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posted by martyb on Thursday October 07 2021, @03:16AM   Printer-friendly

Chronic Pain Treatment Should Include Psychological Interventions:

"There are several effective nonmedical treatments for chronic pain, and psychological treatments emerge among the strongest of these," said Mary Driscoll, a researcher at Yale University and first author on the issue's main article. "People who engage in psychological treatments can expect to experience meaningful reductions in pain itself as well as improvements in physical functioning and emotional well-being."

[...] Research has shown that psychological factors can play a role in the onset, severity, and duration of chronic pain. For those reasons, several psychological interventions have been shown to be effective in treating chronic pain.

In the article, Driscoll and her colleagues describe the interventions that have been most widely studied by the pain community, including:

  • Supportive psychotherapy, which emphasizes unconditional acceptance and empathic understanding
  • Relaxation training, or the use of breathing, muscle relaxation, and visual imagery to counteract the body's stress response
  • Biofeedback, which involves monitoring patients' physiological responses to stress and pain (e.g., increased heart rate, muscle tension) and teaching them how to down-regulate these responses
  • Hypnosis by a trained clinician, which may induce changes in pain processing, expectations, or perception and incorporates relaxation training
  • Cognitive-behavioral therapy, in which patients learn to reframe maladaptive thoughts about pain that cause distress; change unhelpful behaviors, such as isolation and inactivity; and develop helpful behavioral coping strategies (e.g., relaxation)
  • Mindfulness-based interventions, which help to disentangle physical pain from emotional pain via increased awareness of the body, the breath, and activity
  • Psychologically informed physical therapy, which integrates physical therapy and cognitive-behavioral therapy

The PSPI [(Psychological Science in the Public Interest)] report also addresses topics such as integrated pain care, or the blending of medical, psychological, and social aspects of health care; the future of pain treatment; and improving the availability and integration of pain-management strategies.

Journal Reference:
Mary A. Driscoll, Robert R. Edwards, William C. Becker, et al. Psychological Interventions for the Treatment of Chronic Pain in Adults:, Psychological Science in the Public Interest (DOI: 10.1177/15291006211008157)


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  • (Score: 2, Insightful) by Runaway1956 on Thursday October 07 2021, @04:37AM (11 children)

    by Runaway1956 (2926) Subscriber Badge on Thursday October 07 2021, @04:37AM (#1185067) Journal

    An active mind has no time to dwell on little things like pain.

    Seriously, toothache, sore joints, sore muscles, even moderately serious injuries - if you keep your mind busy on something, the pain fades into the background. No, it doesn't magically go away, doesn't disappear, but if you're not thinking about it, the pain is far more tolerable. No, not saying that it works for serious injuries, but "chronic pain" isn't something that just happened to you five minutes ago.

    • (Score: 3, Informative) by driverless on Thursday October 07 2021, @05:12AM (1 child)

      by driverless (4770) on Thursday October 07 2021, @05:12AM (#1185070)

      Chronic pain is something completely different. It's a long-standing, non-curable condition that affects a lot of people and can be at best mitigated with continuous use of painkillers. Causes are typically from either nerves being triggered by something like arthritis or for no apparent reason, one theory being nerves becoming over-sensitive and sending pain signals even when there's nothing to cause it. Talk to someone with fibromyalgia to see what it's really like, and how debilitating it can be.

      • (Score: 1, Interesting) by khallow on Thursday October 07 2021, @02:30PM

        by khallow (3766) Subscriber Badge on Thursday October 07 2021, @02:30PM (#1185180) Journal

        Chronic pain is something completely different.

        Not at all. Runaway's list includes toothaches, a common source of chronic pain in pre-dentistry days. And if you have sore muscles all the time (and the occasional more serious injury) because you couldn't afford to not work, well, that's chronic pain too.

        It's a long-standing, non-curable condition that affects a lot of people and can be at best mitigated with continuous use of painkillers. Causes are typically from either nerves being triggered by something like arthritis or for no apparent reason

        Other causes would include permanent dental illnesses and injuries when you don't have dentists. Sore muscles when you can't stop doing the activity creating those sore muscles, etc.

