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Opioid medications becoming limited in the UK?

WaylayWaylay Posts: 837Member Pioneering
I don't want to panic people, but I read something about this in another post, so I went and did some googling. I could be wrong, but I found a lot of recent documents/sites about limiting/reducing opioid use by chronic pain patients. I'm writing about it here because if this IS happening, we all need to be aware of it and be ready to talk to people (particularly doctors) about it.

One document (an Oxford University Hospitals document entitled, "Guidance for opioid reduction in primary care" (dated 12/2017)) seemed to summarise what a lot of the others were saying:

Opioids Aware five headline points
----------------------------------------------
1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain.
Some patients (hi *waves*) have lived experience that they're good for long-term pain. Are we not evidence? Other sources estimate that about 20% of chronic pain patients find opioids helpful. That's a lot of people!

2. A small proportion of people may obtain good pain relief with opioids in the long term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation).
I wouldn't know about doses, but I assume that if people have really severe pain, higher doses might be required? Just an assumption - I'm not medically-qualified or a chemist. Comments, anyone?

It seems to make sense that intermittent use is probably more likely to stay effective (I occasionally stop my tramadol for days), but again, that's just my opinion. The fact that it's difficult to identify the people who do benefit at the point of initiation of opioid treatment is an issue, but that doesn't mean that they shouldn't have the choice to use them. What if they need them and nothing else helps enough

3. The risk of harm increases substantially at doses above an oral morphine equivalent of 120mg/day, but there is no increased benefit.
Safety at lower doses makes sense, but I'd like to see the studies that say that increased doses don't result in an increased benefit.

4. If a patient is using opioids but is still in pain, the opioids are not effective and should be discontinued, even if no other treatment is available.
UH?!?!?! What?! This goes against everything I've read and been taught about chronic pain . The "magical treatment/med that completely stops the pain" is one of those myths that pain clinicians spend a lot of time fighting. It may exist for some people (although it's very very rare), but for most of us, we need to accept that the magical cure doesn't actually exist (yet) before we can begin to move forward WITH our pain.

However, the lack of a magical, complete cure doesn't mean that a partially effective treatment isn't useful! Why would we continue to use TENS, injections, stretching, pacing, and meds with nasty side-effects if that were the case? In my experience, nothing completely gets rid of my pain (if it does for some of you, congrats!), but a lot of things help. When I have 8/10 pain I'm bed-bound, have trouble standing without help, my body gets twisted into odd shapes by muscle spasms, and I'm in absolute agony. If I take the appropriate doses of opioids and benzos, my pain generally goes down to ~4/10, which is a pain level I can handle. At that point I can stretch, and perhaps do other things that reduce the pain further. I can pay attention to a TV program, or go to sleep. I can get to the loo by myself, or grab something to eat. I'm much more able at 4/10 than I am at 8/10. No, I'm not pain-free - I haven't been for a decade - but my pain (and other symptoms) are far easier to handle on opioids+benzos. They WORK.

5. Chronic pain is very complex and if patients have refractory and disabling symptoms, particularly if they are on high opioid doses, a very detailed assessment of the many emotional influences on their pain experience is essential.
I imagine that almost all chronic pain patients have experienced the "It's all in your head" thing (from both medical and non-medical people). We're often judged to be nuts/malingering/making it up. The pain we feel is real, and often it's due to dysfunction in the peripheral and/or central nervous system(s). However, emotions do have a large effect on how much pain we feel. The brain releases certain chemicals to create pain in the body. It releases similar chemicals to signal emotions. Some of those chemicals are the same, and some affect each other. Happiness *chemically* reduces the amount of pain we feel, while sadness chemically increases it. Mental health problems such as depression and anxiety cause more pain, while love and touching a loved-one really do reduce pain. This isn't us being *crazy*; it's how the nervous system works.

As a result, if we're really down on ourselves, our lives, the people around us, etc., our pain will feel worse. If that's the case, we might benefit from some psychological treatment, some support to change our life circumstances (or an actual functioning benefits system which doesn't torture us and leave us in destitution!). If we're too scared to do anything physical because we think that we'll make things worse, and if that isn't true, then we could benefit from education and support to understand that, and to become more active (in the particular case of ME and the Pace study, ignore this completely!).

