![]() ![]() So what are you supposed to do? If your pain pills aren't doing for you what you want, should you get a higher dose? Should you get a stronger narcotic? I think most pain specialists would say this is the time for a reevaluation of your pain and looking at other options for pain management. So people who use pain on an everyday basis, their pain medicines are not going to work as well and they're going to need more and they might become addicted and it doesn't work for chronic pain in the first place. Particularly for things that are chronic like low back pain, or people who have pelvic pain that's chronic, not just like the acute pain that comes with a bad period or with an ovarian cyst that ruptures or something like that. If our listeners ask, "My painkiller isn't working as well as it used to," then the answer is, "Right, how long have you been taking it, and what have you been taking it for?" So moving is important for most kinds of pain to make you feel better. So our goal is to make it tolerable for people to get up and move around because getting up and moving around is really important to make the pain feel less. We never can make all the pain go away for someone, we'll say, after surgery. So the goal for pain is that acute pain should be treated with the least amount of drugs that do the job well for someone so that they can get up and move around. Acute Pain Should Be Treated with Minimal Medication So in reality, it's almost like acute pain that keeps happening over and over as the cancer spreads to a new area. So cancer pain tends to come and it gets worse and worse as the cancer spreads. now, there is a kind of chronic pain, meaning longer than a couple weeks, in which narcotics can be very helpful and that's the pain associated with cancer. So more and more, we've understood that chronic pain. So you take more narcotics and then the difficulty is are you really needing those narcotics or are you addicted? What is the behavior around getting those? What then happens is that people start taking more narcotics and then you get into this vicious circle of taking more narcotics and then it not working as well and then maybe sensitizing you to pain so your pain actually feels more. So that's where you get used to the narcotic effect. So the other issue is that when you've taken narcotics for a while, the same dose doesn't give you the same effect. Dangers of Long-term Narcotic Use: Addiction and Diminished Effectiveness One is that narcotics can actually sensitize you to pain so you feel it more. So that's a good thing because it's going to hurt for a couple of days and narcotics work for that. My dentist gives me painkillers when I go and have my wisdom tooth taken out.ĭr. Jones: But during that going away time, narcotics can be very useful. Jones: Something that's going to go away 'cause you're going to heal.ĭr. Interviewer: Something that's going to go away.ĭr. You break your leg, you sprain your ankle, you've just got an abscess in your finger or you just had an operation. Jones: Well, chronic pain is pain that goes on longer for a week or two.ĭr. Interviewer: So now, what classifies as chronic pain to you?ĭr. Number one, it doesn't work for chronic pain and, in fact, narcotics can sensitize people to pain so they actually feel more pain. Efficacy of Painkillers in Treating Acute vs Chronic Painĭr. Number one, we have very good evidence that narcotics do not work for chronic pain. However, two things happen if you take it for longer than a week or so. Let's say you just had surgery or you just had a cesarean section, it can be really great for a couple of days. What we do know is that narcotics are opioids and these would be drugs like hydrocodone, oxycodone, and morphine, Demerol, drugs like that, are actually pretty good for acute pain, meaning they work when the pain is acute onset. I'm assuming our questioners are asking about narcotics.ĭr. Now, let's talk a bit about what we're talking about painkillers here. Jones: This is a great question and, in fact, yes, this is normal. Is this normal? Can You Grow a Tolerance to Painkillers?ĭr. Kirtly Jones, a lot of women have been emailing us lately for various reasons of pain and they've been saying that painkillers just don't work for them anymore. ![]() Is this normal? We'll find out next on The Scope. Interviewer: Your painkillers don't work for you anymore. ![]()
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