Wednesday, 9 May 2012


Treating pain is the duty of all doctors. Powerful medicines can help us. Sounds easy, right? Yet the downsides are also powerful. The medicines don't work for everyone. Some people become addicted or use the medicines inappropriately.

During the last 10 years, use of prescription pain medicines called opiates has increased dramatically. These medicines include oxycodone (Oxycontin), morphine and others. Overdoses have increased dramatically as well. This is a national problem. It is particularly evident among teens and young adults in rural areas.

Young women are among the abusers of these drugs. So there is a second concern -- babies born with opiate dependence.

This new article addresses something called neonatal abstinence syndrome (NAS). Between 60% and 80% of babies newly born to mothers who are taking these drugs -- legitimately or not -- have withdrawal symptoms. They include tremors, poor ability to feed, diarrhea, seizures and trouble breathing.

Such babies require time in intensive care. Many of them stay in the hospital for more than 2 weeks after birth. This costs the health care system up to $50,000 per baby. The authors of this study looked at a large database of information on children admitted to U.S. hospitals. They found that the risk of NAS tripled between 2000 and 2009.

At the same time, the use of opiates by mothers increased five-fold. State programs paid the majority of costs for treating the babies.

Why is this important? The authors bring up several issues that are key to all of us as we think about health and health policy. In Florida, for example, the risk of dying from a prescription drug overdose is four times higher than the risk of dying from an illegal drug overdose. The number of addicted babies in the state has increased five-fold.

Money we spend caring for these sick babies is money that can't be spent on everything from repairing roads and bridges to education to maintaining green spaces. It impacts all of us in different ways.

Most importantly, it impacts two generations -- babies and mothers -- who are the future of our country. This article suggests that we need to do more to prevent the problem. We also need to provide more efficient care for its adult and child victims.

What Changes Can I Make Now?

If you live with chronic (long-term) pain, explore options with your doctor. In many cases, opiate pain medicines are perfectly appropriate. But consider alternatives, too. These include various kinds of pills as well as other treatments, such as steroid injections. Some people really benefit from exercise, physical therapy, acupuncture or even massage.

It's unlikely that any one treatment will make pain disappear completely. The goal is to manage pain and gain function in your life. Some people have a higher risk of addiction, or using powerful medicines incorrectly. They include people who have:

A personal or family history of addiction, especially to prescription medicines
Certain mental health problems
A history of being abused in childhood
If you have a history of addiction, tell your doctor. Work with him or her to treat your pain safely.