We might also benefit from some support to adjust to our new lives, if we've become disabled. I went from extremely fit, high-paid, in a career I loved, with lots of savings, and a partner I had a future with, to unable to get up off the floor, destitute and bankrupt, no career, no job, and dumped by my partner in 3 months. That was damned difficult to deal with! My mental health went haywire for years. I would really have liked some expert help to deal with the whole situation (I could still use some help, to be honest!).

Obviously, all the above are individual for each patient.

However, intimating that refractory and disabling symptoms while taking high opioid doses means that somehow these patients' chronic pain is more psychological in character is .... *$&#(# I've run out of words.



Tired. Hope this made sense.



Replies

  • EmmaBEmmaB Posts: 140Member Pioneering
    @Waylay you might find the following article interesting:  

    https://www.theguardian.com/society/2018/jan/24/prescription-drug-addiction-government-launches-investigation

    I think the problem is that GPs/Consultants are basically putting people on various drugs e.g. anti depressants, opioids etc, which are not only addictive but which are also either ineffective long term and/or which cause further problems, i.e. other medical problems, with long term use.

    I see a LOT of people through my work who are on multiple prescriptions who still feel totally and utterly crap, there's something wrong with this for me!  Something isn't working. 

    Whether the NHS has the time, money, and/or inclination to really change things I don't know but they are starting to look into it which is a good thing.  Prescribing the drugs costs the NHS a lot of money so it's possible they could redirect that money to solutions that actually improve people's quality of life rather than just give them medications which don't work and effectively writes them off [for life]...

    I experience pain but I wouldn't touch opioids with a barge pole.

  • Freemum64Freemum64 Posts: 6Member Listener
    @Waylay Current pain levels dictate I have zero concentration (I am sure you can relate!!) but very much look forward to reading your post as I too have been hearing whispers!! Xx
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    I have Fibromyalgia/chronic pain that is unresponsive to any pain medication/opioids. My Mom however survives on a cocktail of pain killers will have to mention this to her.
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    Which ones are opiods please?


    I am a fibrowarrior!
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    edited November 2018
    Thanks @EmmaB I've just had a look and my meds are on there. I don't know if gabapentin is an opiod or not? I'm also on an anti depressant. I don't know how I would cope without my meds. So what's next? 


    I am a fibrowarrior!
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    @debbiedo49 i’m on Pregabalin which is the same sort as Gabapentin, it’s an anti-seizure medication so hopefully that won’t be covered 👍🏼
  • EmmaBEmmaB Posts: 140Member Pioneering
    Gabapentin isn't an opioid but it is a problem drug along with pregabalin - the prescribing of both drugs has gone through the roof in recent years and both are problematic and have 'street value' such are their effects.  

    Nothing is going to change with this in a hurry but the bottom line is that many of the drugs being looked into are ineffective or damaging when used long-term.  

    Psychologically it can feel like they may be helping [at least initially] but then ineffectiveness and addiction kicks in, also the effects of coming off medication can be misinterpreted as 'relapse' when in fact it is just the effects of coming off the medication.  

    The bottom line is that there may be better alternatives including non medication routes.

    This investigation is a good thing as it should mean people will get more effective treatment rather than just being dumped on drugs that don't work...

    @DavidJohn1984 your anti seizure medication should be fine because the thing is that they know how such medications work i.e. they have a clear effect, same as meds for diabetes, heart conditions etc.  

    The problem is that they really don't have a clue how medicines used to 'treat' mental distress and pain work, they've been winging it and its not working so something has to change!  


  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    @EmmaB don’t start to worry me now 🙈. I have one of two options for my Fibromyalgia and Pregabalin has the least side effects. I’ve tried every pain killer/opioid/analgesic drug there is and they all ended in disaster 🤮. I would like to try CBD oil but I can’t stomach the taste. I didn’t realise Pregabalin was a problem, my initial side effects actually nearly prevented me from continuing on them. I got horrendous audible hallucinations from them 🙉.
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    @EmmaB gabapentin is being used to treat my fibro. Even when I tried to reduce the dosage the withdrawal pains were horrendous. I hate being on it but what's the alternative? Just suffer? 


