A Heartbreaking Story with a Happy Ending about lower back pain and pain killers

Pain killers can cause personality changes and memory issues, but there is good news.  Some time ago a gentleman in his mid-40’s walked into my clinic with a story that really hit my heart. In his mid-20’s, when everything was going fine in life, he had lower back pain due to an injury.  His doctor prescribed him an opioid pain-killer, which is commonly prescribed for sciatic pain and lower back pain.  What he didn’t know at the time was that while almost everyone will wind up with an addiction to a painkiller over time, there is a percentage of the population that is genetically predisposed to an addiction within 24 hours.

In this situation, he simply took the drug that he was prescribed, and his pain significantly decreased.  Things went fine for a while, but he couldn’t seem to get off those painkillers.  The dosage increased.  Wanting to help a friend who was also in pain, he shared his prescription.  That helped the person so much, he started helping others.  His pain management doctor was fine with him helping others…

About now in the story, you’re probably starting to feel uncomfortable because we’ve been told “don’t share your prescription medication.”  So let’s say this a different way, a more truthful way: His pain management doctor was also addicted to pharmaceuticals, and they were making money on the side selling prescription drugs, or ‘scripts, on the black market.  The patient had become a drug dealer. And when that doctor died due to an overdose, in order to stay on the painkiller he dealt drugs and wound up deep in a dangerous world of crime.

Did the Opioids cause less pain over time?

With all of this awfulness – lives falling apart and close friends dying – there was one thing I really wanted to know.  What was the pain level of his lower back pain as this was happening?  The answer?  Not much better.  After the first several months, the pain returned, the dosage was increased and he eventually built up a tolerance to that.  And if he tried to get off the medication, he went through withdrawals.  He eventually went through rehab a couple of times, and was able to get free.  He lost 20 years of his life, but he was healthy and alive when I met him.

And yet, this fellow didn’t come from a family background of crime.  In fact, he came from a well-off middle-class family with no history of substance abuse. So what happened?  I got curious, and I did some research.  Here’s what I found.

Effects Opioids Have on Personalities, Memory, and Pain:

  1.        These are the medications that are opioids: hydrocodone (Vicodin®) oxycodone (OxyContin®, Percocet®), oxymorphone (Opana), morphine (Kadian, Avinza), codeine, fentanyl.    
  2.        A person doesn’t  know if they’re genetically pre-disposed to opioid addiction unless they (1) get a genetic test or (2) take it.  No one else in his family had taken opioids, so he didn’t question when it was prescribed to him.  He had a backache, NSAIDs* weren’t working, it seemed logical to go to the doctor and do what the doctor told him.  We’ll talk about what’s wrong with NSAIDs in a future article.
  3.        Here’s where it started getting interesting.  Opioids affect the brain, especially the frontal lobe.  Because the frontal lobe is involved in planning, attention, memory, and executive functioning, the person who starts taking opioids can pretty quickly start to experience judgement impairment, in addition to memory loss – especially learning new things.  We all experience judgement impairment at times – just turn the stress level up high enough, and demand action quickly enough leaving the person no time to think or process, and  everyone will make a not-great decision.  Opioids short-circuit this, and jump straight to: “make crappy selfish decision.”
  4.        Opioids also disrupt the brain circuitry involved in impulse control, which can affect financial decisions, relationships, and problems at work.  The changes in the impulsivity of his brain translates to not having a filter – either in what comes out of the mouth, or in ideas, like “Let’s drive to Houston RIGHT NOW!”  or: “Make crappy selfish decision RIGHT NOW.”
  5.        Opioids can affect the central nervous system in three ways:
    1.        lowers the level of consciousness – sedation, drowsiness, and sleep disturbance.
    2.        affects the thinking process and the ability to react – cognitive impairment, psychomotor impairment, delirium, hallucinations, dreams, and nightmares.
    3.        THIS ONE IS MY FAVORITE.  IT’S CALLED HYPERALGESIA, AND IT MEANS THINGS HURT MORE!  Also, quick jerking movements called myoclonus.  And of course, tolerance.
  6.        The reward system gets disrupted.  Opioids disrupt the brain’s reward system through overstimulation of the pleasure center through neurotransmitters, which makes it hard to feel joy, and very easy to feel depression.    This lack of joy can lead to the next one:
  7.        Thrill seeking & dangerous behavior.  The longer a person is exposed to opioids, the harder it is for the brain to feel pleasure, and the more extreme the pleasure-seeking activities become, like driving while on opioids, or having unprotected sex, or impulse financial decisions.  These behaviors can be very uncomfortable for loved ones, and can make them feel like they’re dealing with a stranger.
  8.       Every pharmaceutical is metabolized through the liver and/or the kidneys, and weakens those systems over time.  This is true for opioids and NSAIDs – those over the counter medications that you get. NSAIDS cause ulcers in the small intestine in 100% of healthy people within 7 days.  Tylenol is one of the hardest medications on the liver.  It is the most common cause of liver transplants.  We’ll talk about this more in a future post.

