Explore the medications commonly used to treat Fibromyalgia, including pain relievers, antidepressants, and other options to manage symptoms effectively.
The Food and Drug Administration has just issued what’s called a “Medwatch Alert” warning that Epidural steroid injections or “ESIs” for back and neck pain can be extremely dangerous. The alert says: “Injection of corticosteroids into the epidural space of the spine may result in rare but serious adverse events, including loss of vision, stroke, paralysis, and death.”
Epidural steroid injections – and catastrophic injuries from them – were the subject of my debut investigation for The Dr. Oz Show almost exactly a year ago. The epidural space is an area between the spinal cord and the bony structure of the spine.
Our investigation revealed that the steroids – called corticosteroids – used for epidural injections are not even FDA approved for this purpose and yet ESIs are done nearly 9 million times a year, according to an analysis by Dr. Laxmaiah Manchikanti.
In 2009, the FDA convened a group to study the safety of some types of epidural steroid injections. In its new notice, the FDA said that the group’s recommendations still are not ready and will be released when they are.
Dennis Capolongo of the EDNC, a group that has been campaigning against epidural steroid injections for years, called the FDA’s new warning “bittersweet” because it did not go further. Capolongo wants the FDA to go beyond telling doctors that injecting steroids into the epidural space COULD have severe side effects and instead state that they MUST NOT do it.
In February of this year, Australian and New Zealand health authorities came out with exactly that stronger language, stating that steroids like this, “MUST NOT be used by the intrathecal, epidural, intravenous or any other unspecified routes.” The South African government issued similar warnings, according to Capolongo.
Since the FDA is still actively studying these procedures, it will be interesting to see if the agency takes any further steps. If and when it does, you can bet I’ll pass the information along.
We have received so many complaints about duloxetine side effects that we have lost count. Far more disturbing is the number of people who tell us how hard it is to discontinue this drug.
Decades ago doctors might have told patients taking a drug like Cymbalta that if they experienced anxiety, irritability, or strange sensations after stopping the drug, it was probably their underlying psychological problem returning. Now we know it is withdrawal from the medicine.
Cymbalta was originally approved by the FDA in 2004 for the treatment of major depression. It is officially an SNRI-type antidepressant. In doctorspeak, that means it is a serotonin-norepinephrine reuptake inhibitor and is somewhat similar to other antidepressants such as Effexor(venlafaxine) and Pristiq(desvenlafaxine).
In other words, there was a drug that could relieve your blues and your aches and pains. And the drug company that makes Cymbalta (Lilly) has been aggressively marketing it as a good way to deal with chronic low back pain and osteoarthritis. Perhaps you have seen the commercials on TV promoting the pain-relieving power of the drug with the slogan “Cymbalta can help.” It sounds almost too good to be true.
Ah…and there is the rub. Although there is a long list of serious side effects mentioned during the commercial, the video images seem quite reassuring and trump the scary message the FDA requires for this medication. So, let’s set the record straight. Here, without visual interference, are a list of potential complications associated with this medication.
Depressed mood, suicidal thoughts and behavior, suicide
Such a long list of side effects makes your eyes glaze over after the top 3 or 4. That is why we have included stories from real people so you can better understand what these complications feel like.
Even though such side effects are scary, there is another problem with Cymbalta. When people try to stop taking this drug they frequently report unpleasant withdrawal symptoms. An organization (QuarterWatch) that monitors the FDA’s database of serious adverse drug events has noted that:
“We observed a signal for serious drug withdrawal symptoms associated with duloxetine (CYMBALTA), a widely used antidepressant that is also approved to treat arthritis and back pain, anxiety, and fibromyalgia. In the first quarter of 2012, the FDA received 48 case reports of drug withdrawal identifying duloxetine as the suspect drug. They described a wide spectrum of withdrawal effects that began when the patients stopped the drug, including blackouts, suicidal thoughts, tremors, and nausea. Several cases involved hospitalization.
Probing deeper into the scientific record for duloxetine we found that withdrawal symptoms were reported in 44-50% of patients abruptly discontinuing duloxetine at the end of clinical studies for depression, and more than half of this total did not resolve within a week or two. In addition, we identified a serious breakdown at both the FDA and the manufacturer, Eli Lilly, and Company, in providing adequate warnings and instructions about how to manage this common adverse effect.”
Doctors have taken to calling this “discontinuation syndrome.” These clinical words do not do justice to what it is like to stop antidepressants like Cymbalta, Effexor(venlafaxine), Paxil (paroxetine), Pristiq (desvenlafaxine), or Zoloft(sertraline) suddenly.
Again, a list of symptoms does not do this problem justice. Below you will read some stories from people who have posted their comments to this website. We would love to hear your story, positive or negative. Share your experience with Cymbalta or any other antidepressant below.
Should you wish to learn more about dealing with depression through some other strategies, we offer our Guide to Dealing with Depression. You will also find a whole chapter on prescribing mistakes doctors make when treating depression and fibromyalgia in our book, Top Screwups Doctors Make and How to Avoid Them.