    I am a fibrowarrior!
  • DezziDezzi Posts: 4Member Listener
    I'm new so hope it's ok to jump into this thread. I wanted to tell David John 1984 that I take cbd oil, but in capsule form. Just in case that would work for David. I take it as well as my prescribed medications which include pregablin, and find it helpful. Thanks, hope I did this right 😊
  • [Deleted User][Deleted User] Posts: 0 Connected
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  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    @debbiedo49 what dosage are you on, i’m only at 200mg a day, nearly been on them a month. I have noticed “some minor changes” like I can shower now without passing out. However my alladonia has gone from feeling like I’ve been hailed upon to a scolding feeling now. @Dezzi i’ve Just found capsule ones but I have to wait for some money as all mine was stopped, how do you find them? @danb I tried every different painkiller for my fibromyalgia pain but none worked they just aggregated my CVS. I do take Diazepam to sedate me though when I do have a cycle and I take 30mg of Amatryptaline to sleep at night.
  • Freemum64Freemum64 Posts: 6Member Listener
    @DavidJohn1984 Pregabalin gave me horrible hallucinations plus a ‘locked-in syndrome’ feeling of complete helplessness. CBD oil can be added to melted chocolate - once it hardens, you genuinely wouldn’t know. I myself take Shortec 120mg daily and Tramadol 50mg as spares. I have a pain management appointment with a consultant on 29th. I was in such agony a few weeks ago and hadn’t slept for two nights, my 20 year old daughter googled ‘fibromyalgia medication’ and something called Savella came back as a medication that was created some years ago, SOLELY for the treatment of fibro. Currently licensed only in N.Ireland and can only be prescribed over here by pain mgt clinics, so we shall see!! Xx
  • Freemum64Freemum64 Posts: 6Member Listener
    Ps Sorry, Shortec is Oxycodone. Amytriptiline made me gain 30lb so I now use Phenergan which is an OTC sleep aid. Xx
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    @Freemum64 I didn’t know Amatryptaline caused weight gain? I read Pregabalin does the same. I have a medical condition that causes drastic weightloss, so so far I have gained no weight from any medications. I’ve been on Amatryptaline about 2-3 months now and i’m On 20-30 mg a night.
  • Freemum64Freemum64 Posts: 6Member Listener
    Have to say, @DavidJohn1984, I’ve only ever known women to take Amy, each and every one of us gained weight. Xx
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    @Freemum64 yeh my Mom takes it and she gained a lot of weight. I guess it must be down to my CVS that i’m an exception. I wouldn’t mind some weight gain to be honest with you. I went from 13 stone 11 in January to 17 stone 8 in March, to now being 11 stone 13. I’ve lost over 5.7 stone. 
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    @debbiedo49 what dosage are you on, i’m only at 200mg a day, nearly been on them a month. I have noticed “some minor changes” like I can shower now without passing out. However my alladonia has gone from feeling like I’ve been hailed upon to a scolding feeling now. @Dezzi i’ve Just found capsule ones but I have to wait for some money as all mine was stopped, how do you find them? @danb I tried every different painkiller for my fibromyalgia pain but none worked they just aggregated my CVS. I do take Diazepam to sedate me though when I do have a cycle and I take 30mg of Amatryptaline to sleep at night.
    3 tabs 3 x daily


    I am a fibrowarrior!
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    Freemum64 said:
    @DavidJohn1984 Pregabalin gave me horrible hallucinations plus a ‘locked-in syndrome’ feeling of complete helplessness. CBD oil can be added to melted chocolate - once it hardens, you genuinely wouldn’t know. I myself take Shortec 120mg daily and Tramadol 50mg as spares. I have a pain management appointment with a consultant on 29th. I was in such agony a few weeks ago and hadn’t slept for two nights, my 20 year old daughter googled ‘fibromyalgia medication’ and something called Savella came back as a medication that was created some years ago, SOLELY for the treatment of fibro. Currently licensed only in N.Ireland and can only be prescribed over here by pain mgt clinics, so we shall see!! Xx
    My friend vapes cbd oil


