To medicate or not to medicate for pain?
It seems as if the entire world is in the throes of crisis right now. No matter where you live, society faces unprecedented issues and problems that threaten the fabric of what we might once have called normal life.
I’m not even talking about the really big global crises like the environment, poverty or terrorism, either. Those are terrifyingly huge problems that appear at the moment to have no simple or practical solution.
I’m talking about the social issues we deal with closer to home. Things like the opioid crisis that started in America and, according to recent figures published by Public Health England, the agency created by the Government to promote better health, is now an issue for the UK.
The survey by PHE revealed that 12 million people – around a quarter of all UK adults – are now receiving medication that, if used or prescribed wrongly, is addictive.
In the main, these drugs are being prescribed for pain, depression or insomnia and figures suggest that of the 12 million identified in the survey, half have been taking that medication for a year or more, and around 2.5 million have been on their prescription for 5 years.
In America, some states have introduced new laws that aim to restrict the way in which some opioids are prescribed in an effort to reduce the dependency rates among users. In the UK, PHE has identified dependency on medication as a key threat to public health in the long term.
Prescription medicines have their place, and I’m certainly not qualified to judge whether the prescription of opioid drugs for any given physical or mental health condition is appropriate or not.
It seems obvious that there are some mental health conditions where it is absolutely necessary in order to be able to provide the other non-pharmaceutical treatments that allow an issue to be resolved or managed.
But as a society are we well-informed enough about the other options that exist to deal with persistent or recurring pain? Are we engaging in a wide debate about how clinical health practitioners like GPs, practice nurses and consultants can use complementary therapies to work alongside pharmaceutical solutions?
In both cases, I don’t think we are – and I believe there should be much better dialogue around how complementary treatments, like acupuncture, hypnotherapy, physiotherapy and homeopathy can support the clinicians in helping people to be pain-free.
When it comes to pain, though, there are few conditions that will be resolved through the use of painkilling medication – usually, the drugs simply mask the symptoms, allowing the patient to get on with life ‘normally’. When the medication stops, the pain returns.
And the danger of that, of course, is that the individual ends up in a cycle of long-term medication with drugs that, by their nature, are addictive. The more the individual uses them, the more likely they are to become dependent.
Many people come into my acupuncture clinic with pain issues having first been to see their GP in an effort to get to the bottom of the problem, only for their doctor to prescribe a painkiller or anti-inflammatory.
In many cases, there is no discussion or advice about other treatments that might be available; the issue is diagnosed – an inflamed joint, or a migraine or a pulled muscle – and the patient is sent away with a box of tablets and advised to ‘come back if it’s not better after a week’.
Very occasionally, that approach works. Sometimes, for example, anti-inflammatory medication can ease a problem enough to allow the problem to resolve itself. But I worry that in the majority of cases, patients are being prescribed drugs as a quick fix in a five-minute appointment slot.
It’s not that doctors are lazy, incompetent or unprofessional – they’re not – they’re just busy and under pressure. Budgets are tight and so referrals in what might be seen as ‘borderline’ cases will always come down to judgement.
If a patient presents with a lump that can’t be explained, they get sent for tests. But if someone comes in with a sore elbow? Most likely not.
But there does need to be better debate about how the health industry – whether clinical or complementary – deals with pain. Drugs alone are not the answer, that much is clear from the opioid crisis in the US and the frankly disturbing figures released by PHE last week.
I worry greatly that as long as big pharma continues to be seen as the only solution to resolving pain when alternative treatment options are available, we will end up with a much bigger health crisis than we might be able to imagine right now.
Pain is merely a symptom of another problem, not the problem itself – yet pain is what medication tackles. Acupuncture is a highly effective treatment for resolving the issues that cause pain.
If you’d like to find out more about how acupuncture can help resolve your pain, please get in touch – we’d love to help you make an informed decision about the best way to protect your wellbeing.