“My lovely, young daughter-in law, who was about to celebrate her 29th birthday, was prescribed Cymbalta, Klonopin, and Ambien and has committed suicide. “She told her physician and her therapist that she’d had thoughts of suicide but no one took her seriously. She suffered from depression, as well as an eating disorder, and had very low body weight. She also used alcohol. “Please remind your readers of the potentially disastrous effects these chemicals can cause when taken carelessly or in combination with alcohol.”
This from – P.J.: “I have been on Prozac over the last 20 years off and on and it finally stopped working. The last time I took it about 2 years ago I was taking the generic from Barr – the blue and white capsule. I was feeling as if I were in the deepest dark hole there ever was.
“My doctor put me on Cymbalta from which I had a lot of side effects such as palpitations, feeling constant dread, panic attacks, sweats, lightheadedness, and a general feeling of not being well.
“She added Abilify which put me over the edge. I was in the worst depression I have ever been in. Finally, after living like this for several months, I asked to be put back on Prozac. I was taking the generic from Sandoz. When the prescription ran out I ended up on the big blue and white capsules from Barr.
“Over the last couple of weeks, it has been constant crying spells, arguing with everyone, and feeling pretty low. I talked to my doctor and she wrote the prescription for Sandoz only generic. The blue and white capsules are like taking a placebo. My doctor said she had had other patients who complained of the same thing and she had to write prescriptions for a certain generic or name brand.”
Click Here to Visit the Store and find Much More…. – R.P. says: “I took Cymbalta for 3 days and thought I’d go nuts. I’m off it now and refuse to try any other drug like this. My main complaint was extreme hot flashes that estrogen wouldn’t help. I thought I’d be given Prozac but was given Cymbalta instead. It was a rough 3 days and I stopped it last night. I am extremely tired yet cannot sleep at night. I think I was sweating even worse and my legs started feeling like I had Lyme disease again. And to be honest, within those 3 days of taking it, I didn’t contemplate suicide, but I had this crappy attitude of “who would care?” – Nancy relates how hard it was to get off Cymbalta: “It took me 18 months to get off Cymbalta, with no doctor’s help. I can hardly believe that doctors have no exit strategy for this dangerous drug. I had to find this out on my own from reading and as soon as I weaned off that – about a month, the tinnitus that had occurred decreased almost completely. No doctor told me this.” — J.K. shares a parent perspective: “My daughter experienced severe side effects when trying to come off Cymbalta – she had nausea, vomiting, lost peripheral vision for 24-48 hours, had to shake, etc. This was while she was doing a clinical in a hospital for college. Had she known she would have stayed on it until after clinical. I called the manufacturer and they acted like there were no such side effects from withdrawal.
“She too took apart the capsules and it took a while, but finally she is free from that drug. I think it is a crime that the manufacturers don’t publish more detailed information concerning withdrawal. They could even make money selling a one-month or two-month step-down prescription so individuals aren’t taking the capsules apart themselves.” – P.C. Tells what it is like to switch around from one drug to another: “I just turned 52 today. I went on a very low dose of Zoloft about 8 years ago to treat generalized anxiety disorder. It really did help for a long time. I recently have been pretty depressed (however I can cover it up really well) and my psychiatrist switched me to Effexor which was terrible for me. Now I’m trying Cymbalta which has not done anything either except make me feel more anxious and headachy and weird.”
“I am a registered nurse and I do not understand what the long-term effects of these meds are and I am concerned. I really want to get off and see what I can do naturally for myself.” – K.T. tells what it is like to try to stop Cymbalta: “Getting off Cymbalta is challenging but not impossible. I, too, experienced light-headedness, dizziness, and “brain zaps.” I described it as being able to “hear my eyes move.” It sounded like the light sabers on Star Wars. Very strange and disconcerting.
“The key is to do it very very slowly. Take the capsules apart and begin by removing 5 or 10 of the tiny balls inside. Do this for a week or so, then slowly increase the amount you remove each week or two as you can tolerate it.
“Your doctor will probably be no help at all. Mine wasn’t. He instructed me to wean off over a two to three-week period and I almost lost my mind. I did it myself over about a YEAR or more. Be patient. I am completely off now and feeling GOOD.” – Karen’s story: “I was prescribed Cymbalta ‘off-label’ to manage fibromyalgia pain When I stopped taking it because it wasn’t delivering on the promised effect of reducing my pain, I became so horribly depressed that I required hospitalization as I had become SUICIDAL!
“I will NEVER take another anti-depressant for an off-label purpose….such as Elavil/amitriptyline as a “sleep aid” which is very commonly prescribed.
