Examples of Narcotic Agonist-Antagonist Painkillers
Buprenorphine (Buprenex)
Butorphanol (Stadol)
Dezocine (Dalgan)
Nalbuphine (Nubain, Nuban)
Pentazocine (Talwin, Talacen)
What Do They Do in the Body? Relieve pain and induce euphoric mood changes.
What Are They Prescribed For? Relieving pain, particularly for postoperative patients.
What Are the Possible Side Effects? These drugs are potent pain-relieving substances that have a lower abuse potential than pure narcotics, but they can still be addictive—and usually are!
These drugs can cause sweating, chills, flushing, water retention, heart or pulse irregularity, nausea, vomiting, abdominal pain, muscular pain, slowed breathing, rashes, slurred speech, blurred vision, hallucinations, dizziness, urinary frequency, heart attacks, seizures, and skin and muscle damage.
CAUTION!
Think Twice About Taking These Drugs If . . .
• You have an allergic reaction to these drugs.
• You have a drug dependence problem.
• You have liver or kidney dysfunction or disease.
• You have a head injury.
• You have heart disease.
• You must drive or operate machinery (that includes cars).
• You have severe allergic reactions (particularly to sulfur).
• You have acute asthma or other significant respiratory problems.
Drugs for Arthritis Pain
There is an entire class of drugs prescribed specifically for arthritis pain. None of them are well studied, none are widely used, and all are uniquely dangerous. We don’t recommend them. Conventional medicine is notoriously unsuccessful at treating arthritis safely and effectively, but there are many alternative approaches that provide great relief and even healing. Please read the later section on arthritis for details.
Natural Remedies for Pain
Most of the pain we suffer we can do something about. We have a pretty good grasp of what causes the pain of headaches, and in alternative medicine we have many effective ways to treat arthritis. Most back pain can be prevented and healed using a combination of physical and emotional healing, and with lifestyle changes alone, the pain of osteoporosis can often be prevented. This means that millions of people can avoid the use of painkilling drugs and their side effects.
If you have an acute pain such as a muscle sprain, you may need to warm up before you exercise in the future. If you have chronic pain such as back pain, you may need to do exercises to strengthen your back muscles. Exercise is the single best cure for chronic back pain and for arthritis. If you have chronic pain such as from arthritis, try an elimination diet to find out whether a food sensitivity is causing inflammation in your joints. Or it could be a side effect of a prescription drug. The anticholinergic drugs can cause muscle stiffness and neck pain, for example. Headache pain is often caused by stress, allergies, or sensitivities to food or chemicals.
The Best Natural Remedies for Occasional Pain Relief
There are many ways to alleviate chronic pain before reaching for pain drugs. Here are a few favorite natural pain relievers. All of the supplements can be found at your health food store.
Hot and Cold Packs. Ice is one of the best and simplest remedies for pain caused by inflammation. The cold very effectively reduces the inflammation. Use a cold pack for 20 minutes every few hours for sprains and strains. For a muscle sprain or strain that’s been around for a few days or swelling caused by a bruise, first use a 20-minute cold pack, then a 20-minute hot pack. The cold will reduce the inflammation, and the heat will encourage blood flow into the area and help break up and remove damaged tissue so that healing can take place.
One of the simplest, cheapest, and most effective ways to relieve chronic pain (with the exception of headaches) is with what is known as moist heat. You can apply moist heat by taking a long, hot shower and aiming the showerhead at the area that hurts. You can take a long, hot bath with relaxing herbal oils, or you can use a hot pack or a hot water bottle. If you have access to a Jacuzzi, you can aim the jets of water at the places that are painful.
Digestive Enzymes. If you have pain from a muscle injury or arthritis, try digestive enzymes. Clinical studies show that enzymes help reduce inflammation caused by arthritis and injuries to joints and connective tissues such as muscle sprains, and can even relieve back pain. Enzymes tend to speed up the rate at which many bodily processes work, and injuries are no exception. Enzymes work at the site of an injury to remove damaged tissue, which reduces swelling, and to help the body repair itself. Bromelain, which comes from pineapples, is an enzyme that has anti-inflammatory properties. One of the best combinations is quercetin, an antioxidant, and bromelain.
DL-Phenylalanine (DLPA). This is a combination of L-phenylalanine, an essential amino acid, and D-phenylalanine, a nonnutrient amino acid that helps promote the production of endorphins, natural painkillers made in the brain. DLPA can be very effective in the relief of chronic pain such as arthritis and back pain. While in most studies there have been no side effects at all from DLPA, it has raised blood pressure in a few people. Although this is unlikely to happen, please monitor your blood pressure if it is high and you take DLPA. Don’t use DLPA in combination with antidepressant drugs or if you have phenylketonuria (PKU).
Vitamins and Minerals. There are vitamins and minerals that can play a part in reducing inflammation. These include vitamin C, vita-min E, and the B-complex vitamins. Taking a magnesium-calcium supplement can help relieve the pain of muscle spasms and often relieves chronic headaches. A copper deficiency can cause inflammation in the joints, as well as fragile skin and connective tissue. The bioflavonoids, such as grapeseed extract and quercetin, can help reduce inflammation reactions.
Herbs for Pain. White willow bark (salix spp.) was used as a pain reliever long before a chemist at the Bayer company in Germany synthesized acetylsalicylic acid, or aspirin, from one of its active ingredients in 1897. Aspirin is a synthetic drug (not found in nature), but various teas, decoctions, tinctures, and poultices of trees of the salix species, most commonly known as wil-low and poplar, have been used to relieve pain for many centuries. White willow bark doesn’t cause gastric bleeding or ringing in the ears as aspirin does and can be a very effective pain reliever, especially for headaches and arthritis pain. Traditionally, a tea of the inner bark was used (a small handful of bark to a cup of hot water) to treat headaches. A bath, wash, or poultice was used to treat aches and pains in the joints. You can find white willow bark in capsule or tincture form at your health food store.
