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What do doctors give former heroin addicts for pain relief when their seriously injured?

Discussion in 'Heroin' started by letitherobe, Jun 22, 2015.

  1. letitherobe

    letitherobe Member

    I saw on a documentary that some docs give them morphine

    But wouldn't giving a former heroin addict Morphine cause them to relapse?
  2. SarahWorksAtHome

    SarahWorksAtHome Community Champion

    I've never used heroin myself and I avoid Morphine at all costs as I didn't like how it felt the one time I got it in the hospital but I would imagine that it could be very dangerous. My understanding is that heroin and Morphine are very similar?
  3. Totalarmordestine

    Totalarmordestine Senior Contributor

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    Normally, I would not answer a question like this as my expertise is generally in medication but I had severe sciatica while I was pregnant with my 3rd child (after having had twins) and I had sciatica so bad that I was finding it difficult to walk. I tried massage therapy and physical therapy and could not take medication
    I went to the chiropractor and the pain was instantly relieved. My hips and lower back were out of alignment because I had carried twins the year before. On occasion a Doctor of Osteopathy (DO) can also work but they usually only work on one joint at a time - the chiropractor will do your whole back which works faster. Anyone who does not believe in chiropractors will tell you they are quacks - don't listen.
    I don't necessarily believe that chiropractors can cure things like diabetes but they can definitely relieve some types of back pain especially if a pinched nerve is involved which is usually the cause of sciatica.
  4. tarverten

    tarverten Senior Contributor

    All opiates are addictive and can be substituted or combined with other opiates for pain relief or pleasure. A smart doctor will give enough opiate to control the pain, and closely supervise the patient, and will slowly withdraw the drug.

    The FDA and DEA have reached an unspoken agreement that, " properly prescribed opiates will not cause addiction." Bull. But, it's the line in the sand that all doctors must observe. If a patient is truthful about his symptoms and says the proscribed words, such as "withdrawal", then the doctor must declare the patient an addict and ruthlessly withdraw him.
  5. blastguardgear

    blastguardgear Senior Contributor

    I can honestly answer this question, because I've seen it: former or active addicts, it doesn't really matter. They've all burned out the pain receptors in the brain.
    And it takes massive amounts of pain medicine to address their pain. Enough to put me on a ventilator.
    But after they've fallen off a roof or jumped off a bridge or crashed their car in a drunken stupor (all recent patients of mine), they have genuine pain, and need adequate pain medication.
    So, there is a specialty of medicine, a branch of anesthesia actually, called Pain Management, and they really do know their stuff. They can medicate a person within an inch of their life, enough to keep them from leaving AMA with 2 broken legs and a broken back.
    Remember, addiction is not only physical dependence, it is psychological. If the patient has been through rehab, and has a support system in place, he does not necessarily HAVE to become addicted again.
  6. thepieeatingjay

    thepieeatingjay Senior Contributor

    A relapse means a relapse back into addictive behaviours and activity. Simply being giving opioids, regardless of the amounts, the duration they were taken, or anything for that matter does not automatically mean a person will relapse.

    The only medications that are beneficial for severe pain (except, perhaps for a few very specific types of problems) are opioids primarily morphone, oxycodone, oxymorphone, hydromorphone, fentanyl, meperidine (aka pethidine), methadone, and levorphanol.

    Doctors will provide appropriate pain medication, especially for severe acute pain (eg car accident) or pain due to terminal illness (eg HIV/AIDS, cancer) fairly liberally (especially if the person is in the hospital) even if they are an addict.

    Most addicts who are given opioids when they were truly required don't have any problems. Also in many cases opioids may be started when a person is unconscious or unable to speak (so the person may not be able to tell the doctors they are a recovering Heroin addict). I had one patient who was an addict and she had a heart attack (morphine or another opioid is almost always given for several reasons) and she screamed to the EMTs not to give the morphine. Their response was to hold her down and give her morphine.

    Most people taking opioids to help with pain control, not for abuse/recreation/self medication, do not develop a problem (not is it as likely to be as "enjoyable"). If a person in recovery in a situation where they have to take opioids or it is best they take opioids they are less likely to relapse.

    Many studies show that addicts, even IV Heroin addicts, can take prescription opioids properly without relapsing (I know people tend to think of using a prescription drug is a relapse, and typically that is true, but actually it is only a relapse if either they used the drug in the first place out of compulsion (ie a person had completely lost control and started using Heroin again) or after taking a prescription medication as prescribed for a legitimate reason they fell back into addictive behaviours including using the medication for reasons that are non-medical.

    Doctors are certainly more careful when prescribing opioids to people in recovery and especially to active users than they are to people without any substance abuse history but never the less opioids are used.

