Drugs and pain

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Drugs remain the predominant approach for chronic pain….

…which is one main reason why the problem of pain is escalating. We can never truly overcome chronic pain by thinking that drugs are going to do it for us. We have been brought up in a society in which medication is embedded in our thinking ~ we expect it, healthcare delivers it.

However the reality is very different, which is why the continued use of the biomedical model for chronic pain consistently lets people down. This is now an old fashioned approach that does not work.

Recent headlines

‘Unnecessary’ painkillers could leave thousands addicted, doctors warn’ in The Guardian, May 2017 ~ read here

‘Accidental addiction to painkillers ‘a public health crisis’, says charity’ on Sky News today ~ read here

Mr Shapiro said: “If you look back to say 2009 when the all-party parliamentary group on drugs produced a report on this very issue, including not just painkillers but tranquilisers and anti-depressants and the Government then took a very complacent view of the whole situation… that attitude hasn’t really changed.”

WHY?

Why is there such little interest from the government, from policy makers, from research funders etc etc? I am sure that when some of these people experience their own chronic pain, they will regret that lack of interest. In the meantime we need social progress for this enormous social problem ~ understand pain a purpose-led enterprise driving social change

You may think that my opening statements suggest that I am anti-drugs. No, I am not. There is a place for medication in the treatment of pain but there must be parameters. For example:

What is the best drug for this person and how their pain problem emerges
- e.g. based on latest evidence ~ ‘Existing evidence on the use of gabapentinoids in CLBP is limited and demonstrates significant risk of adverse effects without any demonstrated benefit’ August 2017 ~ read here
Does the person understand the drug: why am I using this one? What does it do?
How long will the person be on the drug?
When will it be reviewed?
How will the use of this drug fit into an overall treatment programme?

The fact that the old model continues to be used means that other serious problems have emerged, adding further suffering and cost: addiction. To use the Buddhist definition of the word ignorance is relevant. To be ignorant is to fail to see the reality. That is most definitely what has happened and this must change now.

Drugs do not teach us how to overcome pain. They merely mask the underlying issues for a short time before they bubble up again. Whilst this can be convenient and briefly satisfy the search for a ‘quick fix’, each time the pain re-emerges and each time the next dose is taken there is a learning.

We learn to gain a dependence on the relationship between taking something and the pleasure of relief ~ this is not addiction, which is another result from over-using drugs or an inappropriate use of medication. The short-termism is perhaps the way we are designed to work, seeking pleasure and avoiding pain as quickly as possibly. This us understandable, yet it still remains the wrong route to truly overcome pain.

Overcoming pain

So if drugs don’t do it, what does? There are simple steps yet it is challenging and hard work. However, hard work and focus are fundamental when we are seeking results and achievement.

“Success comes from knowing that you did your best to become the best that you are capable of becoming” ~ John Wooden

Firstly we must get our thinking straight. Understand pain: like any problem we must understand it to seek the solution.

Then we must take action, repeatedly, in the desired direction. Actions include our thoughts and how they make us feel and direct what we actually do. We must not make the error of thinking that the mind and our thoughts are somehow separate from the physical-ness of ourself. They are not. Our mind is embodied ~ where else can you experience your thinking but in your perceptions and actions? And where do you experience this from? Your body. Each moment is made of thoughts, perceptions and actions that define how we ‘live’ that moment.

Whilst this can sound a bit wordy and a bit philosophical, it creates a practical way onwards with a range of practices and skills that we can develop. What we practice we get better at and what we focus upon we get more of. What do you want?

“What do you want?”

Re-read the question if you need to. What do you want? What does that look like? How can you orientate yourself towards this vision in your thinking and actions each day, each moment? The answer to the first question is not, I do not want this pain. That is what you don’t want, this pain. It draws your attention, focus and resources to pain, pain, pain. Again, think about what you want. Let the image arise in your mind’s eye. Then make it brighter, more colourful and bigger. How do you feel?

To overcome pain we must learn to coach ourselves. We ask ourselves the right questions to start the day off well, committing to be the ‘best me’. Then we practice the skills we have learned that are all in line with your vision ~ movements, exercises, sensorimotor training, mindfulness, communication (with self and others), attention, gratitude, resilience, re-engaging with desired activities, people and situations to name but a few.

The content of each programme is sculpted according to the individual, who always does his or her best, learning all the way. Learning about the causes of on-going pain and how to transform their state over and over so that there is sustained change as the person reaches their potential. This is the essence of Pain Coach ~ the person getting results.

We are seeking social progress. The vehicle to drive this progress is UP or understand pain. UP is a purpose-led enterprise delivering the pinnacle of our knowledge of pain to those in need via workshops (recent CRPS Workshop success) and other means: including the pain sufferers, their families and friends, the policy makers, patient groups, charities and organisations.

Now is the time. Now we must move onwards and embrace the knowledge that we have gained and the new knowledge that will continue to emerge from research and experience. With this we can carve forward to reduce the enormous suffering and costs for a better society that thrives. Drugs are not the answer. The answers are within us.