“I believe it should be criminal to prescribe ANY drug for a purpose other than the one it was approved to treat.” – R.H. and Erectile Dysfunction: “I’m a 76-year-old man, my libido was very low. Taking Cymbalta for peripheral neuropathy added ED as a side effect of the drug. I had a testosterone blood test; it was 1/3 what the minimum should be. So I’m taking Androgel to raise testosterone levels and it is magic. I have great libido now and am working on minimizing the Cymbalta pills. In the meantime, I have been prescribed Cialis for the ED. Each pill solves the sex problem for a couple of days.” – M.O. on stopping Cymbalta:
“I have the exact symptoms as everyone else and it’s been a week. I only took Cymbalta for 2 months, but the side effects from stopping it are horrible. My doctor didn’t, nor did anyone else tell me, about any side effects and I did read the insert. Most of the time the listed side effects of meds don’t bother me, so I figured no problem. “From reading other posts on this website and on other sites, the drug seems to affect every person the same way. I would never have taken it for my neck pain if I had known about the likelihood of side effects. The worst part for me is the dizziness, the brain zings and the sudden burst of tears for no reason. I would never take this drug again. I think the FDA needs to do longer studies on all drugs and be honest with their findings and that doctors should be honest and tell their patients what really happens when you take Cymbalta.”
Please add your own experience below in the comment section.
Here are the best action steps to get started with on your journey to get fibromyalgia pain relief.
1) Use Anti-Oxidant Rich Herbs: Add turmeric, ginger, oregano, garlic, basil, thyme, and rosemary to as many dishes as possible and drink organic herbal teas on a regular basis. you can get fibromyalgia Pain relief by using anti-oxidant herbs.
2)Change Your Diet: Follow an Anti-Inflammatory nutrition plan here and consider the auto-immune diet and/or the low-oxalate diet, both of which you can find here.
2) Test For Food Sensitivities: You can do a biofeedback test to determine what foods are causing stress in your system and an elimination diet to test how you are responding to eliminating certain foods for periods of time.
4) Improve Your Sleep:Sleeping a high quality 8-9 hours each night is key to healing and improving brain function. you can get fibromyalgia Pain relief by improving your sleep.
5) Power Up Your Nrf2 Pathway: This is the key genetic anti-oxidant pathway. Adding in clinical dosages of resveratrol, curcumin, sulforaphane and Green tea (ECGC) can be extraordinarily beneficial. I use Nrf2 Power here to improve this pathway.
6) Include Magnesium & B Vitamin Rich Foods: Magnesium helps to improve blood sugar signaling patterns and protects the blood-brain barrier. The best magnesium and B vitamin-rich foods include dark green leafy veggies, grass-fed dairy, raw cacao, and pumpkin seeds.
9) Ground Your Body: In our society, we are surrounded by toxic electromagnetic frequencies (EMFs). These EMFs increase stress within our body and alter neurotransmitter function. By going outside daily and walking barefoot on grass, dirt, or sand you absorb natural EMFs from the ground that balance your electrical rhythms.
10) Supplement With Omega 3’s: Omega 3 fatty acids and in particular the long chain variety EPA and DHA are critical for stabilizing blood sugar, reducing inflammation and pain. Consume grass-fed meat, grass-fed butter, wild-caught fish, and spirulina to get it in your diet.
The first thing you should know about CBD oil is that it is completely legal in the United States as long as it is made from industrial hemp rather than marijuana. It is viewed as a dietary supplement, similar to an herbal supplement such as Valerian Root which is commonly used by fibromyalgia patients to relieve insomnia and anxiety. Some years ago I did medical transcription for a pediatric neurologist.
Several parents whose children had epilepsy or seizure conditions asked the physician about the usefulness of CBD oil. Fibromyalgia patients often find themselves in the same boat as the children of these parents: the prescription pharmaceutical options usually have side effects that are too debilitating and unbearable.
Thus, parents who were aware of CBD oil as Treating Fibromyalgia unequivocally preferred it over all of the prescription medication because it has no side effects. However, the physician always responded with the same answer, that he did not have any information about it and therefore was not willing to advise one way or another.
While there have been a number of studies conducted on the efficacy of CBD oil for both epilepsy and fibromyalgia, it is apparently still not enough. That is why you will usually find the same disclaimer on CBD oil that you do for other supplements: “These statements have not been evaluated by the FDA.
This product is not intended to diagnose, treat, cure or prevent any disease.”Regardless of a lack of scientific data, fibromyalgia patients on nearly every online forum dedicated to the condition mention CBD oil and marijuana as highly effective treatments at one point or another. That means it merits our attention.
“CBD hemp oil is made from high-CBD, low-THC hemp, unlike medical marijuana products, which are usually made from plants with high concentrations of psychoactive tetrahydrocannabinol (THC). Because hemp contains only trace amounts of THC, these hemp oil products are non-psychoactive,” say the folks at Medical Marijuana Inc., a leader in prescription-grade CBD products.
They add that since CBD interacts with our naturally occurring systems and is not psychotropic, it will not cause a high like traditional marijuana. For those suffering from fibromyalgia who must also function daily with jobs, children, or other responsibilities, a non-psychotropic option may be just the key. Think of how often you’ve tried to function with prescription pharmaceuticals for fibro, but get knocked down by the side effects of grogginess or fatigue.
