Opioids Increase the Risk of Prolonging Postoperative Pain, Claims Study

While it is common to give prescription drugs to patients after a surgery, a recent study questions the prevailing practice. The study on mice indicated that opioid use after surgery could be counterproductive. The finding has led to concerns among various stakeholders, including medical practitioners, experts, scientists, etc., who fear its consequences on the pain management of patients.

The study highlights some of the lesser-known darker aspects of opioids that are likely to worsen the ongoing battle with opioid crisis. As human physiology of both the mammals – mice and humans – is quite similar, the researchers are apprehensive. Linda Watkins and Peter Grace from the University of Colorado Boulder performed exploratory abdominal surgery on male rats.

Also known as laparotomy, it is a fairly common surgery in America. During the course of the study, around three experiments were conducted to understand the impact of morphine in the long run. Firstly, one half of the rats were administered a moderate dose of morphine for seven days after the surgery and another half was given a saline solution. Secondly, mice were given morphine for eight days and then tapered off on the 10th day. Lastly, mice were given morphine for 10 days, after which it was abruptly withdrawn.

Some of the eye-opening findings were as follows:

Rats on morphine experienced pain for longer than three weeks.
The longevity of pain depends on the duration of the intake of morphine; the consumption of morphine for long makes the pain last longer.
Gradual tapering made no impact on the pain; this was not a result of withdrawal, rather other factors at work.

Researchers identified that the extension of postoperative pain was primarily caused due to increased expression of inflammatory genes, including those encoding Toll-like receptor 4 (TLR4), NOD-like receptor protein 3 (NLRP3), nuclear factor kappa B (NF-κB), caspase-1 (CASP1), interleukin-1β ((IL-1) and tumor necrosis factor.

Nonopioid alternatives for tackling pain

The opioid crisis is undoubtedly one of the worst epidemics to ravage America in recent times. While a couple of years ago opioids were considered as the best cure for chronic pain, they are now under intense scrutiny. Stanford pain specialist Sean Mackey concurs that opioids should never be the first-line treatment due to the risks attached to them. Instead, nonopioid alternatives should be tried first, he suggested.

According to Mackey, there are currently over 200 odd nonopioid medications for pain. Nonopioid medications, like acetaminophen used for osteoarthritis, lower back pain and migraine, do not lead to fatal overdoses associated with opioids. Similarly, topical agents, such as tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are used for treating localized musculoskeletal pain, osteoarthritis, etc.

Nonpharmacologic interventions, like exercise therapy and cognitive behavioral therapy (CBT), play a crucial role in the management of pain. While exercise therapy improves the overall well-being and promotes happiness in patients, CBT reduces pain and enhances functioning in daily life. Apart from educating the patient about relaxation techniques and sequenced breathing, CBT guides him/her through developing coping strategies required for mitigating pain.

Timely intervention essential for recovery

Being highly addictive in nature, prescription drugs, specifically opioid painkillers like Vicodin and hydrocodone, increase the risk of developing an addiction. Timely intervention is essential for containing the spread of the addiction. If left untreated, the consequences of prescription drug abuse could be fatal.

More than anything else, it is necessary to recognize every person living with pain has his or her own unique story and needs. Not everyone who lives with pain will respond in the same way to treatment. So, while exercise therapy and medications could work for one, they would not necessarily work for others. Therefore, one needs to be careful and cautious while taking these medicines.

Role of Family in Addiction Recovery

We all are aware of the life and living cycle of a human being. Between birth and death, there is a lot that happens which shapes our identity. There are certain traits which are inbuilt or inherited and then there are some characters that we build as we go through certain states and situations, which add-on to our identity at various points of time. Now my question here is- What do you identify your first identity as?

Birth; your name given by your family; schooling on the basis of parents’ name; college on the basis of your parents’ name and your marks; your resume requires’ your family details; your bio-data for marriage needs your family details. So everywhere, the family stands first, which makes it your first identity.

