Pain Management in America. Rough Excerpt from Dr. Pingel’s Upcoming Book

The Problem of Pain: Pain Management Pharmaceuticals
The group of pain management drugs is ranked #2 to hypertensives, however, take a look back at the list of the top prescribed drugs in America. #1 is hydrocodone, which many of you will know as vicoden or lorcet or lortab. Let me say that again, the NUMBER ONE drug prescribed in the US is Vicoden. Number 22 in the entire nation is oxycodone (percocet most recognized). Both of these drugs are highly addictive and responsible for numerous deaths and rehab visits each year. According to the CDC in a report produced in 2012, Since 2003, there have been more overdose deaths by prescription opioids that heroin and cocaine combined. 9 million report chronic long term use and 5 million report non prescribed use on a regular basis. The average dose of morphine per person in 1997 was 96mg. In 2007, it was 700mg. That is astonishing. Let’s look back again to the top 25 prescribed drugs in America. We have the vicoden and oxycodone as previously mentioned but also on the list are tramadol, prednisone, and ibuprofen. 5 out of the 25 most prescribed drugs in America are pain medications. I realize I keep reiterating the same point, but it is an important one for a few reasons. First, is it true that that many people are in pain? If so, why? what are we doing to ourselves to produce such pain? With 1/3 of America reporting obesity, it is not surprising that our joint hurt. So why not focus on the reversal of obesity? With Diabetes, Heart Disease and Cancer all being highly inflammatory diseases, it makes sense that people suffering from these diseases are in pain, so let’s look at reversal of these diseases to prevent pain rather than simply treat the symptoms and write them off as side effects. Second, why are doctors prescribing such addictive mediations for the pain and not looking for alternative options? Acupuncture can do wonders for pain. Diet, lifestyle and nutrition are important tools. To reference the previous section on hypertensives, the diuretics have a massive impact on electrolyte imbalances, resulting in low magnesium. Guess what that gives you? Pain! Maybe looking into nutrition as a pain reliever would provide a healthier option. Third, the side effects of these medications result in death. That’s right, death. Do those that are prescribed these medications agree to loss of life? Or are they trying to prevent loss of life?
What do these medications do exactly? They are opioids, which means they block pain receptors. Many of you know of morphine, or heroin, which is an opioid. Make no mistake, oxycodone is the same thing. Vicodin has the same mechanism of action. Ever seen someone go through a heroin withdrawal? How about vicodin? It’s rough. These drugs are over prescribed. It’s incredibly unfortunate, but numerous patients present to me not only on an opioid, but also on ambien and xanax, two more depressant medications. The side effects of opioids are respiratory depression, meaning, you slow or stop breathing. They also slow heart rate, meaning your heart stops beating. Not a good combination with a sleep or anti-anxiety medication. These medications were made for short term use, after surgeries or major accidents. Not for chronic pain. The side effects are not worth it. Evaluate the cause of the pain, not it pain itself. I must return to the oath that all of us doctors take when we graduate medical school: First, Do No Harm. Is the ridiculously high use of opioids following the number one oath that we commit to?

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