Alleviating physical pain is part of the medical record extending back 5,000 years to ancient Egypt. But with the recent development of the powerful synthetic drugs called opioids -- oxycontin, hydrocodone or fentanyl, for example -- pain relief has moved quickly onto promising but hazardous terrain.
The Cook County Medical Examiner's Office reported 609 opioid-related overdose deaths in 2015, the most recent year tallied. A special local task force has investigated the epidemic, and Chicago is pursuing multi-million-dollar litigation against major pharmaceutical companies for allegedly misrepresenting these drugs and their potential for addiction.
The desire by both doctors and patients to manage pain is completely understandable. But if you're considering such drugs, be sure to develop a careful, close and patient relationship with your doctor, with consistent monitoring and consultation. Their use should never be considered "routine."
At my membership medical practice, we discuss the pros, cons and the alternatives to opioids if pain is chronic. And we draft a formal agreement with definite goals: limited use, only in specific situations, and a schedule for early cessation. We work together to redirect the psychological component of pain, and to strengthen the parts of the body that can help the healing process.
Our members have no-delay, no-rush office visits and quick access to the doctor via cell phone and email. They also have the advantage of a very thorough, 2.5-hour annual physical exam, which includes testing and consultation with a dietitian and a professional physical trainer. (Call WellcomeMD at 708-455-2094 for a free consultation and a tour of the practice, or visit us at WellcomeMD.com).
Patients who are experiencing pain sometimes ask me about marijuana -- medical cannabis. Anecdotal evidence about this use is growing, but solid data is scarce because federal anti-cannabis laws make clinical trials very difficult to arrange.
Doctors in Illinois do not prescribe medical cannabis for pain, or anything else. Our role, instead, is to confirm that a patient suffers from one of about forty medical conditions that qualify them for a Medical Cannabis Card. These include cancer, glaucoma, HIV/AIDS, rheumatoid arthritis, Parkinson's, and Alzheimer's. New ones will probably be added to the list soon, but generalized pain -- say, from a backache, or after surgery -- does not currently qualify. Patients must apply online, and be under the care of a physician. Once the state approves the application, a card allows the patient access to purchase cannabis from a private dispensary.
One new study in Michigan found that medical cannabis use for pain reduced opioid dependence by two-thirds, and many patients reported fewer side-effects and improved quality of life. "More research is needed to validate this finding," the study reported, as studies often do. Pain, of course, continues. So, let's hope the necessary research, however it turns out, moves ahead quickly.
Answer Book 2019
To view the full print edition of the Wednesday Journal 2019 Answer Book, please click here.
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