        Sure, maybe Runaway is downplaying the most serious pain a lot, but he has a point. Not all chronic pain is morphine drip-level pain. His suggested approach can help deal with that sort of pain.

    • (Score: 5, Insightful) by DannyB on Thursday October 07 2021, @01:53PM (6 children)

      by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @01:53PM (#1185168) Journal

      An active mind has no time to dwell on little things like pain.

      Spoken like someone who doesn't know what real pain is.

      I take narcotic pain killers. I only take them when the pain reaches a certain threshold. That threshold is when the pain is the only thing in my mind and I am unable to think about anything else or distract myself, then it's time to take a pill. I usually start with 1/2 the prescribed dose, which often is enough. I've been doing this for almost 13 years.

      I don't take much. I haven't gotten in any trouble with it yet. Both my primary care and specialist doctors tell me I'm taking reasonable amounts. My primary care doctor recently increased the frequency (not the dose) that I can take, because some times of the year I am using a bit more.

      Real pain is like a nail or spike in your mind. (But it is in some specific part of your body, and it quite real.) It is not something that any mental health professional is going to fix. I've already figured out breathing and relaxing on my own. When you experience enough pain, I believe, you probably start to figure out things like this on your own. "oh, if I relax, it hurts a bit less" I already take prescription anti inflammation drugs and about 2000 mg of acetaminophen per day. When it feels like a wire saw is cutting through my bone, and I can't think of anything else, then I reach for a small dose of the good stuff.

      When you say "little things like pain", I get that. Lots of "little things" that most people think are painful are things that don't bother me. I can say that if you live with chronic pain, you get somewhat desensitized to it. It's not that you are not aware of various pains in life, it's just that you don't mind so much. That's just my experience. Others may vary.

      --
      People today are educated enough to repeat what they are taught but not to question what they are taught.
      • (Score: 2) by Runaway1956 on Thursday October 07 2021, @02:11PM (4 children)

        by Runaway1956 (2926) Subscriber Badge on Thursday October 07 2021, @02:11PM (#1185175) Journal

        Spoken like someone who doesn't know what real pain is.

        Not exactly "chronic", but do you have any idea what a 3rd degree burn feels like? You're doing that "No true Scotsman" thing, but with pain. That is, "If you haven't experienced my pain, you don't know pain."

        You'll note that I separated moderate injuries from serious injuries, and further distinguished between traumatic pain, and over stressing the body. If you care to argue that none of those types of pain are exactly "chronic", fine. But you can stuff the drivel about "doesn't know what real pain is".

        • (Score: 3, Insightful) by DannyB on Thursday October 07 2021, @03:26PM (3 children)

          by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @03:26PM (#1185192) Journal

          I get what you're saying.

          It's simply that I don't agree that an active mind has no time for pain. When pain wants to get your attention, it does. No matter what code you'd rather be writing.

          --
          People today are educated enough to repeat what they are taught but not to question what they are taught.
          • (Score: 2) by Runaway1956 on Thursday October 07 2021, @04:17PM (2 children)

            by Runaway1956 (2926) Subscriber Badge on Thursday October 07 2021, @04:17PM (#1185200) Journal

            You're at least 90% right. But, from experience, if you're far enough out of pain to think rationally, you're best off getting busy with something, anything, and don't allow yourself to dwell on the pain. You mention breathing and relaxing - and you are effectively doing the same thing I did with staying occupied with something. Take control and step away from the pain.

            Of course, if you're that deep in that you simply CANNOT step away from it, then you need some good drugs. Maybe a shrink can eliminate your pain with hypnosis or acupuncture or whatever, but that's something I'll believe when I see it with my own two eyes.

            • (Score: 3, Informative) by DannyB on Thursday October 07 2021, @04:26PM (1 child)

              by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @04:26PM (#1185203) Journal

              As I had mentioned, the threshold where I take narcotic pain killers is when I CANNOT distract myself from the pain. It invades every thought no matter what. That's when it's time to take some drugs (as my wife says).