CBD oil for Treating Fibromyalgia could also be a great alternative for those who do not wish to use medical marijuana for religious reasons, or for the majority who simply lack legal access. CBD oil comes in many forms, such as lotion, tinctures, drops, vape oil, spray, chocolate bars, salve, capsules, cream, and is even available for pets in drops. In the fibromyalgia community, drops seem to be the number one choice while capsules come in second.
Occasionally you will find those who say that CBD oil does nothing for them. However, it should be noted that an FDA report shows that some hemp oils only contain very little CBD while others have no cannabinoids at all. That may explain why some fibromyalgia patients say they have no response to the oil at all. In other words, quality matters and it would be helpful to check out the report to see the relevant brands.
There are high-quality CBD oil distributors all over the internet, including Amazon where you can check reviews by thousands of people and search for the highest rated products. Additionally, most local health food stores carry it in one or many ways.
The key is to do your research by checking online sources and talking to fellow fibromyalgia patients to see what brands and distributors have been the most helpful. If you have found a particularly good brand, please share it with us and tell us how CBD oil has helped your fibromyalgia symptoms.
However, long-term use of these medications can cause a host of unwanted side effects, and NSAIDs do not actually correct the cause of pain. The use of NSAIDs is no different. You might have heard of how drug company Merck pulled its NSAID Vioxx off the market years ago. They were responding to the results of a long-term (18-month) clinical trial that revealed that some patients developed serious heart problems while taking the drug.
Potential side effects of drugs like Vioxx-COX-2 Inhibitors: Fibromyalgia Pain ReliefVioxx is what doctors call a “COX-2 inhibitor.”Fibromyalgia Pain These drugs were developed to reduce pain and inflammation without the risk of ulcers and other—potentially deadly—gastrointestinal side effects posed by aspirin and similar medications.
But in solving one serious problem, COX-2 inhibitors might be causing another. Just before Celebrex and Vioxx were approved and launched, a group of researchers led by Garret FitzGerald, MD, chair of the Department of Pharmacology, and director of the Institute for Translational Medicine and Therapeutics at Penn, observed that both drugs suppressed prostacyclin in humans.
Potential side effects of other NSAIDs:Fibromyalgia Pain A person taking NSAIDs is seven times more likely to be hospitalized for gastrointestinal ad¬verse effects. The FDA estimates that 200,000 cases of gastric bleed¬ing occur annually and that this leads to 10,000 to 20,000 deaths each year. NSAIDs more than double a person’s risk of developing high blood pressure, possibly leading to more medication. In one study, 41% of those who had recently started on medication to lower their blood pressure were also taking an NSAID. Feel Good Again! Yes I can Do It All By Phone – 90% Of My Practice Is By Phone
I get the results of all your tests and then put together a plan to help you sleep each night, feel refreshed each morning, have dramatically less pain, boost your energy, lose weight if needed, correct your IBS and or RLS once and for all, and if can start to eliminate drugs that aren’t helping.
If someone could give you a vaccine that would cure your fibromyalgia, would you do it? That may sound like a dream, but it’s closer to reality than you might think. Los Angeles-based biomedical firm EpicGenetics and Massachusetts General Hospital researchers are seeking approval from the U.S. Food and Drug Administration (FDA) to conduct a clinical trial next year to test the Bacille Calmette-Guerin (BCG) vaccine as a potential treatment for fibromyalgia.
“BCG is a generic tuberculosis vaccine that is almost 100 years old and has been safely administered millions of times,” explained Dr. Denise Faustman, head of the Faustman Lab at Massachusetts General Hospital. “For over 10 years, our research group at Massachusetts General Hospital has been actively investigating the role that the BCG vaccine could play in treating various forms of autoimmunity. Our current focus is type 1 diabetes, but globally BCG is being tested in a number of autoimmune diseases. Over the next two years, we will begin clinical testing of BCG in fibromyalgia.”
According to the World Health Organization, more than 100 million children are given the BCG vaccine each year. It’s mainly used in developing countries where tuberculosis is still active. The BCG vaccine is not available in the United States because of the low risk of infection. In the U.S., BCG is used in a small number of patients to treat bladder cancer.
So, the obvious question is why would a vaccine for an infectious lung condition be used for fibromyalgia? The answer lies within the immune system.
Vaccines are typically given to healthy people to prevent infection. In this case, however, the BCG vaccine would be administered to fibromyalgia patients in an effort to quell their symptoms.
When EpicGenetics was tasked with creating a diagnostic test for fibromyalgia several years ago, researchers ran all sorts of lab tests on fibromyalgia patients to figure out how they differed from healthy control subjects and what might be causing their symptoms. Researchers discovered several white blood cell abnormalities in fibromyalgia patients, leading them to conclude symptoms are associated with a suppressed immune system.
“We believe [the term] fibromyalgia is a misnomer,” said Dr. Bruce Gillis, EpicGenetics’ CEO. “These people aren’t suffering from anything that’s affecting the muscles, per se. What they are suffering from is their immune system cannot produce normal quantities of protective proteins. …There are cells in the immune system called peripheral blood mononuclear cells. They are not producing normal quantities of the protective proteins called chemokines and cytokines.”