    I am a fibrowarrior!
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    @debbiedo49 I haven’t had visual hallucinations yet, I just have audible ones. It sounds like i’m stood in a busy chopping centre and everybody is talking at once but I can’t hear what they’re saying. I read they usually taper off after a few weeks. I’m being upped every two weeks atm. I want to ask the Dr about CBC oil. I want to give it a try again. Not to sure about the vaping side though. I’ve never heard of say Ella, I shall google it. I’m not in a pain clinic yet. I Tramadol I tried a few weeks ago, had a bad day and took 2 and ended up being blue lighted to hospital. That ended the pain killer route. I did try oromorph which helped but the hospital said it’s not suitable because you build up a tolerance.
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    I tried amitriptylene initially but wasn’t tripping out of my tree and still in agony and I went to my g p crying from the pain and side effects that’s when they gave me Gabapentin for chronic pain. 


    I am a fibrowarrior!
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    Oh no @debbiedo49 that’s no good. The Amatryptaline only help me sleep, not every night but I went days and days without sleeping. The Pregabalin i’m Trailing now to see if that helps with the pain. I’ve just looked at the savella online and i’ll Speak to my Dr about it. But i’m Betting you can’t take the two at once.
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    Ok I am going to look it up. 


    I am a fibrowarrior!
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    I wonder why my g p hasn’t suggested it?


    I am a fibrowarrior!
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    Thanks @debbiedo49. I’ll speak to my Dr, he may want me to see how go with this because the hospital said is usually around 300mg twice a day is what you need before you experience any relief from Symptoms.
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    It did take me s while to get used to Gabapentin then I was diagnosed wit him fibro and the pain was bad so I went up a dose. I get about 4-6 hours sleep on this dose at a time and I drop off in the afternoon wit him fatigue after work.  I can’t manage without a nap as I get more exhsusted which just get some worse. I’m not keen on sleeping tablets as I get a hangover feeling 


    I am a fibrowarrior!
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    Thanks @debbiedo49. I’ll speak to my Dr, he may want me to see how go with this because the hospital said is usually around 300mg twice a day is what you need before you experience any relief from Symptoms.
    Feel free to message me and let me knod how you get on


    I am a fibrowarrior!
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    @debbiedo49 I can’t nap to save my life, if I nap in the day I can’t sleep at all. I can no only sleep with Amatryptaline soon as I lay in one position for to long it’s like lying on hot coals. So I get stressed out moving then i’m So stressed I can’t sleep. I can sleep for 3 hours most nights and wake up, then eventually i’ll have a night when i’ll be asleep for 14 hours. But when I do I wake up in agony because I don’t move when I sleep it’s a bit of a no win situation. The shower gives me the most fatigue, and the stairs walking up them by the time i’m half way i feel like I’ve run a marathon. Do you suffer with alladonia, or restless leg syndrome?
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    Yes I get restless legs. I have a body pillow which helps me feel supported during sleep. 


    I am a fibrowarrior!
  • DavidJohn1984DavidJohn1984 Posts: 99Member Courageous
    Not heard of a body pillow, will have to have a look at them. I did started sleeping with a pillow under my legs to help relieve lower back pain but it didn’t work.
  • WaylayWaylay Posts: 837Member Pioneering
    Or a V-shaped pillow. Works for me. Hug it like a body pillow, and also fits between knees, so hips are straight when lying on side.
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    A body pillow is just a long pillow. I got it in lidl lol you can bend it. My neck is really bad so I have lots of pillows to sleep properly


    I am a fibrowarrior!
  • [Deleted User][Deleted User] Posts: 0 Connected
    The user and all related content has been deleted.
  • XenasMumXenasMum Posts: 27Member Connected
    Hi I've just looked up Savello and it mentions seizures. I'm epileptic but 11yrs free, has anyone tried this that is epileptic? As I really like the sound of it and up to yet I only take Baclofen and amitriptyline but the amitryptaline is for other things too. Gabapentine did nothing and I can't take ibuprofen 
    Btw I have cbd oil in a vape but it doesn't really do anything but I do know someone else who takes it and it's been a lifesaver for her. You can get gummy bears with cbd oil @debbiedo49 ;
  • WaylayWaylay Posts: 837Member Pioneering
    @XenasMum Hi there,

    Never heard of Savella, sorry. Have you tried Pregabalin? It's related to Gabapentin, but sometimes it works when Gabapentin doesn't.