              I am not into hypnosis, acupuncture or any 'whatever'. I don't believe it. But I do pray. Not because doing so changes my circumstances, but because it changes me.

              --
              People today are educated enough to repeat what they are taught but not to question what they are taught.
              • (Score: 0) by Anonymous Coward on Thursday October 07 2021, @04:51PM

                by Anonymous Coward on Thursday October 07 2021, @04:51PM (#1185209)
                Get a room, you two. You're rehashing the same words arguments you made, to each other, again. Stop spamming.
      • (Score: 0) by Anonymous Coward on Friday October 08 2021, @01:49AM

        by Anonymous Coward on Friday October 08 2021, @01:49AM (#1185374)

        This is complete and utter bullshit. Pain is pain, yes there is a bit of a difference between pain that affects the central nervous system versus that of the peripheral nervous system, but ultimately pain is pain. The main difference between chronic pain and acute pain is that chronic pain may not have a condition that can be resolved, or it may not even have an identifiable cause.

        In the majority of cases, the reason for the pain is that you're doing something that causes it or there is an underlying condition that causes it. In either case address the issue and it goes away. Yes, there are situations like neuropathy where pain is basically there and there's not a whole lot that can be done in terms of preventing the source, but that doesn't change the fact that it's still just pain. There's nothing particularly magical about different kinds of pain in most cases.

        As for the wire saw, that's exactly the time to just experience the pain. Trying to run away just makes it worse. I remember 10-15 times a day getting splitting tension headaches that felt like somebody was literally cutting my cranium in half with a saw and I just went with it. I felt it, I felt the waves up and down and I learned to treat it as biofeedback. Eventually, I got to the point where I could just will them away in a matter of a few cycles and even longer after that I just wouldn't get them at all. It doesn't mean that the pain wasn't "real" pain, it just means that the underlying cause responded well to mindfulness.

    • (Score: 2) by Common Joe on Thursday October 07 2021, @07:19PM

      by Common Joe (33) <{common.joe.0101} {at} {gmail.com}> on Thursday October 07 2021, @07:19PM (#1185269) Journal

      Yeah, I learned to ignore my pain until one day I woke up and couldn't walk. (That took a few weeks to undo.) There is such a thing as over doing it. Typically, pain is there to tell you to slow down or change what you're doing -- even chronic pain.

    • (Score: 2) by mcgrew on Friday October 08 2021, @02:19PM

      by mcgrew (701) <publish@mcgrewbooks.com> on Friday October 08 2021, @02:19PM (#1185527) Homepage Journal

      I see you've never had severe chronic pain. I was diagnosed with arthritis at age 19 in the Air Force. REAL pain will prevent your mind from thinking about anything else.

      As to TFA, the arthritis is related to weather, and Delaware has the absolutely worst climate for arthritis I've seen. Didn't hurt at all in Thailand, but there was a bout in Northern California that sent me to sick call. Unlike Delaware where they kept me drugged, the California doctor prescribed yoga. It works. And part of yoga is having a calm mind concentrating on a meaningless sound while doing stretching and breathing exercises. Unlike the drugs, it actually took away the pain. I hurt less often now than I did fifty years ago, and the pain is usually not too bad.

      --
      mcgrewbooks.com mcgrew.info nooze.org
  • (Score: -1, Flamebait) by Anonymous Coward on Thursday October 07 2021, @04:49AM (11 children)

    by Anonymous Coward on Thursday October 07 2021, @04:49AM (#1185069)

    Maybe not. Maybe it's just SoylentNews.

    So many posts about chronic illness affecting mostly the elders.

    SN - Boomers' gerontology "news."

    • (Score: -1, Troll) by Anonymous Coward on Thursday October 07 2021, @05:22AM

      by Anonymous Coward on Thursday October 07 2021, @05:22AM (#1185073)

      What these chronic pain people need is the 2x4 Clue stick therapy. Nothing like blunt force trauma to focus the mind, and get you to order more opiods.

