I suffer from a disease that you cannot see. A disease that there is no cure for and that keeps medical community baffled at how to treat this demon. My pain works silently, stealing my joy and replacing it with tears. My pain is not in my mind. Its there for a reason. It is just as real and as debilitating as one could think of.sni

 Hearing such lines coming from people who are struggling with their long-term illnesses are common. Just the way human body is complex, the pain associated with it has complex dynamics too.sni

Chronic or intractable pain involves multiple factors like history of trauma, musculoskeletal, neurological, surgical or other medical conditions. People spend months and years, switching from one treatment to the other, in order to cope with pain and the disability it brings along.sni

In the initial phase physical and emotional coping of a patient is strong. But as the pain progresses, people become passively dependent on various medications and enter into a recursive cycle which never ends.sni

How do painkillers work?sni

One of the prescribed pain relievers are opioids and their derivatives. They belong to class of drugs derived from opium poppy plant and produced synthetically in laboratories. They include morphine, hydrocodone, oxycodone, codeine, tramadol and many more. They block pain signals in brain and help release dopamine in our body. They can have physical and psychological dependence if the used for prolonged time.sni

Misuse of opioid analgesics

Misuse means taking medicines in a dose other than prescribed. Using any prescribed drug outside of its indication should be prohibited as it can be harmful and even fatal.sni

Misuse of opioid analgesics is a big challenge as these drugs are easily available in pharmacies. For example, hydrocodone and codeine are found in various cold and cough products as even their small doses can relieve cough. Similarly, tramadol is a centrally acting analgesic (painkiller) and often prescribed in oral form for acute pain conditions.sni

Dependance on opioid drugs

Dependance on opioid drugs is common too. When patients achieve dependence, they see multiple physicians for new prescriptions to keep regular influx of these drugs. Addiction destroys a person. It enters people into a loop of never ending pain of self-treatment and over treatment.sni

Withdrawal symptoms

Self-adjusting dosage, timings and route of drugs can lead to withdrawal symptoms; unpleasant physical and mental effects that result when one stops taking drugs he is addicted to. Many patients who use it for long term pain management can experience withdrawal when the effect of drug wears off. It includes:sni

Vomiting

 Dizziness and confusion

Dry mouth

Constipation

Fatigue

Itching

The side effects should always be addressed to the patient and the risk benefit ratio should be calculated when prescribing these drugs for prolonged use. There is a need to effectively regulate drug distribution and apply appropriate safe guards to prevent diversion. Though we justify the use of opioids where they are indicated, self-management is also important for people who deal with pain on regular basis.sni

Understanding our own disease and pain is a gradual process. Everything a person tries is not going to work every time. Be patient with yourself and be aware of how you are feeling. Make time to reflect your pain because it is not worth living in such agony and suffering.sni

Medications are there to cure but they have side effects which need to be understood. If they are misused or abused, they will cause more damage than healing. Be committed to your recovery and do not let the pain cycle take hold of your life.sni

By: Dr Sidra Munawar, General Surgeon

chronic pain management, prevent opioid abuse, painkillers, medicines misuse, health, shifa news