The Danger of Opioid Based Medication

Opioid medication such as codeine, co-codamol, tramadol, oxycodone and fentanyl is derived from the opium poppy. It is thought to work by creating a surge of dopamine which induces relaxation. As the effects of the medication wear off it can make the patient feel terrible. Fight of flight response takes over from the feelings of relaxation so the patient is then eager for their next dose. This can make it difficult to ascertain whether the patient is feeling bad due to withdrawal symptoms or because the pain is returning.

Opioid based pain killers are addictive and must be aproached with care. Different people have different tolerances to the toxins in any medication. If you find this hard to believe, consider coffee. Why is it that one person can drink 8 cups of coffee and feel fine, yet another can drink 1 cup and end up feeling jittery and light-headed? The answer lies in the ability to metabolise toxins. Some people can metabolise them well, others can’t. Thats why when taking any medication you have to take care – you may be the one who can’t metabolise it well and suffer an adverse reaction.

This isn’t unusual. According to a study at the Royal Liverpool University Hospital (RLUH) over 6 months in 2005 14% percent of patients suffered an adverse reaction to their medication. Of these half were potentially avoidable through better practice, the other half were not. The likelihood of an adverse reaction increased as the number of medications taken increased. The study listed opioid medication as one of the top 3 most likely to cause an adverse reaction (the other two were diuretics and anticoagulants).

And Its Not Just Opioids… Be Careful With Anti-Inflammatories too

Asprin, ibuprofen and naproxen are 3 of the most well known NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). They are commonly used for the treatment of inflammation, pain, and fever. These compounds are believed to work by inhibiting an enzyme, cycloooxygenase, which forms substances called prostanoids that are responsible for the inflammatory response.

It’s not a good idea not to take them long term. They are responsible for up to 30% of drug related admissions to hospitals, due mainly to bleeding, stroke or renal damage. They can also cause stomach upsets. For this many doctors may prescribe a Proton Pump Inhibitor such as omeprazole. Omeprazole has been implicated in potential malabsorption of nutrients including vitamin B12, vitamin C, calcium, iron and magnesium.

Opioids & The Pharmaceutical Industry

Before 1990’s opioids were only prescribed for acute pain, palliative care and for cancer patients. It was not indicated for chronic pain. Following extensive marketing by pharmaceutical companies to convince doctors that opioids were safe, non-addictive and suitable for chronic pain, prescriptions quadrupled from 1999 to 2010 in USA. Pharmaceutical companies promoted opioids with scant proof of their claims. One of the culprits, Purdue Pharma was fined $600m for misleading the public about the addictive nature of the drug.

Former Medical Director at New York City Health Department, Andrew Kolodny, raised the alarm on over-prescription of opioids in 2004. At considerable personal cost he fought the might of the pharmaceuticals and the estimated $1bn they have spent on lobbying in the US. (If you’d like to read more – there’s a great article about Andrew Kolodny’s fight against opioid prescriptions in New Scientist, 13 Jan 2018)

Natural Potential Alternatives To Painkillers

Supplements

Before dosing yourself up with vitamins try to optimise your diet to be vitamin and mineral rich, avoiding processed food. Only then should you look to vitamins to fix any issues the improvement in your diet hasn’t fixed.

Vitamins should not be used as a short-cut or “hack” to health. They should be used where you are unable, maybe due to physiological processes in your body, to assimilate enough of the various vitamins and minerals you need. Taking significantly beyond the RDA of a vitamin or mineral does not mean it will do you more good. In some cases it will do you more harm. The body craves balance – excess of any input can create disharmony and dysfunction.

Before taking any supplementation you must carefully assess your symptoms and get a blood test to check levels before self dosing.

Vitamin D. Spend a lot of time indoors? Symptoms get worse in the winter? Don’t eat much in the way of fish, eggs or dairy? Perhaps you have a Vitamin D deficiency. Particularly important to check out given that Vitamin D deficiency has been associated with increased risk of cancer. The RDA (Recommended Dietary Allowance) of Vitamin D for most adults is 600 IU of vitamin D a day. This includes vitamin D you get from diet and sunshine. Some supplements can contain many times this limit. Over a period of months this can become toxic, resulting in calcification of soft tissue with symptoms of nausea and vomiting, weakness, bone pain and calcium stones.

Vitamin B12. Vitamin B12 deficiency can lead to demyelination of nerve sheaths (essentially damaging the nerves), mimicking symptoms of MS; weakness, tiredness, numbness and tingling, depression. Check you are eating enough B12 rich foods (red meat, fish, shell fish, fortified soy products, dairy).

Calcium. Calcium deficiency can cause a variety of symptoms; muscle spasms and cramps, numbness and tingling, brittle nails and confusion and memory loss. Its a common myth that dairy is the only source of calcium. In contrast greens such as broccoli and kale are excellent sources, as are sardines and almonds. Its important to stagger calcium intake. Too much taken at once will not be assimilated – instead taxing the kidneys as its excreted from the body.

Magnesium. Magnesium is an essential electrolyte, Its a macro nutrient meaning its needed in large quantities. It’s a nutrient important for proper muscle and nerve function, allowing muscles to relax. Deficiency can result in muscle weakness, twitching, dizziness, nausea and irritability. It can even be the root cause of low calcium or potassium levels. Bananas, avocados, nuts, dark green leafy vegetables and dark chocolate all contain high levels of magnesium.

Omega 3 Fatty Acids. Fish oil contains 2 important fatty acids – EPA and DHA. The body does not produce many of its own fatty acids. Supplementation of omega 3 found in fish oil can reduce inflammation and pain and seems to boost the effectiveness of NSAIDS such as ibuprofen.

Turmeric. This is a potent anti-inflammatory. Turmeric can suppress pro-inflammatory pathways.So much so that it is contra-indicated whilst exercising as you’ll not get the adaptation from the exercise induced inflammation.

Sleep

Sleep deprivation boosts the brains responses to pain and suppresses activity in the areas that modulate pain processing. During the deep state of Non REM sleep the body repairs and regenerates tissues, builds bone and muscle. If you’re carrying an injury its essential you get enough sleep to allow your body to carry out essential repairs & maintenance.
Depression/ Stress/ Anxiety

Depression, anxiety and stress can all increase central sensitisation – effectively turning up the volume on pain signals in the brain. To find out how to reduce stress and anxiety you can download my guide here.

Stretching

Stretching can help the local fascia release and may help to reduce pain. Initial research suggests that stretching may have more widespread effects; reducing systemic inflammation in the body. Inflammation is a key component of many modern diseases; cancer, diabetes, auto-immune disease, depression.