[mrsD]

Here is a conversion site to help show relative conversion between
opiate drugs.

http://www.globalrph.com/narcoticonv.htm

Not everyone reacts the same way, however, so this is just an approximation.

[mrsD]

This link is quite technical, but it discusses the huge problem of drug interactions.

http://www.fda.gov/Drugs/Development.../ucm110632.htm

It discusses several types of serious interactions including Prolonged QT (heart arrhythmia) which is gaining more attention today.

Read it slowly and carefully. You don't need to understand every word, but the gist of it all is to be careful. Ask your doctor and pharmacist questions when you receive a new medication, and look it up if necessary.

www.rxlist.com typically gives information on pharmacology and warnings/side effects for most common drugs today.
It will even ID your tablets in your bottle, based on the code numbers. And it will list inactive ingredients on the first page of each monograph.

[Dr. Smith]

Originally Posted by mrsD

It is really critical to understand that care/and concern about drugs, to be
used properly and safely, is not to be interpreted as anti-drug.
I have been accused of this frequently, and it illustrates to me how emotional
the subject can be.

This goes both ways. There is a lot of dis- & mis- information floating around about opioid pain medications, and that is a very emotional (and political) subject. In efforts to dispel bad information, confusion, and downright lies, I am often concerned about being accused of or labeled pro-narcotic. I am not pro-drug or pro-narcotic; I am anti-pain. I have spoken & written often about ways of coping with pain aside from using medication, but people in intractable chronic pain should not be afraid - or be made afraid - to take medications their physicians prescribe, or stigmatized for taking them.

Here is a list of some links I have found informative:

The Intractable Pain Patients Handbook For Survival
http://pain-topics.org/pdf/IntractablePainSurvival.pdf
Page 10 - Necessity for Opioid Drugs

Definitions Related to the Use of Opioids for the Treatment of Pain
Addiction, Physical Dependence, Tolerance, & Pseudoaddiction
http://www.ampainsoc.org/advocacy/opioids2.htm
There is a lot of confusion about, and misuse of, these terms - even among medical professionals and in the media. Physical Dependence is NOT Addiction.

Pseudoaddiction and Misinterpretation of Symptoms
http://www.beatingaddictions.co.uk/Pseudoaddiction.html

Narcotic Pain Medications
http://www.webmd.com/pain-management...in-medications

The Truth About Painkillers
http://tinyurl.com/2vmnqf

Painkiller Addiction: A Smaller Risk Than You May Think
http://www.health.com/health/conditi...9482_1,00.html

Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
http://www.jpain.org/article/PIIS152...08316/fulltext

Doc

[smae]

Originally Posted by Dr. Smith

This goes both ways. There is a lot of dis- & mis- information floating around about opioid pain medications, and that is a very emotional (and political) subject. In efforts to dispel bad information, confusion, and downright lies, I am often concerned about being accused of or labeled pro-narcotic. I am not pro-drug or pro-narcotic; I am anti-pain. I have spoken & written often about ways of coping with pain aside from using medication, but people in intractable chronic pain should not be afraid - or be made afraid - to take medications their physicians prescribe, or stigmatized for taking them.

Here is a list of some links I have found informative:

The Intractable Pain Patients Handbook For Survival
http://pain-topics.org/pdf/IntractablePainSurvival.pdf
Page 10 - Necessity for Opioid Drugs

Definitions Related to the Use of Opioids for the Treatment of Pain
Addiction, Physical Dependence, Tolerance, & Pseudoaddiction
http://www.ampainsoc.org/advocacy/opioids2.htm

Pseudoaddiction and Misinterpretation of Symptoms
http://www.beatingaddictions.co.uk/Pseudoaddiction.html

Narcotic Pain Medications
http://www.webmd.com/pain-management...in-medications

The Truth About Painkillers
http://tinyurl.com/2vmnqf

Painkiller Addiction: A Smaller Risk Than You May Think
http://www.health.com/health/conditi...9482_1,00.html

Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
http://www.jpain.org/article/PIIS152...08316/fulltext

Doc

The Intractable Pain Patients Handbook For Survival is a good handbook and one that I have recommended to people many times. Very good, informative resource!

I agree with you, too. I also am anti-pain. All the natural techniques in the world are not -always- enough to eliminate or control pain. I sure wish I didn't need narcotics, but I am not going to refuse them just because others don't like them. I have to do what is best for me, and right now, that is getting any bit of relief I can.

[mrsD]

Dr. Smith:

I do understand your point of view. However, sadly, there are many doctors who are prescribing medications without understanding how to do so safely.

My major concern on this forum is to alert patients to the risks while using these medications. Methadone, which is becoming very popular and common now, is the only opiod that can cause death with normal doses, because of its tendency to cause irregular heart beats. This is called long QT syndrome, and I have posted here and on the chronic pain forum here about it.
There are doctors out there still who do NOT know this about Methadone. So it is up to the patient to inform themselves about it.

