There are certain phenomena in the medical field that are rather hard to understand. We were brought up knowing that opioids and like substances were bad and should be avoided at all costs and we did that but as we grew and each of us went his way in matters there are mysteries that we met. As everybody else chose careers I chose to be here practicing medicine and I tell here my perception of opiates and like substances were changed here we use them as drugs especially as pain management drugs. To many people this may sound irrational. How do you use a drug that has dangerous effects to treat an illness? Don’t worry we had the same questions and curiously we waited to have these mysteries unraveled. We use these drugs in doses that are only able to address the pain and for a time that may not cause any serious health problems. However as patients were put on these drugs the whole medical industry work up to the realization that the use of these drugs in most cases resulted in the patients being addicted to the drugs and hence demanded more and more of these drugs. These drugs are rewarding in nature and so patients that are put on these drugs will automatically tend to crave for them. That is when opiophilia became a disease to be fought from all corners to help patients on these drugs to evade addiction and dependence on these drugs.
Opiophilia is a love of opioids, the love for opioids may not begin as a choice but may begin gradually when a patient is prescribed opiates to help him in pain management. In the past the doctors had given a blind to the possibility of pain patients under opiate drugs to be addicted on these drugs as they believed that the dosage was not enough to make the develop dependence on these drugs. However as patients take these drugs they will become addicted as the drugs are rewarding in nature. This therefore means that before a doctor prescribes opiate to a chronic pain patient he should assess the patient and develop exit strategies that will help these patients avoid addiction.
Fortunately, the medical industry has fought opiophilia and better strategies have been put in place to ensure that patients on these drugs are safe. Opiophilia seems an already won battle. Apart from proper pain management by use of these drugs other natural ways of pain management have been embraced to help patients where necessary. These natural pain cures include Prolozone therapy, PRP and prolotherapy. These natural pain cures are now used worldwide to help patients with chronic pain.
The fight against opiophilia was won but that did not end all the problems associated with the use of opiates in managing pain in patients. Another disease came and replaced opiophilia and this is opiophobia.
Opiophobia is a disorder or affliction, so named because people affected have a great aversion to the use of prescription opioids for the treatment of pain, to the point where they will actually refuse to take or administer it. This is rather new disease in field of drugs and addiction. This term is also used to refer to instances when doctors fear or are unwilling to prescribe opioid medication to patients.
In most cases doctors who have had unwillingness to prescribe opioid medications are often counseled and so they go back to administer the drugs. Opiophobia should be addressed just as much as opiophilia since it is the opioid that goes deep in managing pain. This is because the only direct biologic pain-relief system in the human body is the endogenous opioid receptor system, consisting of endorphins and their tissue based action sites, or receptors. Using opioid based drug in pain offers instant relief and so the opiates still remain to be the best pain relief medication. The public as well as the doctors may be subject to opiophobia owing to the negative information that are spreading concerning the use of opiates in dealing with pain. The major concern of these groups is that they know that when a patient has used the opiates for a short term or long-term pain then he becomes addicted and will show symptoms of withdrawal once he stops using the drugs. This may be true but this is also true with other medications doesn’t a diabetic patient become dependent on insulin? Needless to mention several strategies have been put in place to ensure safe exit from the use of these drugs. When you are dependent on any drug for medical purposes. That is not abuse.
Because of opiophobia and opiophilia State regulators have been introducing legislation to severely curtail availability of opioid class of medication this unfortunately may be a disadvantage rather than an advantage as there are patients that are already dependent on these drugs needless to mention there is no alternative that has been put in place that can work effectively enough to replace opioid class of drugs in managing pain.
There is need for a safe exit strategy to help the patients evade any possible danger that may come from using the drug. However it is better for a doctor to formulate a safe exit strategy. He will be able to do so depending on such factors as; consistence of a patient’s behavior with drug addiction, patient’s willingness to cooperate with an outpatient-based opioid analgesic tapering plan, patient’s history with substances disorders. All these assessments will help the doctor to formulate a safer exit plan for the patient.
Here at AWAREmed we are dedicated to finding the best solutions to chronic illnesses and that is why Dr. Dalal Akoury (MD) is always in the forefront advocating for integrative medicine since it is only through integrative medicine that a person can be healed wholly. Do not hesitate to call on her for help in managing any sort of chronic pain as well as other diseases.