Thank you Ray!
----------
Individual e-post from:
Dr. L. D. Misek-Falkoff, Speaker, and Chronic Pain Caucus Chair of
The National Disability Party http://www.disabilityparty.com . bio (about)
----- Original Message -----
From: "Ray in Virginia" <hrn@...>
To: <chronic_pain@yahoogroups.com>
Sent: Thursday, June 27, 2002 11:07 PM
Subject: [c_p] Fibromyalgia, Medications, Pain and Opioids


> The following excerpt from an article on medications and
> fibromyalgia says what I was trying to say, but in a more
> scientific manner, supported by research evidence of the benefits
> of opioid medications for fibromayalgia patients:
> http://www.sover.net/~devstar/drugs.htm
>
> Too often readers have told me, "My doctor would not prescribe this
> medication because it is too hard to get someone off it." It's hard
> to stop taking a medication that will relieve your pain. It's
> nearly as hard as trying to figure out why any doctor in his/her
> right mind would want you to do so. In the best of all worlds,
> early FMS and single TrPs would be promptly diagnosed and treated.
> In our present reality, central sensitization and allodynia of FMS
> coupled with the pain generated by TrPs can make this world a
> living hell for patients who haven't been promptly diagnosed and
> treated. We must deal with reality as it is today, unhampered by
> outmoded belief systems. Pain control is imperative to reduce any
> further sensitization of the nervous system, as well as to allow
> appropriate bodywork without additional shock to the pain sensing
> system.
>
> I am not advocating opioids as the first method of pain control, or
> as the singular method of pain control. When other options have
> failed, medical literature documents that opioids, in conjunction
> with a thorough pain control program including bodywork, mindwork
> and life style adjustment, are a logical and humane option in the
> treatment of severe FMS and CMP. The rest of this section will be
> from medical journal articles. For more information on this
> subject, see "The Fibromyalgia Advocate".
>
> The treatment of non-cancer pain with opioids may work for patients
> who don't gain sufficient reduction of pain by other therapies
> (Dertwinkel, Wiebalck, Zenz et al.1996).
>
> Opioids may be the only hope of relief to many people with chronic
> pain (Shannon and Baranowski). 1997).
>
> Higher levels of opioid use are not associated with higher levels
> of disability or depression (Ciccone, Just, Bandilla, et al. 2000).
>
> Chronic opioid use at the proper dosage, tailored to patients' need
> and tolerance, did not significantly impair perception, cognition,
> coordination, and behavior. (Galski, Williams and Ehle, 2000).
>
> From a purely pharmacological point of view, opioids have perhaps
> the best side effect profile of any drugs we have available form
> pain (Horning, 1997).
>
> Unlike the chemically dependent patient whose function is impaired
> by medications, the chronic pain patient's level of function may
> improve with proper use of medications, including opioids (Seas and
> Clark, 1993).
>
> Addictive behaviors aren't common in chronic pain patients
> (Fishbain, Rosomoff and Rosomoff, 1992).
>
> There are possible side effects with opioids, and some people do
> have a tendency towards addiction, but, according to these and many
> other references, this is not common in chronic pain patients.
> Opioids often slow intestinal motility. Measures should be taken to
> prevent constipation. Temporary sleepiness and confusion is common
> after initial opioid therapy, and after dose increases. Nausea may
> occur for the first 3 or 4 days.
>
> Some opioids are available in suppository form if nausea and
> vomiting is present. Transdermal patches are also available. The
> liquid form may be very useful because of the ease with which you
> can vary the dose. For example, hydromorphone hydrochloride 5 mg
> per ml is available. My doctor suggests this form because it isn't
> combined with NSAIDS, and because you can adjust the dosage. On
> days when pain is severe you may need your full dose, but on good
> days you can take a lesser amount.
>
> Excerpted from "Fibromyalgia and Chronic Myofascial Pain: A
> Survival Manual (Chapter 21) edition 2" by Devin J. Starlanyl and
> Mary Ellen Copeland coming June 2001. (Vitamins and minerals are
> addressed in Nutrition chapter.)
>
>
>
>
>
>
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