by James Hubbard, M.D., M.P.H.
Like a lot of doctors, I have mixed feelings about narcotics. They are great for severe, short-term pain and a must for some terminal cancer pain. Some people abuse them for nothing more than the high they get. And then there are all of the in-betweens. We doctors are kind of caught in the middle, also. We can lose our license if we prescribe too much or inappropriately. We are told, by some groups, we prescribe too little to the patients that really need it. But how do we know who really needs them? If we are too gullible, we will be prescribing to a bunch of abusers, too strict and we are doing a disservice to those in need.
It is the long-term, chronic use that concerns us the most. Narcotics are habit forming. They alter your mental state. If you take them long enough, you will have a physical withdrawal trying to get off of them. Most people will become tolerant needing more and more to get the same effect.
So what to do?
Dr. Rob at Musings of a Distractable Mind writes an explanation of narcotics and why we have mixed feelings. Although I differ a little from him in some of the definitions, his is an excellent primer, a narcotics:101.
In my opinion, the bottom line is don’t worry about becoming “hooked” if you need them for a week or two to get you by after an injury or surgery. Just remember some people have side effects, and they can effect your mental state. I have taken them twice in my life. Once, in my teens, I took a tylenol with codeine before I went to bed and was in this crazy dream state all night trying to get the strength to put my head back on which I thought was next to me in the bed. In my thirties I took a vicodin and felt like ants were biting me all over my body the entire night. Needless to say, I won’t be actively asking for more.
The tragedy is people with chronic pain which can last for years. My advice to those is find a doctor or pain clinic that utilizes all types of treatment such as physical therapy, counseling, biofeedback, acupuncture etc. and stick with it. You have to learn to cope with the pain mentally and physically.
Please add your comments, critiques or experiences about this complicated subject.
Tags: drug abuse