The finding led to the development of the FM/a blood test for fibromyalgia. (Yes, despite what your doctors may have told you, there IS a blood test for fibromyalgia! It’s just not widely accepted in the medical community.) The test analyzes the levels of four chemokines and cytokines found at reduced levels in fibromyalgia patients. These four chemokines and cytokines just happen to be the same ones that are boosted by the BCG vaccine.
Gillis and Faustman are seeking FDA approval to administer the first BCGvaccines to fibromyalgia patients early next year.
“This is the first time ever that a direct treatment of fibromyalgia will be done,” Gillis said. “As you know, the medications [currently on the market] for fibromyalgia only treat symptoms. They have no immune system benefits. [The pharmaceutical companies] concede they’re only treating symptoms but you need to treat the disease, and that’s why we’re moving ahead with the vaccine application [to the FDA].”
If Gillis’ theory holds true, then “the chemokines and cytokines that are deficient in patients with fibromyalgia will no longer be deficient [once the BCG vaccine is administered],” Gillis said. “Production levels will normalize, and you have to assume then that their symptoms will disappear. … We think we are on the cusp of something major.”
Because the vaccine has such a long history, it’s not expected to cause any major side effects in patients.
The BCG vaccine is anticipated to cost $20-$25 per dose – a nominal amount when compared to the ongoing expense of taking pharmaceuticals every day.
“We think a fibromyalgia patient would need one or two doses maximum so you can understand why I’m not getting much support from drug companies,” Gillis said.
In addition to the vaccine trial, EpicGenetics is partnering with the University of California, Los Angeles (UCLA) and the University of Illinois College of Medicine Chicago to sequence the genomes of up to 250,000 fibromyalgia patients.
“We’re looking for any type of genetic patterns or anomalies or mutations,” Gillis said.
Patients who test positive for fibromyalgia using the FM/a test will be able to participate in the genomic study.
The FM/a test currently costs $936 but is covered by some insurance companies and Medicare. EpicGenetics’ support team helps patients determine if their insurance company will cover the test. A no-interest payment plan is available for people who are uninsured or whose insurance won’t cover the test.
People with fibromyalgia complain of chronic pain throughout their body as well as increased sensitivity to pain. Doctors often have trouble treating this pain because it’s unclear what causes it, the study authors noted.
In the new study, injecting lidocaine into peripheral tissues — such as the muscles in the shoulders or buttocks — effectively reduced pain sensitivity, the researchers found.
“We hypothesized that if the pain comes from the peripheral tissues, and we can take this pain away by injecting local anesthetics, then this would be indirect proof of the importance of peripheral tissues for the clinical pain of these individuals,” study lead author Dr. Roland Staud, a professor of medicine at the University of Florida College of Medicine, said in a university news release.
“Over-the-counter medications and [narcotic] prescriptions such as opiates aren’t really effective for controlling chronic pain conditions,” he added. But with the new therapy, “we are able to explain the pain of chronic patients better and manage it better,” Staud said. “We are making progress but it will take time.”
The study involved 62 women with fibromyalgia. Each woman received four injections: two in certain muscles in their shoulders and two more in their buttocks. Some of the women received lidocaine injections, while a “control group” received saline injections.
Right before the injections were given and 30 minutes afterward, the women received mild pain stimulations delivered through mechanical means or through heat.
Compared to “dummy” saline injections, lidocaine significantly eased the women’s sensitivity to pain, according to the study published recently in the European Journal of Pain.
The researchers noted, however, that both lidocaine and the placebo resulted in a 38 percent reduction in pain at or near the point of injury.
But chronic pain affects the body differently than a specific injury, like a broken leg, the study authors pointed out. Chronic pain, they explained, actually alters nerve function along the spinal cord.
“The best way to treat chronic pain conditions is . . . [by] looking at emotional, sensory and tissue damage,” Michael Robinson, director of the University of Florida Center for Pain Research and Behavioral Health, said in a university news release. “We know there are central and peripheral and social and behavioral components to someone saying, ‘Ow, it hurts.’”
“That sensation may well feel more painful than if they just thought it was a tweaked muscle,” Robinson explained.
Two experts in fibromyalgia were unsure about the significance of the findings, however.
“There was no significant difference between the pain reduction in the placebo versus the treatment group — this signifies that it does not matter what the injection product is, but the act of injection itself might be the cause of pain reduction,” said Dr. Waseem Mir, a rheumatologist at Lenox Hill Hospital in New York City.
“One can then argue that the pain reduction was placebo,” he said. “To examine the placebo point, another arm in the experiment might need to be introduced where patients are not getting injected but taking a placebo pill.”
Dr. Houman Danesh is the director of integrative pain management at Mount Sinai Hospital in New York City. He said that “fibromyalgia is a complex disorder where patients are more sensitive to pain. It is mainly diagnosed by a rheumatologist by touching 18 diagnostic pressure points, and if 11 of them are sensitive, then the diagnosis is made,” he explained.