    I'm curious - I get horrendous back spasms - they're the most painful and limiting part of my chronic pain syndrome. I've never been prescribed any muscle relaxants/antispasmodics like Baclofen (aside from the occasional benzo for emergencies). Does it help?

    Apparently CBD oil varies depending on a bunch of things, the most important being whether it's made from hemp or actual MJ. There are a bunch of sites that discuss this if you search for them. I use Vine CBD E-liquid, and it seems to lessen the frequency of my spasms somewhat, although it doesn't help with the pain.
  • XenasMumXenasMum Posts: 27Member Connected
    @Waylay Pregabolin did nothing for me and @debbiedo49 had mentioned Savella so I thought I'd ask my GP about it. I'm going to Charing Cross to find out if the problems with my legs are a side effect of an accident I had years ago as I fractured 4 vertebrae in my spine and I think I might have bone spurs pressing on my spinal column is narrowing. As I have spinal stenosis now.
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    I've never tried savella and forgot all about it till now lol #fibrofog


    I am a fibrowarrior!
  • debbiedo49debbiedo49 Posts: 2,731Member Disability Gamechanger
    EmmaB said:
    Gabapentin isn't an opioid but it is a problem drug along with pregabalin - the prescribing of both drugs has gone through the roof in recent years and both are problematic and have 'street value' such are their effects.  

    Nothing is going to change with this in a hurry but the bottom line is that many of the drugs being looked into are ineffective or damaging when used long-term.  

    Psychologically it can feel like they may be helping [at least initially] but then ineffectiveness and addiction kicks in, also the effects of coming off medication can be misinterpreted as 'relapse' when in fact it is just the effects of coming off the medication.  

    The bottom line is that there may be better alternatives including non medication routes.

    This investigation is a good thing as it should mean people will get more effective treatment rather than just being dumped on drugs that don't work...

    @DavidJohn1984 your anti seizure medication should be fine because the thing is that they know how such medications work i.e. they have a clear effect, same as meds for diabetes, heart conditions etc.  

    The problem is that they really don't have a clue how medicines used to 'treat' mental distress and pain work, they've been winging it and its not working so something has to change!  


    Where do you get your information from please? 


    I am a fibrowarrior!
  • WaylayWaylay Posts: 837Member Pioneering
    That sounds very unpleasant, @XenasMum! Good luck!
  • WaylayWaylay Posts: 837Member Pioneering
    @EmmaB
    Most chronic pain patients never have any problem with addiction. Dependence (physical) can occur, but that's just when you get withdrawal symptoms if you stop taking it. Addiction involves a psychological component, which often shows up as a craving for the med, needing it to the point that the patient will allow other parts of life to fall away, etc. 

    Opioids help some people with chronic pain, but you have to try them to find out whether you're one of those people. I can't take NSAIDs anymore (naproxen, diclofenac, ibuprofen, etc.) because they damaged my stomach badly, nor can I take paracetamol (caused acute liver failure about 8 years ago). Tramadol really helps me, to the point that I would be much, much more limited without it. I don't take it some days, and take more or less depending on how much pain I'm in. Every few months I go off of it for a few days, just to make sure. I get a few minor withdrawal symptoms, but they're just kinda annoying. 
  • EmmaBEmmaB Posts: 140Member Pioneering
    Hi @Waylay
    You might find this article interesting... I think the medical profession is going to have to wake up to the fact that their prescribing has become lazy, uncreative, and  ineffective, not to mention that it doesn't help let alone cure many people who end up on a horrendous cocktail of medication (then wonder why they still feel rubbish...). 

    https://www.madinamerica.com/2018/12/anatomy-of-an-opioid-epidemic/

    This opportunity prescribing problem is similar to the psychiatric medication problem. In my experience the fundamental problem is that we are not treating the root cause of people's problem which are life's circumstances, especially trauma of some sort...

    Best wishes for 2019 and let's hope thinhtturth around on this front.