The Good News

This brought to mind a different study on addiction – one that was an observation study done on heroin and soldiers during the Vietnam war.  It was a bizarre study that turns the understanding of addiction on its head. It was known that many American soldiers used heroin during the Vietnam war.  This study was conducted during 1970-1971.  It was expected that there would be a major addiction problem upon return to the US.  Instead, it was found that only a small number of the soldiers used heroin more than 5 times after returning home.  This was counter to every study on addiction.  What made those vets nearly immune to long-term addiction?

The Rat Amusement Park Experiment

The answer lies in a study done with rats, and is a study done by Bruce Alexander.  It’s simple.  You get a cage, you get a rat, and you put two bottles in it.  One is just water, and one is heroin water or cocaine water.  The rat will always choose the drugged water, to the point of death.  That’s our theory of addiction: once exposed, the brain will choose the drug.

But in the 1970’s Bruce Alexander conducted a different experiment.  He didn’t make it a solo-isolated-super boring experiment for the rat.  Instead, he gave the rat a Rat Amusement Park!  He gave it food and water and sex and friends and colored balls and interesting toys.  And the same two water bottles. But what happens this time?  The rats DON’T LIKE THE DRUGGED WATER.

“What Bruce says shows that both the right-wing and left-wing theories of addiction are wrong. So the right-wing theory is it’s a moral failing, you’re a hedonist, you party too hard. The left-wing theory is it takes you over, your brain is hijacked. Bruce says it’s not your morality, it’s not your brain; it’s your cage. Addiction is largely an adaptation to your environment.

We’ve created a society where significant numbers of our fellow citizens cannot bear to be present in their lives without being drugged, right? We’ve created a hyperconsumerist, hyperindividualist, isolated world that is, for a lot of people, much more like that first cage than it is like the bonded, connected cages that we need.   The opposite of addiction is not sobriety. The opposite of addiction is connection.”  ~ Johann Hari

How to Come Off a Painkiller

Coming off a painkiller is no small task.  Here’s how we do it:

  1. Work with your doctor on an appropriate dosage, to start decreasing.  This is something you definitely want medical guidance for.
  2. Incorporate acupuncture, energy work, herbs, food, and nutritional supplements to balance the body, correct the root cause of pain, and to start gently detoxing the painkillers out of your system.

But, what about what to do INSTEAD?  What if you’re in pain NOW?

Let’s go over the basics, because they’re important:

  1. Drink good pure clear water.  Inflammation needs to get OUT of the body, and it does that through poop, pee, and sweat, and all of those need water.  Actually measure it.  It should be half of your body weight in ounces of water.  So if you weigh 200 lbs, you should drink 100 oz of water.
  2. Sleep.  The body needs to rest in order to heal.
  3. Eat anti-inflammatory food.  Try this test, if you’re a masochist: Eat primarily pizza and chips and ice cream for a couple of weeks.  Notice how low energy you feel, and how much pain your’e in.  Fried food, gluten and dairy are three big culprits for inflammation.  Opt instead for organic veg and protein, with a little organic fruit.  It does take more energy to think about taking care of yourself when you’re in pain, I know.  But the payoff is BIG, and the alternative is MORE PAIN.
  4. Do what you know works.  Maybe it’s yoga, or an epsom salt bath, or stretching.  Remember that when you’re in pain, everything feels harder, and takes longer to do.  You can be sitting there staring at the epsom salts, knowing you’ll feel better if you take that bath, and just not get around to it.  Flip the script, and know that your self care is you #1 job.  It’s your job because literally no one else can do it for you.
  5. Breathing.  It sounds so simple, it is so simple, and it’s also powerful and profound.  Check out our resources page for some of my favorite breathing exercises.  Scroll down to Wim Hof Breathing: https://longevitywellnessclinic.com/services/resources/
  6. Skip the coffee and drink the green tea.  On the Resources link above, there’s a video on why and how to do this.
  7. Ask for help!  We can help!  Please call us – either for an in-person appointment, or a remote energy work appointment – see the testimonials below.  Help might be a lot easier than you think.(941) 923-9355 or office@longevitywc.com

References:

https://nida.nih.gov/publications/drugfacts/prescription-opioids

https://pubmed.ncbi.nlm.nih.gov/17430825/

https://firststepbh.com/blog/5-personality-changes-that-occur-in-opiate-addicts/

https://www.psychologytoday.com/us/conditions/opioids

https://www.webmd.com/connect-to-care/addiction-treatment-recovery/prescription/things-you-should-know-about-opioid-brain-damage

https://www.ted.com/…/johann_hari_everything_you_think…