Half of Those Prescribed Opiates for a Month Still Taking Them 3 Years Later

opiate2If you are taking opiates for pain, how long can you take them before you become dependent or addicted to them?  Those who have undergone major surgery, or had a serious bone-breaking accident, have likely known the benefit that opiates can provide for pain relief. As an Addictionologist who treats primarily opiate addicts who are mostly in their 20’s, I have seen all too often the story of a dental procedure or relatively minor surgery that resulted in a prescription for opiate pain killers that then led to an opiate addiction and, ultimately, heroin when the availability of pills disappeared.

The express scripts study, “A nation in pain,” (which you can find here… ) looked at more than 36 million opioid prescriptions issued to 6.8 million Americans from 2009-2013.  Here were some of the findings:

  • Half (50%) of the group taking opiates for an average of 3 years or longer were on short-acting opioids (much more likely to cause an addiction).
  • Younger adults (20-44) filled more prescriptions.
  • 60% used these opiate with other medications (1/3 were benzodiazepines, which are known to be a fatal combination with opioids).

 

Those who have become addicted or dependent on opioids probably need help getting off of them.  If you wish to try this at home, start by having someone else hold your medications, then reduce the dose by 10-20% every 1-4 weeks until you get off of them.  Most addicts will need the support of addiction counselors, a treatment program, or an addiction specialist.

If you have had surgery or an injury that resulted in a prescription for opioids, ask your doctor what is the usual length of time you would need to use opiates. If you feel that you are now continuing to have pain past that expected time frame, get re-evaluated by your doctor or surgeon. Perhaps something is wrong and perhaps you are starting to become dependent on the opiates.  Withdrawal symptoms can  first can feel like the pain of your surgery or injury, making you think you need more opiates, when, in fact, you need to wean off.

If you have had trouble getting off of opiates in the past and need a legitimate prescription, have someone else hold it and dispense to you only as prescribed.

We physicians and nurses were trained the past two decades that pain was a vital sign, and to not pay attention to that pain was a form of neglect.  We undoubtedly have ignored the huge down side to the use of opiates for pain that has become chronic.

 

Dr. Paul

 

Integrative Medicine, Naturopathic Medicine, Chiropractic, Acupuncture, Oriental Medicine, Massage Therapy- The partners in health and wellness you should not do without

integrativemedicineAs an Integrative Medicine physician, board-certified (ABIHM) in Integrative and Holistic Medicine, I am often asked what I mean by “Integrative Medicine”?  There are a number of medical professionals who are sharing similar approaches that emphasize life-style, optimal nutrients, minimizing toxins, and using the best evidenced-based medicine research to apply modalities of nutritional medicine, herbal, and nutrient medicine as the first line in prevention of chronic diseases. There are conditions that seem to improve dramatically when approached in a manner that determines food sensitivities.  Other conditions respond to herbal treatments that seemed resistant to pharmaceuticals.

Integrative Medicine is knowing when to collaborate with our peers, MD, DO, Acupuncture, Chiropractic, Naturopathic, Massage, Herbal, Chinese Medicine, etc.  Integrative Medicine, Naturopathic, and functional medicine approaches look for underlying causes and conditions that may predispose the individual to less than optimal health.  This is a very satisfying practice style in contrast the “business as usual” practice where you wait for a disease to develop, then you treat the symptoms.

Some think of Integrative in terms of one provider using and integrating approaches from many of these disciplines.  Others consider integrative practices as those that actually have practitioners of many of these modalities working as a team in one clinic or virtual clinic through collaboration.

Here is an overview article on this topic.

Don’t forget about our other clinic, Natura Integrative Medicine. While mostly for adults, Natura features many of the modalities I have mentioned above to bring the best approach to patients looking for care beyond the traditional western methods. I encourage you to look at the website to see a very comprehensive list of treatments Natura is offering.

 

 

Dr. Paul

 

Endocrine Disruptors- The Key to Health

baby sealChemicals in our world (man-made direct toxins and endocrine disruptors) represent the largest threat to our health and survival as a species.  This isn’t something that just affects the rare, poor unfortunate ones. This is affecting everyone, and if you live in the USA or many developing countries lacking regulations, we are all affected and our health is suffering. Do you know anyone with neurological issues, fertility issues, cancer, or endocrine/hormone issues?  We are at just the tip of the iceberg.  Everyone is affected.