Despite the claims of some government agencies, research has shown that the overwhelming majority of addictions do not start with a prescription, and most opioid prescriptions do not cause addiction.
When 58-year-old Zyp Czyk* had a serious mountain biking accident in June, she refused to go to the emergency room even though her injuries knocked her out cold and her husband pleaded for her to seek help.
Instead, Czyk slept for two days—contrary to the conventional wisdom of what you’re supposed to do after sustaining a head injury. Only then did she finally agree to go to an urgent care center, where she discovered she had broken her collarbone and some ribs and needed surgery. Czyk isn’t afraid of doctors, hospitals, or pain medication, and she’s not opposed to Western medicine. In fact, she’s been taking Oxycontin for chronic pain for nearly two decades. And that’s the problem: She feared that if she went to the hospital she might be labeled a drug-seeker, which could lead to her doctor cutting off her opioid prescription, leaving her without the treatment that makes her life bearable.
Czyk is just one of the more than 100 million Americans with chronic pain caught in the latest drug war crossfire. These patients and their doctors are often targeted by federal agencies like the Centers for Disease Control (CDC) and the Drug Enforcement Agency (DEA) in an intensifying crackdown on painkillers that fall in the same class of drugs—opioids—as heroin. But these efforts are as misguided as most “supply-side” drug war initiatives, and the collateral damage tends to be excruciating.
Last week, the CDC released a report showing that the rate of heroin overdose deaths in America quadrupled between 2002 and 2013. In a press briefing, CDC director Thomas Friedman said that the rising use of medical opioids “primed” Americans for heroin addiction and called for “an all-of-society response,” including a reduction in prescriptions and better law enforcement. Likewise, in its 2015 assessment of the threat from heroin, the DEA reported, “Increased demand for, and use of, heroin is being driven by both increasing availability of heroin in the US market and by some controlled prescription drug (CPD) abusers using heroin.”
You’d never know it from the official government line, but while the “opioid epidemic” is linked to increased use of pain medications, the overwhelming majority of addictions do not start with a prescription—and most opioid prescriptions do not cause addiction.
All of which is to say that chronic pain patients are bearing the brunt of yet another drug war blunder.
Like Czyk, those who genuinely need painkilling drugs are now subject to policies like random reports to the doctor’s office for pill counts, prescription limits, extra refill appointments, urine testing, and other restrictions that can become expensive and onerous. Worse, they are often made to stop taking drugs that help them. While she knew she risked her health by postponing care after her crash, Czyk tells me that she felt waiting offered less risk than being falsely labeled an “addict” and was “not as dangerous as losing my pain medications.”
Opioid addiction usually begins in the same place that all other addictions start: in the childhoods, traumas, mental illnesses, and genes of those affected.
Her fears are far from unrealistic given reports of pain doctors being arrested and charged with crimes resulting from so-called overprescribing, leaving their patients to seek emergency care. Chronic pain support groups are filled with horror stories about pharmacists refusing to fill prescriptions and physicians simply dropping patients or deciding that they no longer want to risk treating pain with opioids. But according to a new study in the journal Addictive Behaviors, the greatest predictor of whether a person misuses opioids is not poor health—instead, it’s having used illegal drugs in the past year.
Drug warriors don’t like to tell this story. In the stereotypical account, addiction starts with an evil doctor—probably high on Big Pharma propaganda—hooking innocent patients. For example, when Massachusetts Governor Charlie Baker was inaugurated this January, he incorrectly described the experience of the parents of a young man who died of an overdose.
“After a routine medical procedure their 19-year-old son, Evan was prescribed opiates for pain,” Baker said. “Slowly and unknowingly, he became addicted to them. When the prescription ended, he turned to heroin,”
In fact, Evan started taking drugs with his friends, who introduced him to pills the same way they did marijuana—no doctors were involved. It’s not clear what put him in the 10 to 20 percent of drug users who become addicted, but it definitely wasn’t pain treatment.
And Evan’s route to opioid addiction is by far the most common. Since the Substance Abuse and Mental Health Service Administration (SAMHSA) started collecting this data, it has always been found that over 75 percent of people who misuse painkillers get them from friends, relatives, dealers, or other illicit sources—not physicians.
Data on people who start pain treatment yields the same conclusion: The vast majority don’t misuse their drugs.
Even among the most frequent users, less than a third see doctors get their drugs.
And there’s more research supporting the idea that the vast majority of opioid addiction starts on the street. In 2014, a national study of nearly 136,000 emergency room patients admitted for overdoses containing opioids found that just under 13 percent had a chronic pain diagnosis. And a 2008 study, this one from an addiction-ravaged region in West Virginia, found that 78 percent of victims had a history of substance misuse and nearly two-thirds possessed prescription drugs that were not prescribed to them.
Looking at people treated for Oxycontin addiction alone, a study in the American Journal of Psychiatry found that the vast majority—78 percent—never had a legitimate prescription and a similar number reported cocaine use and previous treatment for substance abuse.