The reason I am quoting this point is that family has its role everywhere. Even in addiction, it has its unequivocal involvement. Addiction is known as a Family Disease. It cannot be denied that family has its significant role to play in enabling addiction and ending it as well.

Once an addict has been treated and has started his journey of recovery, your role as family does not just end there. Rather it is just the beginning and you have to make sure that your loved one takes it to a long way. Without your knowledge and support, it is not going to be possible. There are certain definite steps that you as a family need to take, so that your whole family can enjoy a sober and happy recovery life.

Be Alert and On the Watch

Do not commit the same mistakes again. Having your emotions attached with someone might not be something that you can control, but a sure measure that can be taken is to keep them under your control.

You should not get over-emotional whenever your recovering addict is trying to get you in his trap. You must keep in mind, all the things he did previously. If there is an excess of any behavior, which you think, was previously used, to go for using substance, you must immediately get aware of it and take a tough step. You will have to let go your gullible nature and be more sagacious.

Be alert about his routine and daily activities. Trust him in what he is doing, but not so blindly that he would take you for a ride. Know that he is not supposed to take you for granted. Have all your questions answered about any kind of deviations that you see or hear of in a clear manner.

Always discuss whatever move he wants to make and then considering its practicality and profitability, you can decide to finance or support it. But do not get too much defensive and doubtful about his capability. That is a tough job, right?

Do Not Leave Him Free

‘Empty mind is devil’s workshop’. You must have been hearing this since your childhood. So when you leave him without any work or engagement in the family, he would drag himself to drugs/alcohol and maybe utilize his pent-up energy in using it in newer ways. Understand the line of his privacy and his alibis to use drugs in private, hiding from you. Show your full involvement in his talks and tasks. Make sure that he does not take anything casually. If he loses his sincerity and starts frittering away time, he would lose his awareness, which might turn out to be a reason for relapse. In treatment, they are taught many unwritten philosophies, such as No Free Meals and Being Aware Is Being Alive. They must practice them and for practicing them you need to be their role models too. Also, make sure that his circadian rhythm does not change, i.e. his sleep cycle and even eating habits remain healthy.

Be Emotionally Available

Always be emotionally available to him. There are times when we all feel low. Apparently, those who become addicts, their coping mechanism is automated towards drugs and alcohol or self harm only. So, whenever you see that your loved one is getting sad and negative about life, or has chosen the silent corner for himself for a persistent time period, you need to intervene. Cook for him and ask him to help, play good music, go out for a nice lunch or dinner, refresh some childhood memories. There are many things to do together. Treatment does not get over with the addict getting out of the rehabilitation center. Don’t take him lightly ever. He needs the feeling of love and belonging, more than anybody else needs. And at the same time, don’t commit this mistake of asking him to consume a little bit of alcohol or smoke once a while at social gatherings, thinking that might uplift his mood and you are keeping an eye on him, so he won’t go out of control. An addict can never settle at peanuts. He would get back to the same intensity again.

Don’t be Scared

Do not ignore his anger and over that, do not be scared of it. Don’t be scared of the self harm threats he would be driveling before you. If he is losing his calm over petty matters and snapping at everything you say, beware then. For it indicates that he is again going to use his substance. If you become submissive, which is what he wants, you will lose this battle with addiction. You have to practice Tough Love. Forget about what he used to do earlier when his wishes were not fulfilled. You do not have to be his Jinn again. He knows when to rub the lamp, but you need to decide whether your emotions have to come out or not, even if he is trying to be forceful. The moment you give-in and hand over your emotional control to him, he would relapse. No anger, no threats of self harm, no abuses shall work on you. You need to be stronger than him. Not all the time do you have to be pleasant with him and specially for his irrational demands and behaviors. Don’t let him overpower you. Identify when is he trying to do that. He cannot raise his unnecessary demands, financial/fake emotional/unimportant medical needs over your necessities and routine. He would be testing your patience most of the times. He would be trying to see if he still has control over you, so don’t give-in his tactics. Let him know that no drama would work in your house and on you.