    • (Score: 2, Disagree) by driverless on Thursday October 07 2021, @05:30AM (2 children)

      by driverless (4770) on Thursday October 07 2021, @05:30AM (#1185075)

      Some types of chronic pain affect people of all ages, but then the slew of medical-treatment-related posts does seem a bit off-topic for a tech forum as opposed to Mednews or similar.

      Perhaps we should ask Bennett Haselton what he thinks?

      • (Score: 0) by Anonymous Coward on Thursday October 07 2021, @06:28AM

        by Anonymous Coward on Thursday October 07 2021, @06:28AM (#1185076)

        My butt hurts.

      • (Score: 2) by hendrikboom on Saturday October 09 2021, @09:19PM

        by hendrikboom (1125) Subscriber Badge on Saturday October 09 2021, @09:19PM (#1185834) Homepage Journal

        What? Medicine isn't a technology? Who knew?

    • (Score: 3, Insightful) by DannyB on Thursday October 07 2021, @01:55PM (6 children)

      by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @01:55PM (#1185169) Journal

      So many posts about chronic illness affecting mostly the elders.

      SN - Boomers' gerontology "news."

      Don't worry, you'll get old too. And it will happen to you faster than you think.

      --
      People today are educated enough to repeat what they are taught but not to question what they are taught.
      • (Score: 1) by khallow on Thursday October 07 2021, @02:33PM (5 children)

        by khallow (3766) Subscriber Badge on Thursday October 07 2021, @02:33PM (#1185182) Journal
        Especially since he doesn't seem to think very fast. Mean ole Boomers and their embarrassing medical problems. Maybe in a few decades, he'll appreciate that someone looked into that stuff.
        • (Score: 3, Insightful) by DannyB on Thursday October 07 2021, @03:28PM

          by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @03:28PM (#1185193) Journal

          He probably won't appreciate it at all.

          And lots of stuff that comes with getting old has happened to most people who ever lived. When it happens to him, suddenly it will be important.

          --
          People today are educated enough to repeat what they are taught but not to question what they are taught.
        • (Score: 3, Funny) by DannyB on Thursday October 07 2021, @03:49PM

          by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @03:49PM (#1185197) Journal

          Mean ole Boomers and their embarrassing medical problems.

          The one that will be the funniest is when he is old enough to need boner drugs but will be too embarrassed to ask a doctor for them.

          --
          People today are educated enough to repeat what they are taught but not to question what they are taught.
        • (Score: 0) by Anonymous Coward on Friday October 08 2021, @01:52AM (2 children)

          by Anonymous Coward on Friday October 08 2021, @01:52AM (#1185375)

          Thanks to mean old boomers there won't be the preventative care to avoid it in the first place. We could have better medical care for all and better workplace conditions, but they chose to not pass the good fortune and to fight tooth and nail for kleptocracy. Some of this stuff is effectively inevitable, there may never be a completely effective preventative technique, but some of the worst of it is completely preventable, but not if you're a poor schlub that has to actually work.

          • (Score: 0) by Anonymous Coward on Friday October 08 2021, @02:46AM

            by Anonymous Coward on Friday October 08 2021, @02:46AM (#1185396)

            Boomers aren't happy unless they're pissed off.

          • (Score: 2, Insightful) by khallow on Friday October 08 2021, @03:28AM

            by khallow (3766) Subscriber Badge on Friday October 08 2021, @03:28AM (#1185409) Journal

            We could have better medical care for all and better workplace conditions

            I think the term to describe this effect is "unintended consequences". Boomers wanted better medical care for all and better workplace conditions too. Some things you just can't force.

  • (Score: 4, Informative) by Frosty Piss on Thursday October 07 2021, @06:51AM (15 children)

    by Frosty Piss (4971) on Thursday October 07 2021, @06:51AM (#1185080)

    There used to be this miracle drug called “Oxycodone” that sufferers of permanent and long term pain issues could use to mitigate some of the pain. But then the drug addicts ruined it for everyone, and now many pain sufferers have no choices but to “live with it”.