This forum is not here to discourage medication use. But is for patients to inform themselves about the medications they use and often in combination with other drugs, so that when an alarming side effect presents, they can seek helpful medical intervention. If a doctor minimizes a patient's concern, which often happens, there are choices that patient can take.

I believe that all drugs have potential for harm. Even aspirin.
Even Tylenol. Those two drugs cause much harm over the long haul in some patients.

Here is a new article explaining the links between OTC and RX anti-inflammatories, and the heart:
http://contractresearch.pharmaceutic...k-risks-120111

Each patient I believe should understand the benefits of a medication vs the risk taking it. Gone are the days of putting yourself 100% in your doctors hands for day to day treatments.

My neighbor did not research Naproxen RX and took it for 3 yrs every day. She had a massive GI hemorrhage, and was in intensive care for 13 days, and almost died. Did she share with me her use of this drug? Nope... Did her doctor give it freely...yep. I personally think her treatment could have been better. But she didn't know that.

http://www.uspharmacist.com/content/s/64/c/13028/

http://www.naturalnews.com/027548_sw...eath_risk.html

I really think having a platform like NeuroTalk is like having a Consumer Reports venue. We check Consumer reports before making a major purchase in this house. Likewise I research all medications I take for my pain issues and other problems.

This forum is here for those with questions about their medications. People who find us here are looking for answers, to some issue that troubles them.

[Dr. Smith]

mrsD,

I don't think we're in disagreement or at cross purposes on anything here. Pretty much everything you've mentioned is talked about to some degree (some more than others) in the links I posted, especially the concerns about methadone (as well as the risks of other opioids) in the last link.

I agree that there are many doctors who are prescribing medications without understanding how to do so safely. We can't reach the doctors on this forum, however we can reach and inform patients with good information.

Just about every time I log onto NT, I see posts by folks that reflect:
1. Inadequately addressed/treated pain, and/or
2. Misunderstanding/misinformation about pain medications.

Sometimes these are outright questions, and sometimes they are comments (inferred questions) that something troubles them about appropriately prescribed & taken pain meds.

I think we're very much on the same page!

Doc

[oldersis1]

Interesting information. Thank you.

[LynnAlfie]

Sorry, Im not sure where I need to post this Question.. ( Im not great sussing out how to post things) I am wondering if Anyone can give me any advice...I am trying to sort out vaccinations I need to go on my holiday..Yellow Fever vaccine is needed but the drs are concerned about the live vaccine and reactions to it with my meds..Has anyone had a Yellow Fever vaccine and Malaria tablets along side meds for my CRPS.? would welcome thoughts ..and I can give the list of my meds..Purrs Lyn aka Crazy Cat Lady..again..sorry if im in the wrong place..Im lost here.

[mrsD]

This list was posted today on our PD forum.
It includes some foods, and mostly herbs.
It is pretty good:
http://www.integrativeinc.com/Resour...eractions.aspx

[Morgan Herritage]

Originally Posted by mrsD

Dr. Smith:

I do understand your point of view. However, sadly, there are many doctors who are prescribing medications without understanding how to do so safely.

My major concern on this forum is to alert patients to the risks while using these medications. Methadone, which is becoming very popular and common now, is the only opiod that can cause death with normal doses, because of its tendency to cause irregular heart beats. This is called long QT syndrome, and I have posted here and on the chronic pain forum here about it.
There are doctors out there still who do NOT know this about Methadone. So it is up to the patient to inform themselves about it.

This forum is not here to discourage medication use. But is for patients to inform themselves about the medications they use and often in combination with other drugs, so that when an alarming side effect presents, they can seek helpful medical intervention. If a doctor minimizes a patient's concern, which often happens, there are choices that patient can take.

I believe that all drugs have potential for harm. Even aspirin.
Even Tylenol. Those two drugs cause much harm over the long haul in some patients.

Here is a new article explaining the links between OTC and RX anti-inflammatories, and the heart:
http://contractresearch.pharmaceutic...k-risks-120111

Each patient I believe should understand the benefits of a medication vs the risk taking it. Gone are the days of putting yourself 100% in your doctors hands for day to day treatments.

My neighbor did not research Naproxen RX and took it for 3 yrs every day. She had a massive GI hemorrhage, and was in intensive care for 13 days, and almost died. Did she share with me her use of this drug? Nope... Did her doctor give it freely...yep. I personally think her treatment could have been better. But she didn't know that.

http://www.uspharmacist.com/content/s/64/c/13028/

http://www.naturalnews.com/027548_sw...eath_risk.html

I really think having a platform like NeuroTalk is like having a Consumer Reports venue. We check Consumer reports before making a major purchase in this house. Likewise I research all medications I take for my pain issues and other problems.

This forum is here for those with questions about their medications. People who find us here are looking for answers, to some issue that troubles them.

I just got put on methadone. My doctor ordered an ekg before I started treatment and I have to get one after a while of treatment. He told me to stay away from NSAIDs. Told me to be very careful. I am also on norco 3x a day. He seems to be very wise and I will follow the rules.