Unless you’re ready to believe that doctors can turn pain patients into coke fiends, the simpler explanation is that painkiller addiction hits people who are already abusing other drugs. These people know where to buy stuff like coke and heroin, unlike pain patients—a.k.a. your parents and grandparents—who tend to be unfamiliar with how street drug markets operate.
Data on people who start pain treatment yields the same conclusion: The vast majority don’t misuse their drugs. Here, Czyk’s case is typical. Formerly a computer systems administrator, she had suffered inexplicable pain since childhood. Eventually, she was diagnosed by specialists at Stanford with Ehlers Danlos Syndrome, a painful connective tissue disorder that often manifests in visible bruises. She says she has never misused her drugs, and even initially refused to take enough of them to effectively treat her pain.
In 1995, Czyk’s doctor suggested that she try a newly-introduced drug called Oxycontin. “I took it as prescribed,” she tells me. “I took as little I could as get away with.” She adds that her doctor finally sat her down and said she’d get more relief if she “took enough that it would actually work.”
Although opioids can make people sleepy, Czyk had the opposite experience. “I was able to work,” she says, “When I took the pills, my energy went up because the pain [had been] so tiring.” Ever since she says she’s used it judiciously. While chronic pain patients may suffer withdrawal symptoms if they stop using a drug abruptly, this is the not same thing as addiction, which is defined by experts as compulsively using a drug in the face of negative consequences.
Clinical studies of pain patients without a history of heavy drug use find that less than 1 percent become addicted during treatment—as summarized by a stringent review by the respected Cochrane Collaboration. (In actual pain practice, researchers find addiction rates of up to 33 percent, but this is more likely due to poor screening for addiction history and to drug-seekers faking pain than to new cases, given the rest of the data out there.)
Dee Dee Stout, an addictions consultant, and expert counselor has been taking opioids for fibromyalgia and pain from a car accident for ten years. Recently, she was refused a refill due to complex regulations that neither doctor nor patient had been warned about. Consequently, she had to spend a weekend enduring pain and withdrawal symptoms like diarrhea and restlessness until her doctor was back in the game on Monday.
“I can’t begin to tell you how stressful it’s been,” she tells me, echoing the voices of other chronic pain patients who are often ignored in media coverage of the opioid “crisis” but appear in the comments en masse under most such articles.
If we really want to deal with opioid addiction, we have to face facts. Most cases don’t start at doctors’ offices. Instead, kids get drugs the way they always have: through friends and family. To do better, we need to stop tightening the screws on chronic pain patients and start looking at why so many young people are turning to the most dangerous class of drugs.
Mistreating patients doesn’t stop addiction; that requires compassionate care.
Sometimes prescription drugs are warranted in acute conditions and can save lives. But more often than not, prescription drugs for chronic health conditions can actually deteriorate your health in the long run, and many people are overprescribed drugs that cover up the underlying health issue found in their lifestyle or diet choices.
There are some major downfalls of relying on pills for a chronic condition. Western medicine tends to focus on managing and suppressing individual symptoms one at a time, rather than carefully identifying the root cause underneath and working to improve it in a holistic way. Unfortunately, in many cases, there is also the risk of addiction to prescription drugs; abuse of medications has been increasing steadily in the United States for years. Currently, opioid addictions are more widespread than cocaine overdoses.
Not to mention, the majority of prescription drugs for chronic conditions are associated with nutrient deficiencies and a number of side effects that become another health battle of their own. Soon, patients are stuck in a cycle of prescription after prescription; trying to manage the symptoms caused by the medication that came before it. In fact, the CDC states that 48.9% of people are currently taking at least one prescription and 23.1% of people are taking three or more! The most frequently prescribed therapeutic drugs are antidepressants, painkillers, and antihyperlipidemic agents (such as cholesterol medications).
You have a higher risk of dying from a preventable adverse drug reaction than you do of dying from cardiovascular disease, lung cancer, breast cancer, or diabetes. And that’s cause for concern. While the following list compromises some of the most popularly prescribed medications with the worst side effects and risks, it by no means approaches a comprehensive list of prescriptions to be careful of. The bottom line is to do your research on every prescription your doctor recommends and talks openly with him or her about your concerns with potential side effects and reactions with your body.
Otherwise known as PPIs, proton pump inhibitors are commonly prescribed for acid reflux. You may be familiar with their brand names Nexium, Prevacid, and Prilosec. However, they have been associated with higher risks of dementia, kidney disease, and heart attacks. Furthermore, PPIs can cause chronic constipation, low magnesium levels, and increase the risk of bone fractures.
If you’ve been prescribed PPIs for heartburn, talk to your doctor or an integrative healthcare practitioner about finding natural treatments instead. Your focus should be on finding the underlying cause of your acid reflux (either an element of your diet, lifestyle, or a side effect of H.pylori bacteria). Oftentimes, the root cause of acid reflux is low stomach acid, not excess acid. Therefore taking PPIs can inadvertently make digestion and overall health worse, as stomach acid is crucial for digestion of protein, absorption of minerals, and protecting against pathogens in contaminated food and water.
