroin dealers now rent apartments in upper-middle class neighborhoods and have teams that deliver to "clients" homes, offices, gyms and even in parking lots of grocery stores or salons. While we are not saying your daughter is using heroin, anyone addicted to opiate painkillers should be seen as high risk.

Families are often reluctant to take action to help someone addicted to painkillers, seeing the need for the drug as legitimate.

However, opiates are lousy drugs for chronic pain. They just don't work well over time. There are other far better alternatives, such as non-prescription pain drugs that contain aspirin, acetaminophen and caffeine. If these don't prove sufficient, prescription drugs called triptans work quite well and can be combined with acetaminophen. There are also nasal sprays and injections for migraine relief. Opiate painkillers should be prescribed as a last resort and only used occasionally–not on a regular basis.

We suggest you have a candid and confidential conversation with your daughter's husband to fill in the details. Once you gather more information, consult with a clinical interventionist to determine the best next step.

In the meantime, educate yourself about chronic pain and opiate addiction. Begin by researching work in pain recovery by reading "A Day Without Pain," by Mel Pohl M.D. You can access a thorough assessment and treatment for your daughter at two excellent programs: the Berry Ford Center's non-narcotic pain management program or the Las Vegas Recovery Center.

The Jays have authored several books, including "Love First, Aging and Addiction" and "No More Letting Go." They live in Grosse Pointe Farms. Contact them at (313) 882-6921 or through their lovefirst.net.

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