    Emma
  • WaylayWaylay Posts: 837Member Pioneering
    I agree completely about not treating trauma! I was diagnosed with Borderline PD several years ago. I go to a programme for it two days a week. We aren't allowed to talk about anything bad from our pasts, despite the fact that most of us have significant histories of trauma (we talk about these things when out of smoke breaks). I've recently been re-diagnosed with Complex PTSD, which fits me much better than BPD. Unfortunately there's no treatment available. Great. I'm very lucky to have a very good counselor who charges me 10GBP/week, and is helping me to talk through all this stuff.

    I'll add that the benefits system is making many of us (in the BPD programme) MUCH worse. Living in poverty, constantly worried about losing our benefits, etc., is really stressful. My odyssey over PIP last year seems to have re-activated my worst C-PTSD symptoms, too.

    IMHO, that article is part of the problem. Many chronic pain patients, like me, are helped by opioids. We remain on the same doses (I have for many, many years), and our pain doesn't increase (except when stress, flares, etc. cause it).

    The opioid epidemic is massively overblown. When institutions such as the CDC report numbers, they almost always combine deaths due to prescription opioids with deaths due to heroin/fentanyl overdoses. (They also assume that all deaths with any amount of opioids involved are overdoses, when in many cases the dose of opioids wasn't lethal. Additionally, they assume that all overdoses are mistakes, when some are on purpose (chronic pain patients are at high risk of suicide).) But combining prescription opioid deaths with heroin deaths is the biggest issue.

    The addition of fentanyl to heroin is the main driver of the increase in deaths. Of course some doctors have been overprescribing opioids. Giving someone oxys for a sprained ankle is ridiculous (this happened to a friend of mine - he didn't take any). This kind of prescribing is irresponsible. These prescriptions often get stuck in a medicine cabinet and forgotten, and can be grabbed by curious teenagers, etc. Leaving these kinds of meds around the house is also irresponsible.

    So yes, definitely get rid of doctors who run pill mills. Yes, educate doctors on when opioids are necessary, and how many should reasonably be prescribed. (Giving a month's worth of pills for wisdom tooth removal or post surgical pain isn't a good idea. Give a couple of days' worth, perhaps a week, depending on the situation. Don't give them for a sprained ankle!) Yes, educate patients on the dangers of leaving opioids around the house - get them to hand them in if they have any left.

    But don't punish pain patients! Banning the prescription of opioids except in cases of terminal disease is cruel and not supported by the evidence. Some chronic pain patients NEED these meds to function - I do. Without them I'd be bed-bound most of the time, in agony. Life would not be worth living. Many pain patients in the US are killing themselves when they're forced off opioids - not because of withdrawal, but because living with that amount of pain day in, day out is not worth it.

    My thought is that it's easier for the government to blame prescription opioids, and to go on a crusade against them, than for them to fix the much more serious and complicated problems driving the epidemic. People addicted to street heroin, particularly with the introduction of fentanyl, need complex interventions. Why are they using the drugs? Generally trauma, difficult lives, poverty, etc. Sorting that kind of thing out is much more complicated (and expensive). Why are more people taking these drugs? Because society is falling apart, poverty is everywhere, lifestyles are spiraling downward, and all many people see in their futures are lifetimes of penury and poverty. Fixing that takes massive investment in society, in how the system works, huge changes so that the US values all its members, etc. That's way too much. So blame the prescription opioids. That's easily dealt with, and they can crow about it on TV while chronic pain patients suffer and die.





  • EmmaBEmmaB Posts: 140Member Pioneering
    Hi @Waylay

    Your long post was really interesting.  I think a lot of people are misdiagnosed with BPD when really it's cPTSD which is because of a worrying lack of awareness in the medical profession.

    It's great you've got a good counsellor; many of the counsellors who work with trauma are saying that to work with it you need to work through the body as that is where the trauma gets trapped [and that's is what causes the physical symptoms], it's a fascinating approach but one the NHS is some way off incorporating!

    I think the bottom line is that it's complicated.  If people could get the right treatment right at the start then they might well not progress to pain meds/opioids and that is where we are going wrong big time.  

    Bio-chemically there just doesn't seem to be a place for long term opioid prescriptions... but there is a placebo effect with any medication.

    Did you ever see The Doctor Who Gave Up Drugs, fascinating stuff:





    What would be great is more people with experience of these issues working with others with the same issues.

    All the best.

    Emma
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