I feel that firstly I will refer only to the narcotic pain medications that are legal in Australia at the present date. I specify this as I want it to be clear without a doubt that I will not be discussing the involvement of marijuana or hemp.
I feel secondly that I should elaborate on exactly what a narcotic is, why I consider it to be the ‘other extreme‘ type of pain management medication for treating Systemic Lupus Erythematosus (SLE or Lupus) as well as many other ongoing and chronic pain illnesses, diseases and injuries. Indeed it is important I feel not only because it may be a medication a patient comes across, but also because the fear of addiction to medications and regular illness treatment stems from a keen awareness of the risk of narcotic addiction in the chronic illness community.
So first things first, what are narcotics?
Narcotic (middle English, via French, via middle Latin from Greek-narkotikos to make numb) A drug which induces drowsiness, stupor or insensibility, and relieves pain. (Google)
From the above translation it can be understood to anyone who has experienced extreme pain, or even not-so-extreme pain on an ongoing basis, why the use of these types of drugs may be desirable at first.
I mention I consider it as the other ‘extreme‘ pain medication. So this means there is another treatment I consider to be extreme, and please note I did not say I consider them to be equally extreme. The other ‘extreme’ I mentioned are the range of corticosteroids used by medical practitioners as anti-inflammatories and immunosuppressants.
Of course, as I mention regularly throughout my writings, I am not a medical practitioner, nor do I have qualifications regarding to the knowledge of diagnosing or treating illnesses from the perspective of a professional of any sort. I may have missed pain management treatments between basic ‘over the counter’ medications, general prescription drugs, NSAIDs and DMARDs, corticosteroids and narcotics that are used to treat pain for the many chronic pain illnesses such as Lupus and Rheumatoid Arthritis (RA).
I simply share what I have found and learned to add depth to my knowledge and hopefully make the awareness of those around me, and those like me, deeper and more meaningful. I say this because I have never needed to surpass the above lists and my previously mentioned topics of pain medication. My illnesses has not progressed that far. Thankfully. My mother thinks I put too much concern in things that may never happen to me, so I should not do it. But isn’t it human nature to be inquisitive? The need and desire to inquire and solidify our own understanding is one of the first actions a child grasps with any certainty. As we age we want to have more control over our actions and thus begin to plan.
I have never been on a narcotic treatment plan. What I have found, from my experience with and through others is that they are difficult. When you enter into this course, you may not have the clarity of mind to acquire this type of information. They are strong and they usually have an affect on more areas than the one area they are meant to be treating. Having not been on them, as I say, I do not know much and would love for readers to share their own experiences and thoughts with me. I will cover what I can find in as complete and organised a way as I can think of, but sadly I cannot include my preferred ‘zesty’ personal humour.
What and Why?
Narcotic drugs used in the treatment of chronic illnesses are only used to attend to the severity of the pain. This is simply because they do not offer any control of the diseases, they only offer relief from the pain. Narcotic treatments are analgesics. They do not prevent or protect against damage, nor do they limit or reduce the site of injury or cause for the pain. They just minimise the amount of pain messages that are sent to and received by the brain (rheuminfo.com).
Common names you may hear in the narcotic conversations include:
Codeine, Hydrocodone, Hydromorphone, Methadone, Morphine, Oxycodone, Tapentadol, Tramadol, Ultram, Dextropropoxyphene (emedexpert.com) (dailystrength.org)
When narcotics are referred to in the medical profession, they are referring to narcotic analgesics. Another name for ‘narcotic analgesics’ are opioid medications. They are only used to treat moderate to severe pain which is expected to last for an extended length of time. Please bear in mind this is compared to more typical pains which are expected to pass after a very brief period of time and can be managed by attending to the cause of the pain directly.
Narcotic analgesics attach to receptors on nerves in the brain that increase the threshold to pain (i.e., the amount of stimulation it takes to feel pain), and reduce the perception of pain (the perceived importance of the pain) (medicinenet.com).
