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In Remembrance
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Join Date: Nov 2006
Location: SE Kansas.
Posts: 374
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In Remembrance
Join Date: Nov 2006
Location: SE Kansas.
Posts: 374
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Hi guys,
Adding my 2 cent input, based primarily on 27 years of daily opioid usage but also on a fair amount of researching the medical literature generally:
I have mentioned before that despite courses in research methodology and statistics, I prefer abstracts over full articles; to really understand articles you need to understand what all those darn numbers mean, otherwise they just get in the way of reading the text. All I really want to know is what is being investigated, some idea about the methodology, what was learned and whether they claim some scientific validity.
Abstracts generally provide this information, and while this method of "research" means I can't confirm any data, I have no plans to bring myself up to date on statistics so it doesn't really matter. I don't bother reading abstracts that don't have any methodological information, this generally means that the article is a lecture; speculation; or just another sign of the "publish or perish" environment in academia. This abstract appears to be of the latter type.
We are all tought in research methods 101 not to use the word "proved", there are stronger words than "may" or
"could".
Opiod tolerance is a fact; one we need to guard against constantly. Unfortunately, my personal experience and everything I have learned from other 'pain people', the only way to limit tolerance is to tolerate as much pain as you can. The more you try to limit the pain, the more rapidly tolerance develops. This is not a fun way to live your life, but I was 36 when I was injured, knew I faced a long future of pain, and understood that there is a limit to the amount of opiods one can take before side-effects become more significant than the pain itself.
Finally, I view articles like this with a certain amount of fear: That they will be used to justify political limitation of a physician's right to treat pain.
I realize that the possibility that opiods may activate a pronociceptive (literally: increased pain sensitivity), mechanism, means that it should be researched, but even this brief an abstract would be more helpful if it suggested some sort of research, or even better, suggested a way to research how to turn off such a mechanism.
Those of us who live with pain face the fact that no useful alternative to opiods is currently being discussed in the context of the next few years, and the only way the DEA can keep getting increased budgets is to find new ways to fight drugs; we don't need them interfering further into the physician-patient relationship.
Physician overprescription of Lipitor (due to various "kickback" mechanisms), is probably a greater danger to public health, and certainly to increasing medical costs, than overprescription of opiods, and DEA aggressiveness in going after doctors is already adversely all of our lives...Vic
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