Prednisone is a multi-tasking steroid often prescribed for autoimmune conditions such as rheumatoid arthritis, lupus, and ulcerative colitis. It works by suppressing the immune response that causes the body to attack itself, but at the same time, it is literally compromising your immune system and making you more susceptible to infections, both mild and serious. Long-term use has been associated with bruising, changes in body fat in certain locations (face, neck, back, and waist), low libido, acne, and complicated menstruation. Potential side effects also include insomnia, mood problems, headaches, dizziness, bloating, and nausea.
Talk to your doctor about alternatives to combat inflammation (such as in rheumatoid arthritis) using natural solutions.
Long-term use of statins has been linked to a deficit of coenzyme Q10 and vitamin K2 increases your risk of breast cancer and diabetes and can raise the risk of Parkinson’s disease.
If you have been diagnosed with high levels of LDL cholesterol, talk to your doctor about what you can change at home to help manage your levels naturally.
1 in 10 Americans over the age of 12 take antidepressants, according to the CDC. One in ten! And 60% of those people have been taking antidepressants for more than two years in a row. Unfortunately, their side effects are plentiful; they include weight gain, low libido, nausea, problems sleeping, constipation, irritability, and anxiety. But for adolescents and children taking antidepressants, there’s also a heightened risk of suicide.
It’s crucial to note that antidepressants do work well for some people, but for many people, they simply aren’t an effective treatment. Pay special attention to your body and your wellbeing overall and work with your practitioner to find strategies that help you manage depression. Natural options to consider are exercise, minimizing processed foods and eating a nutrient-dense diet, and natural supplementation such as St. John’s Wort, magnesium, and valerian root. Note: do not take yourself off prescription medication without the guidance of your practitioner, and keep in mind that some natural treatments such as St. John’s Wort are contraindicated with SSRIs.
If you or someone close to you is showing signs of needing help, don’t ignore the red flags. The Suicide Prevention Lifeline can be reached at any time at 1-800-273-8255
While most doctors agree with the appropriate prescription of opioid painkillers for acute pain, opioids are not an appropriate solution for chronicconditions. Moreover, because of their highly addictive nature, even people who have prescribed opioids for a brief time (such as for post-operation recovery) can very easily become addicted and begin abusing their prescriptions. For this reason, there is a growing movement to avoid prescribing opioid painkillers altogether to reduce the risk. (Not to mention short-term side effects such as nausea and constipation).
If you’re preparing for major surgery, talk to your doctor or surgeon about your recovery options and express your concerns about steering clear of potentially addictive substances. Likewise, if you struggle with chronic pain, it’s important to turn to as many natural solutions as possible to avoid dependence on drugs.
You should never remove yourself from a prescription without speaking to your medical care provider about it. You can work with your family doctor or a naturopathic doctor to determine a plan to safely wean yourself off of a prescription and replace it with a natural and safer alternative that works for your lifestyle and your body.
Remember that there are many ways to keep your body healthy, and the first thing your doctor suggests is not always the best option for you. Holistic Nutritionist, Alina Islam summarizes it perfectly:
“REMEMBER, JUST BECAUSE A PARTICULAR SPICE, HERB OR FOOD DOES NOT HAVE CORPORATE-BACKED RESEARCH WORTH MILLIONS OF DOLLARS, IT DOES NOT MEAN THERE IS NO SCIENTIFIC EXPLANATION BEHIND ITS BENEFITS. IT MEANS THERE IS LACK OF INTEREST IN PURSUING THE RESEARCH.”
People around the world are becoming increasingly aware of natural remedies and alternative medicine.
However, this does not change the attitude of Big Pharma to enforce their drugs on an open-mouthed public despite their numerous and well-documented, harsh side-effects.
The almighty health benefits of cannabis are becoming increasingly accepted in mainstream society and are being bolstered by numerous recent studies.
The Foria Relief Company has even invented a vaginal suppository, based on aromatic cocoa butter, which is a perfect substitution for Vicodin, Midol, and Ibuprofen. It effectively treats menstrual cramps by relaxing the muscles. Additionally, it does not lead to psychotropic properties.
It is produced from pesticide and additive-free cannabis. Therefore, their active ingredients are used in a process without microbials and are combined with exact doses; 60 mg of tetrahydrocannabinol (THC) and 10 mg of cannabidiol (CBD).
The pain is blocked by the THC, which inhabits the pleasure areas of the brain’s cannabinoid system. CBD relaxes the muscles, treats the spasms, and has a favorable effect on inflammatory mechanisms within the body.
According to a woman who tried the vaginal suppository, it relaxed her clenched and cramped muscles and soothed the pain in her midriff. She explained that she felt the area below the waist to the thighs “as if floating in some other galaxy”.
Yet, this amazing remedy is only sold in California and is still not approved by the FDA. However, if you decide to use it, make sure you consult your doctor beforehand, even though there have been no complaints from people who have tried it.