    • (Score: 0, Troll) by Anonymous Coward on Thursday October 07 2021, @07:02AM (7 children)

      by Anonymous Coward on Thursday October 07 2021, @07:02AM (#1185083)

      Smoke weed, d00d.

      • (Score: 5, Informative) by DannyB on Thursday October 07 2021, @01:57PM (6 children)

        by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @01:57PM (#1185170) Journal

        I tried weed d00d. And some edible products. It helps some. But hydrocodone is like a nuclear weapon for pain. And it's way cheaper after insurance. About $5 for a bottle of 30 tablets.

        --
        People today are educated enough to repeat what they are taught but not to question what they are taught.
        • (Score: 3, Insightful) by Anonymous Coward on Thursday October 07 2021, @02:19PM (5 children)

          by Anonymous Coward on Thursday October 07 2021, @02:19PM (#1185178)

          Yeah, I was on hydrocodone for 10 years. Back injury from a car accident. Then cancer treatment left me with early onset arthritis. So I took hydrocodone to ease the pain. Never enough to eliminate it totally, just to take the edge off so I could haul my carcass to work and get my job done. Was on a "drug contract" for those last 6 years, having to take drug tests every 3 months to prove that I was taking the pills and not selling them on the street, and also prove I hadn't started shooting up heroin or anything else. Passed all the tests for 6 fucking years. Then finally had to retire, and moved states.

          That was a mistake. If there's a doctor in this state that will give me a prescription for hydrocodone I haven't been able to find them. No, they can't give people in pain a pill, since someone else might shoot up smack in an alley somewhere. The "pain center" wouldn't even see me, and wouldn't even say why. I've never tried weed; can get it here for medical use but then I'd never be able to buy a gun at a dealer again. So I take Tylenol and slowly poison my liver, and wait for a "good" day to try to take the garbage out.

          I'm poisoned in another way, too. I hate this country and watching it fall apart is about all that brings a smile to my face anymore. I enjoy the stupidity of the mindless raging loons on the left, and the utter impotence of the frightful right to do anything about it. If a country refuses to let people in pain take a pill that improves their lives -- and it's explicitly a LEGAL drug to boot -- all so some DEA agents can make a few busts and the politicians look like they care about drug addicts, then fuck them, and fuck you, and fuck everything.

          Remember that while the world goes to hell, there really is a gen-xer sitting on the sidelines, and in between the spasms of pain, he's laughing as he watches the world burn.

          • (Score: 2) by DannyB on Thursday October 07 2021, @03:47PM (1 child)

            by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @03:47PM (#1185196) Journal

            So I took hydrocodone to ease the pain. Never enough to eliminate it totally, just to take the edge off so I could haul my carcass to work and get my job done.

            Similar here. Although it seems more effective for me, because it mostly takes the pain away, but not totally.

            Was on a "drug contract" for those last 6 years, having to take drug tests every 3 months to prove that I was taking the pills and not selling them on the street, and also prove I hadn't started shooting up heroin or anything else.

            Wow. Nobody has ever suggested that to me. I think my Dr. believed me that I did not use recreational drugs. When I first started hydrocodone, I was very clear that I did not want to get addicted to narcotics -- and I brought that point up quite pointedly. I had also seen this doctor for a long time, and had been employed in same job for a very long time and had a nice job title.

            If there's a doctor in this state that will give me a prescription for hydrocodone I haven't been able to find them. No, they can't give people in pain a pill, since someone else might shoot up smack in an alley somewhere.

            That kind of thing had been an anxiety for me at times. But my doctor never stopped filling my hydrocodone refills. Plus I see her at least annually, and she gets a copy of regular labs that my arthritis specialist requires because of a different drug I take which can affect liver function and must be monitored every couple months.