A sufferer of a chronic illness is not likely to simply be prescribed this form of pain management treatment for their typical pain. They are expected to experience largely prolonged periods of pain and the damage that comes with it. A surgery or operational procedure of particular parts of the body are likely to be followed up with short narcotic pain management plans. As are some injuries incurred from severe physical traumas or nerve damage. I have a friend that undertook numerous brain surgeries and another that was in a large road accident. Both of those were treated with opioids during their recovery. When I had extreme pain in my pain and back from my Rheumatoid Arthritis and Cerebral Vasculitis I was not treated with narcotics.
Typically for chronic illness sufferers the use of narcotics appears largely to emerge from one of two things. The first is the appearance of specific neural injuries. Brain and spinal cord injuries and pain are an area that are treated often with opioid or narcotic medications. I cannot say why as the reasons and causes are simply too varied, as I also cannot explain why this is the way it happens. It is just something that is. The second treatment of pain in chronic pain sufferers is for what is known as ‘break-through’ pain. This is when the pain breaks through the barriers that the regular treatments and medications create to hold out inflammation and pain. Breakthrough pain does not necessarily mean that the medications aren’t working, rather that the pain is on occasions stronger than what the medication is designed to prevent. It is higher levels of pain, not higher levels of injury.
I feel that I could go on, rambling, for a long time. It would be unnecessary and dull if I did however. So I think I will just finish this by saying:
I do not know of any categories of pain management drugs other than the ones I have covered which would be considered for the treatment of Lupus or similar chronic pain illnesses. I will delve into pain management techniques that do not involve drugs at a later point in time. I also will delve into my earlier comment regarding why many people are concerned with addiction to pain management drugs. Now is not the time for that. Now is the time for you to think on your concerns and considerations for drugs used to treat pain. What have you used? What have you felt to be the most effective and which would you prefer to avoid? Why?
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I suffer from Lupas I have had it since 2000so I know and feel your pain very close to my heart I long for a pain free day the only thing iam grateful for is I have had my family long before I have Lupas but in saying that I had a baby boy in 2004 and he is the only one that I had madgur sideaffects from but he is 11 now and is in great health just a pain free day would b like heaven thank you for sharing
I have taken tramadol for years and the dosage is losing it’s effectiveness from tolerance. The doctors are now afraid to up dosages of tramadol (ultram) because they changed the schedule ( status) if the drug.
It is frustrating for people who need these pain meds to function and do daily tasks like washing the dishes and taking a shower.
I also have gabapentin which helps some but makes me groggy, whereas the tramadol does not.
The “powers that be” want to play God and take power away from the doctors, who are trained to know what meds the patient needs.
I suffer daily with chronic pain and it has the terrible effect of lowering my quality of life, and my ability to do things. The government should leave the doctor decisions to the doctors.
I hope you are feeling ok today. Thank you for all the things you share on your blog.
Oh dear Annie my heart is with you! We are facing a similar (if much more novel) issue in Aus). I don’t know if you are in Australia, but the government wants to make it so we need prescriptions from doctors for any codeine-based product. I’m talking things like panadol osteo, mersyndol and cold and flu night medications.
I pride myself on having a somewhat high pain tolerance but sometimes that doesn’t help you sleep and mersyndol has been my big spin for so many years. I’d hate to add that to my reasons for seeing a doctor, it’d feel about as appropriate as seeing her for Head lice!!
God I wish some PM’s got Lyme’s, lupus, fibro or something. Live like the chronically I’ll, THEN try to take our pills away!
I hope you are managing OK my dear, big love xx
I have been taking Physeptone (methadone)tablets for years for chronic pain associated with Lupus. I have a very physical job that I enjoy (aged and community care ) but I also experience pain in my normal everyday life. It gives me quality of life and control of my body. After years of anti flammatories paracetamol codeine morphine fentanyl I am most comfortable and stable using physeptone. Doctors prefer not to prescribe opiates but as I had tried everything else I was desperate and insisted. Good luck everybody. Lupus is a lonely disease as outwardly you look well but your body feels like it has been run over by a truck!! And fatigue and exhaustion are something you just live with and family and friends just don’t understand and quite often forget your illness. I seem to suffer from bronchial pneumonia every winter chronic migraines as well as constant pain even with taking strong pain killers. At least the pain meds make life bearable and I never feel sorry for myself as there are so many people in the world worse off than me. If you feel opiate meds will help you find a good doctor who will prescribe to you. Stay strong. (Australia)