Tuesday, June 20, 2017

The Right Opioid Dosing And Avoiding The Addiction Trap

By Kevin Graham


Many opioids are available today, most synthetically derived and not opiates. Examples of opioids that are not opiates include oxycodone, hydrocodone, hydromorphone, and others, Opioids are used therapeutically primarily for their analgesic, or pain-relieving effect. Despite the serious potential side effects, and knows addiction issues, a correct opioid dosing remains the primary analgesic used for moderate to severe pain.

Opioid medications are prescribed for patients with painful conditions and the response is typically excellent pain relief. There are side effects which may include constipation, tolerance, depression, and sedation. With chronic pain affecting 15% of the US population, doctors are prescribing narcotic medications with alarming frequency.

However, naltrexone is used mainly as a drug that acts to control alcohol dependence and addiction. This action of naltrexone occurs in high doses. Low dose naltrexone is used to treat a number of illnesses including Crohn's disease, multiple sclerosis (MS) and fibromyalgia. Whilst some degree of extensive research into the effect of the drug and Crohn's disease has been done, the use of this drug on multiple sclerosis and fibromyalgia still need much investigation.

Research shows narcotic use is higher among the less educated and unemployed. A recent report in the American Journal of Medicine specifically looked at fibromyalgia patients receiving opioids for their pain. There was an increased incidence of unemployment, disability payments, and history of substance abuse. Also, the statistics showed overall lower education and an increased incidence of unstable psychiatric disorders. The study was not small and contained over 450 patients, so the results were most likely valid despite potential statistical variances.

Methadone is a synthetic opioid mainly prescribed as a long range replacement therapy for dependence to opioids. While methadone was once administered strictly at licensed methadone rehabilitation detox hospitals and drug clinics, within the past several years the drug is being prescribed in a pill form for severe pain. As such, the drug now can be discovered on the street, and quickly has become a top cause of accidental overdose within recreational drug users.

Opioid-induced hyperalgesia is a condition that can result from long-term opioid use. It represents a heightened perception of pain and can make one feel worse with more pain sensation. The solution to this problem is a decrease or discontinuation of the medication which should be accomplished under medical supervision. The discontinuation can result in less pain than while on the medications.

The Clinical Opiate Withdrawal Scale (COWS) includes an evaluation tool which is utilized to measure the extent of an individual's withdrawal from opioids. The tool assesses the severity and presence of different withdrawal symptoms (such as restlessness, tremor, sweating, chills, nausea, etc.). It helps medical staff in deciding the necessity for a medicine increase and amount of increase which should be offered.

There was also a temporary absence of REM sleep, which is the type of sleep people go into as they go deeper into sleep. So narcotics appear to affect both the quality and quantity of sleep, which is obviously suboptimal for patients who have painful conditions and need sleep for regeneration and healing potential.

By blending drugs, abusers will risk overdose and dangerous interactions. Permitting this harmful experimentation encourages and enables addiction. If someone you love or yourself is abusing methadone, quit before you cause further harm.




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