            My arthritis doctor is also willing to write me hydrocodone if that would become necessary. But we all agree that there should be only one doctor writing narcotic pain killer prescriptions. I make sure both doctors have all of my records.

            My primary care doctor retired a few years ago, so I started seeing a new doctor at this practice. Since I had been taking hydrocodone for so long, without problems, and she could see all of my long history, she continued to prescribe the hydrocodone. After several years, she recently increased the frequency of dosing, at my request after we discussed how I used it.

            Another thing I realized, is that even when I first started hydrocodone, nobody had ever specified any kind of "limit". I just typically ended up getting about two refills of 30 tablets per year. Sometimes less. In one year, a bit more, but nobody ever said anything about it. One year I went eleven months on a bottle of 30. I just use it as needed. Not on any kind of schedule.

            So I take Tylenol and slowly poison my liver,

            As mentioned, I get regular liver tests for a different drug. I take about 2000 mg of Tylenol every day. And have for years.

            I'm poisoned in another way, too. I hate this country and watching it fall apart is about all that brings a smile to my face anymore. I enjoy the stupidity of the mindless raging loons on the left, and the utter impotence of the frightful right to do anything about it. If a country refuses to let people in pain take a pill that improves their lives -- and it's explicitly a LEGAL drug to boot -- all so some DEA agents can make a few busts and the politicians look like they care about drug addicts, then fuck them, and fuck you, and fuck everything.

            I'm a spectator watching everything fall apart too. We are more divided than ever and cannot seem to come to any kind of consensus on almost anything. One thing my doctors recognize is that my occasional use of hydrocodone does improve my quality of life. It is too bad that some people screw up the availability of useful drugs so that some others cannot get it when they need it.

            I have never been to a "pain center". Maybe that's a good thing.

            --
            People today are educated enough to repeat what they are taught but not to question what they are taught.
            • (Score: 3, Insightful) by Magic Oddball on Friday October 08 2021, @10:50AM

              by Magic Oddball (3847) on Friday October 08 2021, @10:50AM (#1185485) Journal

              My mother's in the same situation as the AC is. Her original doctor retired around the same time that our state really began hassling doctors, and suddenly she had to sign "pain contracts" mandating blood & urine tests every 1-3 months, was forced to switch from hydrocodone to some barely-functional form of oral morphine (which has negative side-effects on her memory, respiration, etc.), then a couple of years later, they cut the dosage in half largely because of the side-effects.

              When she had adequate hydrocodone, she was able to walk around relatively well in spite of her fractured, crumbling vertebrae & crushed discs, so she went to physical therapy and we often went out just to go do things. After they took the effective medication away, her pain levels left her pretty close to bedridden, and without physical therapy, the worsening spinal situation & inactivity have left her with a half-paralyzed diaphragm.

              "Pain management" departments/centers are the places that regulations have pushed medical clinics to effectively outsource the job of refusing to give the patient adequate pain medication (often remotely through email) so the doctor who actually sees them doesn't have to do it. If asked for more help or told the medication isn't adequate, the "pain managment" pharmacology doctors pretty much just repeat the same smugly idiotic ideas that are in the article.

              Personally, I suspect that the entire opioid-phobic shift in the medical industry is at least partly driven by insurance companies who figure that even though the drugs are cheap as dirt, they can save a ton of money by coming up with reasons to keep doctors from prescribing them and instead pressure patients to use mental tricks to cope with pain.

          • (Score: 2) by epitaxial on Thursday October 07 2021, @06:21PM (2 children)

            by epitaxial (3165) on Thursday October 07 2021, @06:21PM (#1185250)

            I love how you elevate your gun rights over your health.

            • (Score: 0) by Anonymous Coward on Friday October 08 2021, @01:41AM (1 child)

              by Anonymous Coward on Friday October 08 2021, @01:41AM (#1185370)

              Have you ever been struggling to walk down a street, and realize that anyone who wants to mug or stab or knockout game you can do it easily because you can't run away? No, I bet you haven't. My gun rights are the last bit of health I have left, as they might keep me alive.