Addictive behavior can be spotted in any phase of life. Those behaviors would be leading to relapse. For example, excessive shopping, which you might take as being normal to pamper self once a while; but if you see a large amount of money being wasted on shopping, you need to beware again. Spending too much of time on phone, internet, movies, and preferring to be isolated for long hours. Even eating too much is a sign of approaching relapse. These are just actions that a recovering addict takes as substitutes of his substance and to find his temporary solace. You can always call the rehab for help and continue going to Family Association Meetings. But being a family member of a recovering addict, Never Give Up.

Ways Schools Can Fight A Drug Menace

A combination of factors, including the ease with which drugs can be procured, alienation and peer pressure, is driving American teens toward their abuse. As a result, adolescents in high school and college do drugs on the sly. In dorm and frat parties, it has become customary to pool all drugs – stolen from elder’s medicine cabinets, or procured from vendors or pill mills – before going on the adventure ride of a collective high. However, this fun and adventure comes at a cost. As most teens doing drugs are aware of the implications of the misdemeanor once caught, they do not report to the authorities in case a peer overdoses, resulting in tragic loss of young lives.

The problem of drug abuse has spread its deadly tentacles across schools, posing a significant threat to the future of children in terms of impact on their health, academics, career and personal life. In the wake of such a serious implication on the future of the society, many schools, despite the paucity of funds, have put together programs for spreading awareness and keeping drug abuse under check. While some approaches rely on prohibition and punishment, others stress on education and rehabilitation. The objective is to keep drugs off the campus and establish a solid foundation to empower individuals to resist such temptations.

As youngsters prefer engagement to long boring lectures, some of the means adopted by the schools are as follows:

Disseminating knowledge through antidrug assemblies: Antidrug assemblies are engaging means to showcase the grim consequences of drug-seeking habit. With addiction treatment doctors and recovering patients turning up as guest lecturers, students can have a realistic picture of how drugs take them away from their loved ones and cause impairment of cognitive skills, such as difficulty following instructions. Students get the opportunity to clarify their doubts during such sessions.

Educating children as early as possible: Considering the fact that most youths start doing drugs, smoking cigarettes or drinking alcohol in school days, or when they are on the cusp of adolescence, it is the best time to drive home the dangers of doing drugs and other addictive substances.

Conducting self-reliance programs: Children who are confident about themselves are less likely to take drugs. Therefore, some programs stress on building the child’s self-reliance in all sorts of social situations. This helps them even under adverse peer pressure to not succumb to the temptation of doing drugs and say no to such activities firmly. Such programs are effective even in the long run as they teach children some essential life skills necessary for abstaining from drugs, alcohol, etc.

Stocking antidotes: As it makes no sense to shy away from the truth that youngsters, especially those in college, will be doing drugs irrespective of the controls, authorities are advised to stock up their supply of opioid overdose antidote naloxone.

Engaging children from families grappling with addiction: Instead of isolating a child with a problematic family, including members addicted to drugs, it is essential to engage him or her in all school or college activities. Irrespective of whether the child reports late to school or has problems with homework, a concerned and supportive school environment will mitigate the chances of the child falling into the same addiction cycle. Children of drug addicted families could also participate as guest lecturers in antidrug assemblies.

Focusing on building teen assertiveness: With the help of a trained child counselor and other professional services, schools could focus on providing training to teens to develop their assertiveness and emotional control level. This is not only handy in career building, but could also help the teen realize his or her worth. Teens who feel sad and befuddled have greater risks of taking drugs to feel successful or empowered.

Get help for drug addiction

Children run the increased risk of falling into the trap of drug addiction due to their emotional vulnerability and undeveloped brain still in the process of developing the key cognitive skills. It becomes essential for parents and teachers to listen and talk to their fears and emotional upheavals, rather than ignoring them as their tantrums.