[Hugh Jacobs]

Hugh Jacobs asked the Naked Scientists:
   
Dear Naked Scientists -

In an earlier newbielink:http://www.thenakedscientists.com/HTML/podcasts/ [nonactive] (Beer & Brewing 07.10.07) you state unequivocally that taking an opiate-based pain killer is a problem because the patient can (will?) become addicted.

If true, so what?

I am a 71 year old male who, after a minor cycling accident at age 16, developed lower back pain.  After years of intermittent pain, it became chronic and progressively worse.  Almost seven years ago I discovered Percocet, a combination of Oxycontin and Acetaminophen.  The pain-killing effect was remarkable.  I now take one 10 mg Oxycontin tablets twice a day and one 5 mg Percocet per day, the latter to be taken before I engage in  physical activity.

My life has changed dramatically.  After retirement and before being prescribed Oxycontin I was almost housebound and impossible to live with.  Even though I can no longer play squash, racket ball and badminton, ski (downhill and cross-country), participate in speedskating (we have the best skaing oval in the world right here in Calgary), hike and backpack, play football, handball and volleyball, I do ride my bike almost daily from April until Ocober.  During the winter I go camping in Mexico.  Three times a week I ride with the Elbow Valley Cycle Club and we cover distances between 60 and 80 km at an average speed of up to 25 km/h.  I'm in very good health.

I wish I'd been prescribed Oxycontin much earlier.  The pain has not disappeared, but is manageable.

I'm probably hooked, but I have no need for an increased dosage.  When I occasionally forget to take a pill, I do not develop withdrawal symptoms.  Increased pain, however, reminds me after a few hours that I skipped a pill.  Depending on the time of day, I'll take one or wait it out until the next one is due.

The medical profession, including you, regularly makes sweeping derogatory statements about the use of Oxycontin and similar medications without, it seems, considering the many dramatic benefits.

Please explain why taking a habit-forming drug such as Oxycontin is such a bad idea.  My doctor still seems unhappy to provide the prescriptions.  I think there is pressure on him from his colleagues to treat pain with anything other than Oxycontin and similar medications.

Hooked or not, I am alive again, and retirement is wonderful.

Would you be willing to address the use of narcotics to treat chronic pain in an upcoming episode?

Regards,

Hugh, newbielink:http://www.thenakedscientists.com/HTML/podcasts/ [nonactive]
Calgary, Alberta
Canada

What do you think?

[glovesforfoxes]

The division between addiction and medicinal use is blurry, but in your case it seems to be the latter. The main difference to me is that while addictions screw your life up socially, emotionally, and possibly physically, medicinal use really does the opposite. It's the idea of balance - people say that drinking water, eating vegetables, that sort of thing is good for you, and it is in the right quantity - but drink or eat too much and you'll get sick. It's the same with addictive medication.

So carry on eating the porridge, it's just right []

[BenV]

With opiates (and feel free to correct me if I'm wrong) you develop a tolerance that requires ever greater amounts to have the same benefits.  At some point, the required dosage for analgesia will be so high as to incur damage to the body.  However, the user would now suffer withdrawal symptoms when the dosage is dropped.  Withdrawal is highly unpleasant, and can lead to irrational behaviours that could result in accidental overdose.

I'm not a doctor, so I'm not basing this on any medical knowledge or experience, so please tell me if I'm way off the mark!