              • (Score: 3, Insightful) by epitaxial on Friday October 08 2021, @11:35AM

                by epitaxial (3165) on Friday October 08 2021, @11:35AM (#1185496)

                Folks this is what Fox News does to your brain. Pushing the victim mentality on everyone and convincing them that violence is around every corner. Your chances on being a crime victim are incredibly low. If you're that worried then you should stop driving a car as you're much more likely to die in car wreck than getting mugged.

    • (Score: 4, Insightful) by MIRV888 on Thursday October 07 2021, @07:51AM (1 child)

      by MIRV888 (11376) on Thursday October 07 2021, @07:51AM (#1185090)

      So the pain pill users all moved to heroin, and Doctors are scared to death to prescribe any kind of pain meds. Long term pain sufferers are SOL in the US. Less you wanna ride the horse.

      • (Score: 2) by DannyB on Monday October 11 2021, @01:57PM

        by DannyB (5839) Subscriber Badge on Monday October 11 2021, @01:57PM (#1186132) Journal

        I don't agree with the advice that when the pane is two bad use heroine.

        --
        People today are educated enough to repeat what they are taught but not to question what they are taught.
    • (Score: -1, Offtopic) by Anonymous Coward on Thursday October 07 2021, @07:55AM (2 children)

      by Anonymous Coward on Thursday October 07 2021, @07:55AM (#1185092)

      There is a reason why oxycontin was called "synthetic heroine."

      There is still vicodin, bit weaker but still effective.

      Want stronger? Fentanyl - used to be a (the?) palliative pain reliever for terminal cancer patients, but now ...

      • (Score: 3, Flamebait) by sjames on Thursday October 07 2021, @09:23AM

        by sjames (2882) on Thursday October 07 2021, @09:23AM (#1185116) Journal

        Oxycontin != oxycodone. Oxycontin is a specific formulation for extended release that marketing claimed had nearly no addiction potential while, in fact, the dosing schedule was designed such that it maximized addictive potential.

        It turns out that minimum dosing such that the patient is on the verge of screaming agony just as the next dose comes is more addictive (through repeated reinforcement) than maintaining good pain control through the day.

        It also turns out that keeping the drugs expensive and treating a medical issue as a law enforcement issue turns a livable and treatable condition into a nightmare trip to skid row. Consider, WWI produced a lot of involuntary heroin addicts, most of whom lived a productive life.

        Meanwhile, all heroin is synthetic. It has always been made by acetylating morphine.

      • (Score: 0) by Anonymous Coward on Thursday October 07 2021, @01:41PM

        by Anonymous Coward on Thursday October 07 2021, @01:41PM (#1185161)
        Heroin IS synthetic. Diacetylmorphine. I.e., a synthetic morphine derivative (and morphine is naturally occuring).
    • (Score: 3, Interesting) by DannyB on Thursday October 07 2021, @01:59PM

      by DannyB (5839) Subscriber Badge on Thursday October 07 2021, @01:59PM (#1185171) Journal

      There used to be this miracle drug called “Oxycodone” that sufferers of permanent and long term pain issues could use to mitigate some of the pain. But then the drug addicts ruined it for everyone, and now many pain sufferers have no choices but to “live with it”.

      I was quite worried about that. But both of my primary care and specialist doctors are willing to write me prescriptions for hydrocodone. I hate oxycodone because it gives me some nausea. I don't have any side effects with hydrocodone -- in the small doses and frequency that I use it.

      --
      People today are educated enough to repeat what they are taught but not to question what they are taught.
    • (Score: -1, Troll) by Anonymous Coward on Friday October 08 2021, @01:54AM

      by Anonymous Coward on Friday October 08 2021, @01:54AM (#1185377)

      The problem was partially that hydrocodone is highly addictive and partially that people were being prescribed it without a proper management plan that included how to decrease and eliminate the dose over time. Without a plan to get off it, things weren't likely to end well in many cases.

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