Pain and Role of Medications
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Medications should improve function
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Medications are only part of a good management plan
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All medications should be reviewed regularly
In this episode, you will learn that medications are only part of a good pain management plan. Certainly, long term use of a number of pain medications have been found to be ineffective in controlling the intensity of pain you experience. All medications need to be reviewed regularly to ensure there is a benefit to your function and quality of life. Some people may benefit from long term medication use, but usually other strategies are required to support this. If you plan to reduce your medication, discuss this with your GP as other pain management techniques may be required to assist you through this process.
Please note: This website has relevance to those with cancer pain or receiving palliative or residential care management. However, opiates may have a larger role to play in the management of chronic pain for these people.
At the end of the video, fill out the health plan and talk to your GP, build your healthcare team and get started!
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Transcript: Pain and Role of Medications
Yeah look, you can use medications in chronic pain management, um… it's something we do and something we certainly try, but it's not necessarily the answer to your pain and there are a number other things we need to take into consideration.
Well we've been prescribing opiates for a long time and we know that they’re good for relieving pain but we now are very aware of their side affects.
Even in short term use they can certainly can affect your ability to do things in daily life.
Going off the pain medication was really good for me because I became… very clear in my head, my thinking became clearer.
I um… became less tired so I had more energy to do things and then I found that I was doing things that I forgot that I used to do and take for granted.
So the doctor put me on to… put me on fentanyl patches, I tried oxycontin, um… multiple doses of endone, I've had morphine patches, goodness me, panadeine forte um… pretty much you name it I've tried it in the way of medication to try and calm my pain down um… it didn't really succeed… I think if anything it caused more of a hypersensitivity to my body after a while I had that much on board my husband described it as me walking around in a morphine haze for, you know, a good couple of years he just said I was just a zombie um… and I was - I couldn't function I couldn’t… deal with just the general household day to day things.
I was forever getting my child babysat because I couldn't cope… mentally, physically um… which was all quite degrading for me from where I'd come from being this energetic, adventurous person down to pretty much a shell of myself.
Short term use is what we prescribe them for and we don't like prescribe them long term, because the long term affects are even worse than the short term affects.
Common side affects include, drowsiness, blurred vision, dry mouth, headache, nausea, constipation, brain fog and memory loss.
they can affect sleep and worsen sleep apnoea, lower immunity and testosterone levels, they can affect sex drive, fertility and depression.
Other major sides affects include falls, accidental overdose and death.
You know some people experience hyperalgesia when they take opiates at reasonable doses or high doses for a long time.
Now this is where people experience more pain instead of less pain taking something that is supposed to relieve their pain and it's related to the way the opiates have changed the body.
Ah yeah, after being on medication for probably… probably about a good year I started noticing that if someone bumped me or I walked passed or I kicked my toe or something it was more sore than what it would normally be, which I thought was weird.
So when I saw my GP for one of my visits I explained to her that you know, I was getting a bit hypersensitive and she said that it can be caused by, you know… too much medication in your system.
It has like a reverse affect when you have too much of a build up of opiates in your body and it was actually causing me to have more pain and I was taking opiates and it was probably causing more pain than reducing the pain because of the hypersensitivity that I was getting through it all.
When you've been taking opioids for a while you might find that they become less beneficial and they’re giving you less pain relief.
This is what we call tolerance and it's a physical dependance on the medication and it means that we start to become concerned because you have to keep increasing your dose to get the same benefit and that's going to produce more… more harm to your body.
Because I've been taking it for so long my body got used to the… to the actual drug, and therefore I felt that after taking it for a few months it wasn't doing as well, I wasn't doing as well as when I first started taking it, and then I realised that, you know, I was going up five and another five and then another five milligrams until I was right up the top and I was having other drugs then to supplement as well um… and it just kept getting bigger and bigger and waking up in intensive care after a surgery and not being able to control the pain levels really had alarm bells for me, that how far do I go up? Will there come a time when they're not going to be able to control my pain when I really have another bad surgery? Um… so that was something that I have learnt and I am more aware of now that I want to be able to take medication for the pain I've got when I'm experiencing it and then come off it, not too continually take it and have to… keep going up so my body gets used to it and it works.
It's very important that you see your GP and have regular reviews, your GP is going to look at whether they continue to be of benefit by assessing pain relief, function and side affects.
if you are getting significant side affects then we would be concerned about the harm that we are actually doing you and would like to… discuss that and look at other ways of managing your pain.
There are lots of different medications used in pain management and you've just been hearing about, mainly about opioid medication in the management of pain, but we also use anticonvulsants, antidepressants, antiinflammatories and simple analgesics like paracetamol.
As health professionals we are always weighing up the benefits versus the risks of any treatments that we give our patients.
Now if your on medication and it's working well for you that's fine, but what we would say is please consider some of the other therapies that are out there because you might get further benefit from them and really, what it's about is improving your quality of life.
I experienced um… terrible withdrawal symptoms coming off the medication, but it was worth it in the end run, and it was slow, it wasn't something that I did overnight.
It was something that I gradually did, and so that each time that I went down bit I… the pain got less, the sickness got less until um… one day I woke up and thought I feel great, like, you know, I… I… I… I was planning my day which was something I hadn't done before.
It's very important that you just don't stop your medications because you can become very unwell and quite distressed, so if you’re finding the medications aren't helpful then it's important to talk to your doctor and work out a plan.
I was extremely sceptical at first because they were like “No we're going to take you off all your medication, it's gonna be a mind over matter thing…” and I probably put up a bit of a resistance to do it at first then um… I was at crisis point and I needed to… the medication wasn't working so I needed to go down a different route, And like I said I tried physio, hydro, acupuncture, sort of everything and nothing was really working.
But then once you get all the information together of how to pace, how to distract your mind, how to get off your medication slowly not… quickly and crazily like I did the first time, um… you can put all those tools and actually get your mind… working with your body instead of against your body and hating it.
I was a bit of a rebel and I was told that I wouldn't be able allowed to have another child after the car accident from all my damage and… I persisted, ended up falling pregnant um… unfortunately it did happen to flare everything up again, so I have had to go on again intermittent types of medication ah… but I don't let it control my life at all, I don’t… have to have it every day, I don't freak out if I haven't got anything in the house because I do have other tools that I can use, so my first instinct's not to grab medication anymore whereas before I'd be scuffling around trying to get medication, anything to get rid of this pain but… after coming off all my, you know, all my medication and learning all the different techniques just… standing out on the back verandah, like… life's so much brighter and everything seems so different and just doing the simplest little things like, you know… going down the back to get some hay for the rabbit to put in her cage, it's not a chore anymore it's something that I enjoy doing.
Now is a great time to fill out the medication section of your health plan.
If you haven't already done so, click on the health plan button below the video and download the PDF.
Print it out.
After each video fill out the relevant sections.
You only have to fill it out once.
Take your completed health plan along to your GP or your health professional.
This is a great starting point to managing your pain.