Chronic Pain Medication Research Paper

The usage of pain medications has gone up severely over the years. It is guaranteed that some types of pain medications exist in your medicine cabinet. With a readily available supply of pain medications, it have brought up problems associated with abusing such medications that have led negligent American families into abandoning their health for comfort. Pain medications are administered in a variety of setting, from nurses at hospital beds to paramedics at vehicle collision scenes. Pain medication is a broad term as it varies from over-the-counter strength to prescription strength. Each type of medication will have different ingredients, which are paired with different side effects. Many painkillers can allow the patients to develop an addiction

that leads to drug dependency, while other painkillers are non-habit forming. Everyone responds and reacts to pain medications differently, thus careful consideration must be made before prescribing such drugs. Healthcare providers must consider the appropriate types, strength, length of duration, possible abuse, and withdrawal before releasing the prescription to the pharmacy.
The United States Pharmacopeia (USP) and the U.S. Food and Drug Administration (U.S. FDA) have worked closely together to ensure the qualities and standards of the pain medications distributed throughout the United States are being met. One of the FDA’s top priorities are pain medications, and they have approved many painkillers over the years, including “Zohydro ER (hydrocodone bitartrate extended-release capsules) for the management of pain severe enough to require daily, around-the-clock, long-term treatment and for which alternative treatment options are inadequate” (U.S. Food and Drug). In the past, it was a custom to combine hydrocodone with acetaminophen or ibuprofen. However, since the introduction of Zohydro ER, patients are demanding the switch to the non-liver poisoning drugs. This attracts more patients to overdose on such drugs since it does significantly less damage to their livers, thus leading them down the rabbit hole. Healthcare providers have to be aware of such cases and determine if their patient is a great candidate for Zohydro ER with the necessity of such drug. However, when it comes to children, determining their level of pain may much more difficult. Adult patients know how they can express their pain in words, but children have difficulty expressing their pain with their limited vocabulary. This can easily lead to over prescribing pain medications to children who may exaggerate their symptoms. This is when “Donna Wong, a pediatric nurse consultant, and Connie Morain Baker, a child life specialist,” (Baker) have worked together to develop an easy to read pain-rating scale. “[They] believed with the proper tools, children could participate in assessing their pain, leading to more success in managing their pain” (Baker). With the introduction of the Wong-Baker FACES pain rating scale, children are able to identify their levels of pain based on their face descriptions. This greatly reduces the chance of overestimating the children’s conditions and decreases the chances of prescribing a higher dosage than necessary. This helps the patients, as they can rest assured knowing that they are receiving adequate treatment for their conditions.
Acetaminophen has been one of the highly regarded drugs to relieve pain and reduce fever. However, acetaminophen alone is not sufficient enough to relieve moderate to severe pain. Once combined with hydrocodone or oxycodone, it can be sufficient to relieve and offset the pain. The strength of these medications can be adjusted by increasing or decreasing the amount of narcotics while the acetaminophen remains constant at or below 325 milligrams. The FDA asks all “health care professionals to stop...dispensing prescription combination drug products that contain more than 325 milligrams (mg) of acetaminophen…[as] these products are no longer considered safe by FDA” (U.S. Food and Drug). Acetaminophen has been identified to severely damage one’s liver, yet pharmaceutical companies still continue to use the maximum allowed amount of acetaminophen in a single pill. This is to ensure that patients are not overdosing on narcotics when they are on these combination drugs. All prescription bottles containing acetaminophen are required have a warning label to alert consumers about possible liver damages when taking more than prescribed. The warning label is effective as it includes death as one of the many consequences if overdosed. If patients follow the instructed dosage, then it will be up to the provider to control the narcotic to acetaminophen ratio when treating and managing severe pain. The providers can adjust the narcotics ratio accordingly, while allowing their patients to relieve painful symptoms without receiving too much acetaminophen, resulting in a better outcome of their overall health.
Many healthcare providers are worrisome when it comes to treating chronic pain patients, as they require around-the-clock pain relief, which with time, will develop tolerance to their pain medications.

