About 20 years ago, with one quarter of Americans having chronic pain, the U.S. government declared a war on pain. Unfortunately, it gave physicians absolutely no guidance on how to relieve pain effectively. So, with drug company encouragement, physicians turned to increasingly prescribing narcotics.
Now, we have one-third of Americans suffering with chronic pain, and 16,500 overdose deaths year from prescribed narcotics. The government has decided to deal with this by declaring a “War on People in Pain.” Narcotic medications are being stopped abruptly, with people given no alternatives for pain relief.
Sometimes, all they are getting from their physicians is the attitude “All pain is tolerable, as long as it is somebody else’s!”
Meanwhile, the propaganda war is ratcheting up with blame being fixed, instead of the problem. Instead of the actual 16,500 yearly deaths from prescribed narcotics (the actual figure) being discussed, the government is lumping in all deaths from even street drugs like heroin to inflate the figures and justify their actions.
So, let’s take a step back, and get some perspective on the real numbers:
1. 16,500 yearly deaths from prescribed narcotics.1 The biggest culprits have been the fentanyl patch and OxyContin.
2. 30,000 to 50,000 U.S. deaths yearly (conservatively) from NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (calculations available on request). Despite this being shown in numerous studies, including a major meta-analysis of almost half a million patients which showed a 35 percent increase in MI (myocardial infarction) risk2 and as many as 16,500 bleeding ulcer deaths yearly,3 I suspect that few of you have heard about the research. Why? As one news editor put it very simply, “any reporter who loses me an advertiser is fired!”
I do want to stress that the chronic pain is still far more toxic than the NSAIDs medications. It’s simply that natural options are usually more effective, and much safer, in head-on studies.
3. Approximately 30,000 to 40,000 U.S. deaths a year from PPI (proton-pump inhibitor) acid blocker medications.4 Ironically often given for no reason except that the person is on NSAIDs (these numbers are in addition to the NSAIDs deaths). These are also associated with a 44 percent higher risk of dementia.5
4. In a recent survey, 6.7 percent of people with chronic pain note they have “thoughtfully reflect[ed] upon their suicide stories; 89 persons shared the story of a friend or family member who ended their life.” Seventy percent report that their health care has either worsened or they have lost support entirely. Twenty-five percent of individuals have lost access to a primary care provider.6
5. Approximately 100 million Americans suffer from chronic pain. Chronic pain affects more Americans than diabetes, heart disease and cancer combined.7
All of this suggests that the current ill-designed war on prescribed narcotics may cause far more deaths by collateral damage than it prevents. It suggests that as many as seven million additional Americans face the risk of suicide from unabated pain, in an attempt to prevent 16,500 prescribed narcotic overdose deaths yearly. Surprisingly, increased NSAIDs use may even be more toxic than the narcotics. Meanwhile, numerous people may turn to illicit drugs for pain relief, which carry a higher risk of overdose, as they have no idea what’s in what they are taking.
The answer is not to either ignore the overdose deaths or the suffering of those with chronic pain. There is a third option, which can effectively address both, that is being largely ignored.
Treat the root causes of pain.
Our published research has shown that this can dramatically decrease pain and improve function without narcotics. Using fibromyalgia as a model, our placebo-controlled study showed that pain can be decreased doing so by 50 percent. A very large percent of people no longer qualified as having fibromyalgia by the end of the study.9
Using the entire toolkit, including structural therapies (such as physical therapy and chiropractic) low-cost generic medications, and natural remedies, most pain can be effectively controlled, and often eliminated, without narcotics. But most physicians are simply not trained in, or even open to, these options.”
It is time to look for door number three in addressing both of these major problems.
A critical concept in pain management is that pain is not an outside invader. Rather it is part of our bodies’ monitoring system telling us that something needs attention. Kind of like the oil light on our car’s dashboard. The standard medical approach has been to put a Band-Aid over the oil light or cut it out.
Might it not simply make more sense to put oil in the car?
Research shows that this is so. Let’s take a look at a few types of pain as examples (there are countless more):
1. Muscle pain. This is arguably the most common type of pain. And the most underdiagnosed. The best test for it is a good exam—which almost no physicians know how to do. You can’t diagnose something if you don’t know that it exists. Although arguably an oversimplification, muscle pain comes from decreased energy in the muscles. Muscles are like a spring. They take more energy to stretch than to contract. As noted above, optimizing energy in the muscles with the SHINE protocol decreases even the most severe forms of muscle pain by at least 50 percent (and often completely). SHINE stands for optimizing Sleep, Hormones, Immunity/Infections, Nutrition and Exercise. You can email me for free treatment tools that will dramatically simplify treating fibromyalgia.
Meanwhile, once the inadequate energy in the muscles is addressed with SHINE, then structural therapies to stretch the muscle show dramatically increased and longer lasting benefits.
