Chronic Pain: Should there be a ban on narcotics? What about acetaminophen?

Should there be a ban on Vicodin and Percocet? Darvocet or other narcotics containing acetaminophen? What about over-the-counter medications with acetaminophen?

This is what I think...

We can't just ban every medication that has serious problems associated with overuse. It seems to me that educating people who are taking these medications would be more helpful, than making them totally unavailable.

Don't get me wrong, I'm not denying the seriousness of Acetaminophen overdose...

A Food and Drug Administration advisory committee met late last month to review the actions the agency could take to reduce accidental acetaminophen poisoning. The drug, also found in over-the-counter cold formulas and pain-relieving prescription favorites Vicodin and Percocet, is the most common cause of acute liver failure in the U.S.

In acute liver failure, the organ fails quickly, sometimes in 48 hours, as opposed to the more usual forms of liver failure, caused by disease or alcoholism, which can take years to develop.

I just don't think banning medications with acetaminophen in them is the answer. And I think this whole controversy is just exacerbating the stigma associated with chronic pain and the use of therapeutic doses of narcotics.

Earlier today I received an email supporting a ban on narcotics for chronic pain from a "leading expert" in holistic treatments for back pain. This really rubbed me the wrong way, especially after spending the last few days trying to help my mother find a doctor to renew her Darvocet prescription (after she recently moved and changed insurance).

Here is an excerpt from the email...

The ban will force doctors to better diagnose their patients to prescribe other courses of treatment. Some patients might need to see a physiatrist; others might need an acupuncturist. Others may require spinal surgery.

Here is an excerpt from my response...

With all due respect...this sounds like insanity to me.

. . . Could acupuncture and other alternative modalities help? Maybe in addition to medical intervention (including meds). But as far as I know insurance doesn't even cover acupuncture.

. . . These types of regulations are wrong and there is no way to "holistically" sugar-coat it into being anything else. And I say this being someone who is a promoter (not a hater) of holistic and alternative medicine. I have always believed that a healthy collaboration between traditional medicine and holistic medicine is the best policy...But throwing the patient under the bus to get more people to choose alternative medicine is not the way to go.

There was more, but you get the idea.

Yes, there are people that abuse narcotics, but that doesn't make everyone that needs them some kind of drug addict. And that doesn't mean these medications can't be used successfully and without abuse in patients with chronic pain. Doctors take an oath to "do no harm" - In my mind, a doctor that refuses to treat a patient's pain is doing harm. And that is just WRONG.

What do you think? Should we ban narcotics because there are people that abuse them? Here is some of what other women are blogging on this topic. Let me know what you think in comments.

From Somebody Heal Me - Hint of Good News Regarding Possible Ban of Certain Pain Medications...

Although the recent recommendation of an FDA advisory panel to take prescription pain medications containing acetaminophen off the market is worrisome, there is some hopeful news.

On Tuesday the FDA announced it would not adopt a ban on propoxyphene (aka Darvon or Darvocet) at this time despite the advisory panel's recommendation that it do just that. The FDA said that based on the information currently available, the benefits of using propoxyphene as directed outweigh the risks. However, manufacturers will be required to strengthen package warnings and provide patients with a medication guide explaining the importance of taking the medication as directed. The FDA is also initiating a study of the safety of propoxyphene, which could lead to stricter regulation of the product. For now the agency believes providing patients with more information can improve safety without removing the product from the market.

From Feministe - Federal Advisory Panel Recommends Ban on Vicodin and Percocet...

I’m sure many people will jump in the comments to “inform” me that narcotic use for chronic pain is dangerous and inadvisable. This is simply wrong; when there is a medical professional overseeing a patient’s pain management regimen, carefully monitoring the use of such drugs, these pain killers can make an enormous difference in a patient’s quality of life. Dosages will have to be watched, as patients develop a tolerance to narcotics over time, but this does not preclude the use of narcotics whatsoever.

. . .

With knowledge of the potential for dependence in mind, painkillers are a viable treatment option for chronic pain patients. Many patients do not respond to other available treatments (whether pharmaceutical or otherwise), or they do but those improvements ultimately still leave them in considerable pain. The range of available treatments today may not work for every patient — there may be other conditions and considerations that would make one drug dangerous, or another drug might trigger severe side effects, or another drug may just plain not work for them. Every body is different; every person’s body chemistry will interact differently with a certain drug. Considering this, it is important to leave open the option of using narcotic painkillers for chronic pain patients.

From Suzy Cohen - Vicodin and Percocet Ban?

The chatter at the FDA has triggered panic in many people who genuinely need pain relievers for some quality of life. Drug-seekers, who exaggerate their level of pain to physicians (to get their monthly stash), are also in a tizzy. Put it this way, if Percocet and Vicodin disappear, millions of lives will become unbearable for one reason or another.

From About.com - Michael Jackson's Death & Painkiller Backlash...

I do agree that doctors need to act responsibly when prescribing medications that can be addictive. They need to look for signs of addiction and try to help their patients who become addicted. But already, many of us who live with chronic pain have trouble getting the painkillers we need in order to function. Many doctors are already afraid to prescribe opiates for chronic pain because they've seen some of their colleagues face criminal charges and lose their license for doing so.
. . .
And to everyone who's taking these kinds of drugs, BE CAREFUL. A woman I know, who had lupus and fibromyalgia, died from an accidental overdose. Please keep in mind that these drugs can be dangerous, and if you're in a bad flare be sure to use pill sorters, write down what you take when, or give your pills to someone else to make sure you don't take too many. Believe me, I understand the desperation caused by severe, unrelenting pain (especially on top of sleep deprivation), and it's easy to see how someone could keep taking more and more painkillers trying to get relief. Add brain fog on top of it, and you've got a ticking time bomb waiting to go off. Don't let it blow up on you.

Also See:

From iVillage - Ban Vicodin? Pain Patients React

From Feministe - Salon Says Your disabling Pain Is Imaginary

Lady Mercury - How I came to be...the chronic illness version

How Can We Measure Chronic Pain

Hyster Sisters - Still in pain!!! Out of pain meds

Contributing Editor Catherine Morgan
also at Catherine-Morgan.com