Patients with chronic pain will slowly “notice that the one or two tablets no longer work as well and to obtain the same level of pain relief they need to take three of four tablets” (McAllister). When patients can no longer suppress their pain with the current dosage, they will barge into their provider’s office demanding for an addendum to their prescription. While being prescribed a stronger dose will ease their pain, it also poses an addiction problem. Their bodies will slowly depend on such painkillers when relieving any underlying pain. Once they attempt to veer off the pain medications, the excruciating pain will force them right back onto the drugs with a higher dose. Some patients have different cases, such as patients with terminal illness are suffering from chronic pain, they should be allowed to continue receiving narcotic drugs without thoughts into their future health. However, the cases with chronic pain patients are different, as “most people with chronic pain will die with chronic pain, not from it” (McAllister). Chronic pain is often not the source of death; but rather from the long-term use of narcotic painkillers that have led them to a decrease in their general health. Painkillers should not be used indefinitely, especially for those with a normal life expectancy. There are better and healthier alternatives as opposed to taking pain medications. A great example is aquatic therapy, it allows patients to be in a “gravity-reduces environment,” (White) and thus greatly reduce the weight off of their joints and spine. Natural methods used to relieve pain are also non-habit forming, and this will not cause any long term problems are otherwise associated with pain medications. There are many other excellent alternatives, and providers should look into

referring the patients before prescribing pain medications.
The active narcotic ingredients attract many users to take advantage of abusing such drugs. These drugs can relieve pain, and also put the users in a happy and altered state, which can be addicting for some. Once addiction takes over, some pain medication users may discover that these narcotic painkillers are ideal for recreational uses. For example, MS Contin, which contains morphine, “is a strong opiate and is highly addictive” (Effects of Morphine). The outcome of abusing MS Contin includes: “unconsciousness, cardiac arrest, suffocation due to lack of breathing and coma, even death” (Effects of Morphine). When abusing such drugs, it will not only decline your general health, but it can also be a costly mistake. Patients will need to seek costly treatments, such as at specialized drug treatment clinics to put an end to abusing such drugs, otherwise their liver can fail and be forced to receive a lifetime treatment at a liver dialysis center. Before getting addicted to narcotic pain medications, these users should think twice before introducing the painkiller in their bodies. In efforts to reducing drug abuse, the Controlled Substances Act was signed into place, which created the drug schedules. There are currently five drug schedules, in which the “Schedule I drugs are considered the most dangerous class of drugs with a high potential for abuse and...Schedule V drugs [represent] the least potential for abuse” (DEA). The drug schedules outlines how a healthcare provider can make such drugs available to patients, with the exception of Schedule I drugs, which are prohibited for medical uses. It gives both the users and healthcare practitioners a general idea of how dangerous the drug will be once the drug sorted into one of the five schedules. This allows drug users to make informed decisions and think twice before using highly addictive narcotics for recreational uses.
Narcotic dependent patients will find difficulty when the time comes to withdrawal. Their bodies will not be able to handle such dramatic withdraw as the production of natural endorphins have significantly decreased during the course of being on painkillers. Withdrawing means that patients will experience intense pain without any endorphins to spring into action and fight off the pain. As patients withdraw on narcotic pain medication, such as Percocet, it will cause the blood level to rise and drop rapidly, and “when the blood level of the acting medicine drops quickly, pain returns quickly, leading to the need for additional doses and higher doses overall” (Clauw). Patients seeking help will need support from their family members and guidance from professionals. The reason that patients are on pain medications is obvious, and they do not want to go back to living their lives with excruciating pain. This is difficult for many, but there is help available. Currently, “the addiction profession workforce is estimated at more than 76,000 individuals that include counselors, educators, and other addiction-focused health care professionals who specialize in addiction prevention, intervention, treatment, recovery support, and education” (NAADAC). Seeking professional help is the first step the patients have to take to reduce and end all narcotic uses. Professionals can help by “[suggesting] the best approach, and [providing] guidance to what type of treatment and follow-up plan is likely to work best” (Intervention). These experienced counselors are trained to support and guide patients who do not wish to depend on such drugs, and help them along their drug free journey. Escaping from drug addiction will never be easy, but it is up to the patients, themselves, to listen to the professionals and follow their procedures to a brighter future.
All patients tend to have a different response to pain medications than others, so it is important for healthcare providers to make the right decision when it comes to prescribing such drugs. The providers are faced with numerous types and strengths of pain medications, and they have to decide how to tailor for each individual’s needs. After establishing the type and strength of the pain medication, the providers have to determine the length of duration their patients will spend on the specific drug without developing a tolerance to such drug. Lastly, the providers have to question themselves whether their patients will follow their instructions on safe drug usage or take advantage of such drugs for recreational uses before sending off the prescription to the pharmacy. Providers should always suggest an alternative before using pain medications as part of their patient's’ treatment plan. They have to keep patients in check to monitor and ensure they are using the painkillers as prescribed. Healthcare providers are the patient’s best advocate when it comes to safe drug usage, their main duty is to alleviate their patient’s pain and allowing them to live a healthy life.