2. Arthritis. Natural therapies have been shown to be as or more effective than NSAIDs. For example, Curaphen (By EuroMedica) was shown to be more effective than Celebrex in two head-on studies looking at osteoarthritis9 and rheumatoid arthritis.10
The large NIH (National Institutes of Health) study showed glucosamine plus chondroitin to be statistically equivalent for osteoarthritis. But as all but one of the study authors were on the payroll of the drug companies, the data was tortured and natural remedies were reported to be ineffective.
What the research showed was that for one measure (which was later changed to be the “primary outcome measure” after the study was done. When I checked it on clinicaltrials.gov, the timeframe had been changed) the p=.04 for Celebrex and .06 for glucosamine/chondroitin. If you think about it, statistically that means there is nowhere near a significant difference between Celebrex and glucosamine chondroitin. Many of the hundreds of endpoints showed the natural remedies to be much more effective. This data was ignored in the study “conclusions.”
3. Migraines. Research has shown that simply taking riboflavin (vitamin B2) 300-400 mg daily decreases migraine frequency by about 69 percent after six weeks. Adding magnesium increases its effectiveness. Multiple other therapies are also effective, as is addressing the role of hormonal fluctuations in migraines that occur around ovulation and menses. Meanwhile, IV magnesium 1 g over 15 minutes was shown to eliminate 85 percent of acute migraines in under one hour, making it the most effective treatment available short of decapitation.
4. Central sensitization. Most chronic pain, when severe, can trigger central sensitization (brain pain) with microglial activation. Although several expensive medications can address these, they often are ineffectual or inadequate, and certainly do not reverse the underlying problem.
Highly effective for central sensitization or treatment such as low dose naltrexone and Palmitoylethanolamide (PEA) 350 mg four times daily for two to four weeks, then twice a day (or three times per day if more helpful). Higher doses of the PEA can be helpful but start with low doses and work up.
And these are just a few examples.
I would add two other options that we are seeing dramatic responses to for pain in general. I like to begin with the Curaphen (which is a pain relief miracle for many people) and another herbal mix called the Pain Formula (Integrative Therapeutics), giving them six weeks to see the full effect. In severe refractory pain, I am adding in:
1. Hemp Oil. I like using the entire hemp oil because there are more than 10 cannabinoids that have been shown to be effective against seven key components of pain, making them very synergistic. I am very picky about the brand I use, as many do not have therapeutic amounts. I like to use the one by EuroMedica. The optimal dose is three capsules twice a day for pain and five for sleep. In many, lower doses can be helpful.
2. Kratom. This herb is becoming controversial because the FDA (U.S. Food and Drug Administration) and DEA (Drug Enforcement Agency) are both going after it. Unfortunately, as part of a sensationalized media attack, the data is again being tortured. If any of the herb is found in the patient’s blood at death, the death is being attributed to the kratom. Even if the person drank a gallon of tequila and took 60 OxyContin.
In real life, used at a maximum dose of approximately .5 to 1 teaspoon up to three times a day, it has been a safe treatment. In a number of patients, it has also eliminated severe pain that was refractory to most everything. For example, I have one patient considering moving here from Japan because her pain went from 10 to a zero in one day after taking it, and she can’t get it in Japan. Use the red form of the herb. It can be found in vape shops, dispensaries and online. (You can email me for more information.
3. Using the entire healing arts toolkit, including structural therapies (e.g. chiropractic, osteopathic and myofascial release) and biophysics (e.g. – Frequency Specific Microcurrent) are also remarkably helpful as part of a comprehensive treatment approach. Although this article’s focus is on pain’s biochemistry, people do best when the entire “toolkit” is optimally applied.
Virtually all pain can be effectively treat-ed, and most often without narcotics. But in the few cases that narcotics are needed, when properly used in combination with these other treatments they can be a godsend, and be much safer than leaving the person in pain.
The problem is not lack of effective treatment. Rather it is lack of proper physician education, and access to natural remedies.
The people you treat no longer have to make a choice between being on narcotics or being in pain. Pain is usually optional!
3. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. The American Journal of Medicine, Volume 105, Issue 1, Pages 31S-38S.Gurkirpal Singh. http://linkinghub.elsevier.com/retrieve/pii/S0002-9343%2898%2900072-2?showall=true.
9. Osteoarthritis Abstract 316. Osteoarthritis Cartilage. 2011;19(S1):S145-S146.] https://pdfs.semanticscholar.org/e8d4/76ea39303de736eb353d9f31e85b43c3f183.pdf.
10. Phytother Res. 2012 Nov;26(11):1719-25.
Jacob Teitelbaum, MD specializes in treating fibromyalgia and chronic pain. He is the author of Pain Free 1-2-3, From Fatigued to Fantastic!, and the free Cures A-Z phone app. To get the NSAID death calculations noted above, or the free fibromyalgia treatment tools, feel free to email him and request these at FatigueDoc@gmail.com.