The Menace Of Painkiller Abuse

March is National Kidney month so I decided to publish this article to help promote kidney health.
Pain is not palatable. Yet pain is nature's way of warning us of what could be lurking within the human body. It's almost like a warning sign to deal with whatever is causing the pain.
Many people have devised different ways to deal with their pain. Some pain are physical while some are deeply emotional. I am talking about the first one today.
There was a day I was at the airport, innocently waiting in line for my turn to check in my bag when I looked far ahead of me and saw a man trying to reduce the size of his luggage probably because it was beyond the recommended weight of checkable luggage. Then with my eyes caught a large package of pain medications. Specifically, Advil which happens to be a non steroidal anti-inflammatory. You seriously cannot blame me for seeing it. I committed no crime. You can call it "lookery" if you like.

I am simply very observant nature, no offense. Don't be too quick to judge me, it is one of the qualities of a good doctor. You have to be able to see that which your patient is not even saying. Sometimes practicing medicine is like playing "detective". Let us just put it as, I am a person who is very aware of her surroundings and by the way you should be. I guess that is one of the rules of defensive driving right.Okay, enough digression, back to the topic of discuss.
There is a raging epidemic in our society right now with opioid abuse. I have heard of people doing crazy things like breaking their own bones to have genuine excuse to get opioids. I mean , it is insane.
The situation is very grievious.

I was once at a place and a lady talked about how so close to home the issue of opioid abuse had hit her. Her sister had abused opioids and had been in and out of rehab several times. Someone in her family had died from overdose.
I am sure you know more than two celebrities that died from complications of Opioid overdose.
It is so surreal. Almost a very scary and precarious situation.

Maybe because I am a health care professional with deep understanding of the impact of these medications, I blatantly refused any form of analgesia when I was in the thrones of labor with my children. I opted for a completely natural birth with no epidural or pain meds. Many thought I was crazy, but no. Even after, the birth of my babies I still politely declined to ask for my percocet. I did choose something milder.

Everyone's pain threshold is different and I do not look down on those who really need their pain killers.Painkillers are supposed to be 'life savers' not 'life takers'. Please be cautious if you have need for pain medication.
Always remember that a pain killer no matter how mild still has side effects. What doctors have to do most times is a risk-benefit analysis plus we detest seeing patient in pain, it is not our thing. We are good people with kind hearts.

There are two main types of over-the-counter(OTC) pain medications- Acetaminophen(Tylenol) and Non-steroidal anti-inflammatory drugs(NSAIDs) such as Aspirin, Naproxen( Aleve), Ibruprofen(Advil or Motrin).

When the OTC drugs do not do the trick, that is when doctors prescribe something stronger.

A word of caution on the use of NSAIDs. They can cause great harm to your kidneys.
I once rotated through a Nephrology rotation and was opportune to see a number of patients who ended up on dialysis from complications of using NSAIDs . A large number of the patients I saw had one thing in common. They had taken lots of NSAIDs. However, so many other factors can lead to kidney failure.

Below are listed some of the complications of NSAID use:

1) NSAIDs can cause hypersensitivity reactions.

2) NSAIDs constrict the afferent arteriole and decrease renal perfusion. This is asymptomatic in a healthy patient. Such that there is damage to the kidney, but the patient does not see the symptoms.

3) When patients are older and have underlying renal insufficiency from diabetes and/or hypertension, then NSAIDs can tip them over into clinically apparent renal insufficiency.

4) NSAIDs can also cause :

a) Analgesic Nephropathy.
b) Papillary necrosis which is the sloughing off the renal papillae, which is one of the internal structures of the kidney.

Opioids are not usually first line in pain management because of the potential for abuse.

I hope I have succeeded in scaring you from touching NSAIDs ever again. Actually, that's not my goal. My goal is to help create awareness of the possible complications associated with excessive use of NSAIDs, let alone opioids. Also to help reinforce choosing moderation with the use of pain killers.

"Life is not always easy to live, but the opportunity to do so is a blessing beyond comprehension. In the process of living, we will face struggles, many of which will cause us to suffer and to experience pain."
                                                                                                                                - L. Lionel Kendrick



Warm regards,
Dr Funmi.