    Also no matter what people may think Heroin is actually not more active than other full opioid agonists including morphine, oxymorphone, hydromorphone, fentanyl, and others. Some may be more potent than others and as a result require a lower dose to achieve the same effect but aside from that (almost) all full opioid agonists can produce the same level of effects as each other but at different doses. In fact Heroin is less potent ("weaker") than hydromorphone, fentanyl, and a few other opioids. Studies have also shown that Heroin addicts can't tell the difference between equivalent amounts of other full opioid agonists given IV (except in some cases morphine because morphine often has more side effects in some people).
  7. SarahWorksAtHome

    SarahWorksAtHome Community Champion

    I'm a Pain Management patient but they do not use ANY heavy anesthesia on me or medicate me within an inch of my life. It was more of a case planning type thing. A way to get my long term pain... well... managed. I take a NSAID in the morning and a hydrocodone/apap in the evening IF I need it. That's my Pain Management plan. There must be a different type of clinic that handles what you are talking about.
  8. shadowsupernature

    shadowsupernature Senior Contributor

    No, not morphine because morphine is pharmacologically MUCH weaker than heroin. They usually up it to fentanyl or dilaudid.

    Relapse is not a concern in an emergency situation. Relapses can be managed
  9. SarahWorksAtHome

    SarahWorksAtHome Community Champion

    I agree that in an emergency situation, the benefit of pain relief outweighs the risk of relapse. And true that if it known there could be one a plan could be set in place to prevent a problem.
    The question of long term pain management comes more into play for those with some type of chronic pain.
  10. MyDigitalpoint

    MyDigitalpoint Community Champion

    Absolutely, I second the same motion, because relapse can be certainly managed and recovery is always possible as long as it's conducted adequately and the person is willing to recover.

    But in an emergency situation what does really matter is to apply what might be the only solution coping with it.
  11. tasha

    tasha Community Listener Community Listener

    It puts them into the same state and this is why they cannot give an addict any form of medication especially Morphine. It would most definitely get an addict to want to use again and unfortunately to take the pain or go through an entire process again is not a difficult choice, I would take the pain any day compared to using.
    SarahWorksAtHome likes this.
  12. SarahWorksAtHome

    SarahWorksAtHome Community Champion

    That's a strong statement @tasha and if you have the courage to stick to that, I give you five million kudos and a hundred million high fives!
    I'm sure there are many options for "alternative medicine" to step in and help with pain management for addicts.
  13. tasha

    tasha Community Listener Community Listener

    It is wishful thinking that people would choose the pain over medication but sadly medication is medication herbal, alternative or other and it is not recommended for addicts to get any form. I guess it also depends on how bad the scene is .
  14. SarahWorksAtHome

    SarahWorksAtHome Community Champion

    I've never heard before that alternative or herbal medicine was bad for addicts. I would think that if Chiropractic care, accupuncture, flexology, vitamin or mineral supplements could reduce their ailments, symptoms or pain making the need for narcotic pain relievers less necessary it would be very good. I myself, a former addict, use some of those remedies and it lessens my need for my prescription narcotics.
  15. tasha

    tasha Community Listener Community Listener

    Well that's good to know. Yes if you are not in a hospital and need emergency medical attention you can choose to have acupuncture etc but we were saying in hospital if you need something for the pain, they do not give it out unless absolutely have to.
  16. SarahWorksAtHome

    SarahWorksAtHome Community Champion

    I've been in a few emergency situations (in emergency room for pain or ailment or at doctor's office with kidney stone also in surgery for gallbladder) and in each scenario I let the staff know I used to have a drug problem. I explained to them that I didn't want to heavily rely on narcotics and did not want something that would make me feel very high or cause me risk. In each situation (aside from surgery where I got a pump but was weaned off it carefully) I was given injections of anti-imflammatory medication over narcotic or opiod pain relief options and they gave me high respects for being so cautious.
  17. Jack Wallace

    Jack Wallace Senior Contributor

    Аll оpiаtеs аrе аddiсtivе аnd саn bе substitutеd оr соmbinеd with оthеr оpiаtеs fоr pаin rеliеf оr plеаsurе. А smаrt dосtоr will givе еnоugh оpiаtе tо соntrоl thе pаin, аnd сlоsеly supеrvisе thе pаtiеnt, аnd will slоwly withdrаw thе drug.

    Thе FDА аnd DЕА hаvе rеасhеd аn unspоkеn аgrееmеnt thаt, " prоpеrly prеsсribеd оpiаtеs will nоt саusе аddiсtiоn." Bull. But, it's thе linе in thе sаnd thаt аll dосtоrs must оbsеrvе. If а pаtiеnt is truthful аbоut his symptоms аnd sаys thе prоsсribеd wоrds, suсh аs "withdrаwаl", thеn thе dосtоr must dесlаrе thе pаtiеnt аn аddiсt аnd ruthlеssly withdrаw him.