The important thing to realize is that we can do a lot to minimize personal exposures (eat organic, avoid plastics, avoid flame retardants, avoid pesticides and herbicides) and as a society we must work together to regulate these toxic chemicals. When we removed lead from gasoline in 1972, the lead levels in the USA population went to near zero in most people over the next couple of decades.  We have not been so fortunate with DDT, which can still be found in high levels even in the arctic animals.

The WHO report “State of the Science of Endocrine Disrupting Chemicals – 2012” published last year (you can read it here… ) is a great overview with graphs and pictures making this topic easy to understand.  I have included a few paragraphs below:

“This Summary for Decision-Makers, together with the main document, State of the Science of Endocrine Disrupting Chemicals—2012, presents information and key concerns for policy-makers on endocrine disruptors as part of the ongoing collaboration between the World Health Organization (WHO) and the United Nations Environment Programme (UNEP) to address concerns about the potential adverse health effects of chemicals on humans and wildlife ”

 

  • “Many endocrine-related diseases and disorders are on the rise.

    • Large proportions (up to 40%) of young men in some countries have low semen quality, which reduces their ability to father children.

    • The incidence of genital malformations, such as non-descending testes (cryptorchidisms) and penile malformations (hypospadias), in baby boys has increased over time or levelled off at unfavourably high rates.

    • The incidence of adverse pregnancy outcomes, such as preterm birth and low birth weight, has increased in many countries.

    • Neurobehavioural disorders associated with thyroid disruption affect a high proportion of children in some countries and have increased over past decades.

    • Global rates of endocrine-related cancers (breast, endometrial, ovarian, prostate, testicular and thyroid) have been increasing over the past 40–50 years.

    • There is a trend towards earlier onset of breast development in young girls in all countries where this has been studied. This is a risk factor for breast cancer.

    • The prevalence of obesity and type 2 diabetes has dramatically increased worldwide over the last 40 years. WHO estimates that 1.5 billion adults worldwide are overweight or obese and that the number with type 2 diabetes increased from 153 million to 347 million between 1980 and 2008.

  • Close to 800 chemicals are known or suspected to
    be capable of interfering with hormone receptors, hormone synthesis or hormone conversion. However, only a small fraction of these chemicals have been investigated in tests capable of identifying overt endocrine effects in intact organisms. “

This issue is one of those key fights for our generation, and losing this one will be disastrous. Generations to come will look back on this period as one of the most insane of all time.  Hopefully there will be such generations. Unfortunately, companies that are guided by profit do not have a conscience.  For your own family and personal health, paying attention to this one issue could mean the difference between life and death.

Sorry for all the heavy words.  Don’t blame the messenger.

 

Dr. Paul

 

 

 

Early Childhood Shyness Linked to Teen Anxiety

shy childIn the article “Infant Attachment Security and Early Childhood Behavioral Inhibition Interact to Predict Adolescent Social Anxiety Symptoms,” a few interesting points that might guide us in our parenting were found that social anxiety as teenagers was increased for:

  • Infants who were insecure as infants and who either ignored their parents after a time of separation
  • Infants who were angry with their parents after a time of separation.

 

Those infants who were easily comforted by their parents after a time of separation (thought to be securely attached as infants) had the least social anxiety as teenagers.

By observing these infants/children at 14 months, and 2, 4 ,and 8 years of age, researchers could determine those who were secure and easily comforted by parents after times of separation and determine those who were shy, unattached or became angry and detached with their parents after a time of separation.  As teenagers, those who felt nervous going to parties, dances, or other groups where there were people they didn’t know, or speaking in front of groups or to play a team sport scored highest on social anxiety scales than youth without these nervous feelings.

So what can we do as parents when we seem to have an anxious or shy infant or toddler or child?

The study did not give us answers but I have a couple thoughts:

  • If your infant is shy and anxious in new situations, don’t force them into these situations in a way that creates even more anxiety (stress overload).
  • Do gently encourage and I like to think of you sitting on your hands in a group of family or friends and not providing a lap or comforting arms when your little one comes for “protection”. You see they need to get the message that this is a safe group and there is nothing to protect them from.  When you wrap your arms around them and say “mommy/daddy will protect you”, it’s as if you are saying these are scary people, stay with me.

We learn to overcome our fears little by little.  Provide your child opportunities to overcome and build confidence. Small steps at a time.

Most public speakers have developed that skill over years and years of hard work and many still have fear but they don’t let the fear define them.

You can read the article here…

 

 

Dr. Paul