Nearly 2,000 years ago, the Roman doctor Dioscorides, one of the first to write a medical textbook, recommended the herb feverfew (Chrysanthemum parthenium) for headaches. Fever-few is still the most effective treatment known for migraines. It is the only medicine that will help migraine headaches without side effects. This member of the daisy family is also called bachelor’s buttons. Feverfew has undergone much testing and research as a migraine remedy, as pharmaceutical companies are trying to find the active ingredient so they can isolate it and synthesize it. However, the lowly feverfew is not revealing its healing secrets, and the freeze-dried herb in capsules, or a tincture of the fresh leaves, is still the best way to take the plant. Feverfew has also been used successfully to treat arthritis.
Treating Chronic Pain
As scientists research pain, they’re finding that a wide variety of techniques that induce relaxation and increase body awareness can be used very effectively to beat the demon of chronic pain. In fact, an expert panel at the National Institutes of Health concluded that there is enough positive research data to now integrate behavioral and relaxation therapies into standard treatment of chronic pain and insomnia. This does not mean it’s “all in your head,” which implies that somehow it’s your fault you’re in pain. It means there are techniques you can use to induce deep relaxation and become more aware of stress poi
nts in your body and how to relax them.
People in chronic pain tend to tense specific areas of muscle, such as the neck and shoulder areas, creating other areas of pain and skeletal imbalances. This creates a vicious cycle, with a new area of pain leading to increased tension, which creates yet more pain. Pretty soon, pain seems to exist everywhere in the body and the person in pain doesn’t want to move at all—the worst thing you can do for most pain!
Emotional factors such as tension, anxiety, depression, loneliness, anger, an inability to communicate, a sense of being a victim, and a sense of being estranged from the world can all contribute to more severe pain by blocking the body’s production of natural painkillers called endorphins. People who strive to become more aware of their pain—exactly where it is located, what causes it, what makes it worse, and what makes it better, for example, rather than blocking it with analgesics and narcotics—tend to have a great sense of empowerment and less severe pain. The first tendency for most of us when we’re in pain is to try to block it, usually with medication. It’s ironic that the reverse approach of becoming more aware and paying more attention can be the key to coping effectively with chronic pain.
Two of the most powerful techniques for both increasing body awareness and inducing relaxation are meditation and the Asian movement disciplines such as yoga, qi gong, and tai chi.
Meditate Your Pain Away. Meditation can bring a greater awareness of what we’re doing with our consciousness in any given moment. It may begin simply by paying attention to breathing and progress to a “detached observing” of what is happening with the mind and emotions. As people learn to separate their physical sensations from their thoughts, pain will often begin to dissipate some. A favorite basic meditation that can be used anytime by anyone for relieving stress or tension is this: Breathe deeply and slowly in through the nose to the slow count of five, hold the breath for the slow count of five, and breathe out to the slow count of five. Repeat at least three times. A few rounds of this elegantly simple technique and you’ll be amazed at how relaxed you can feel.
Another simple meditation technique is to repeat one word silently over and over. Many meditation disciplines use the word om. You can use any word or phrase you want as long as it has a positive association.
A form of meditation especially designed to induce relaxation is called visualization or guided imagery. In these techniques, you sit or lie down, close your eyes, and take three long, deep breaths. Then you visualize the most relaxing place or situation you can think of and make it your “vacation spot” that you visit whenever you feel tense. Many people like to envision themselves on a tropical beach. As you visualize, engage all of your senses: the sky is deep blue, the water turquoise; you sift the warm, white sand between your fingers and feel the hot sun; you hear the waves breaking and the palm trees rustling; and you smell the salt water and sweet aromas of tropical flowers.
A technique you can use to help you become more aware of your body is to lie on your back in a comfortable place with your eyes closed, perhaps with some soothing music on. Starting at your toes, slowly and in turn, become aware of every part of your body, and as you become aware of it, gently tense the muscles around it for 5 to 15 seconds (keep breathing) and then relax them. For example, feel each toe on your right foot by wiggling it, and then curl all five of them forward. Do the same with your foot and ankle, move to your other foot, and then move up to your calves, your knees, and your thighs, tensing and relaxing each area. By the time you finish with your face, you’ll be deeply relaxed.
Exercise Your Pain Away. It is extremely important to exercise in whatever way you can when you’re suffering from chronic pain. If you do exercises such as yoga or qi gong, sometimes called “enlightened exercise,” you will stretch, tone, and strengthen your muscles; limber up your joints; improve your circulation, coordination, and balance; get your lymph system flowing; bring greater alignment to your musculo-skeletal system; improve your posture; increase relaxation; and become more aware of your body. People who do these practices regularly claim that they also speed healing, boost the immune system, improve digestion, increase energy, and improve mood. Studies show they can also reduce blood pressure. If your arthritis pain is severe, work with a physical therapist to create an exercise program or try swimming or water exercise to keep pressure off of tender joints while moving through full ranges of motion.
Much pain, particularly back pain, results from poor posture and improper use of the spine (i.e., lifting something without bending your knees). Greater body awareness will alert you when you’re doing something that creates pain and can teach you to move away from habitual patterns of movement and into new, more healing patterns. With any exercise, especially yoga, remember to ease off on whatever you’re doing if you experience any pain. Contrary to the “no pain, no gain” philosophy, adopt a new philosophy of “there’s no gain in pain.” Stretching is an essential part of all the forms of enlightened exercise. You can stretch gently anytime you’re starting to feel pain or tension.
Although much pain is caused by the improper use of the muscles and spine, it is also caused by muscles that aren’t used and aren’t toned. For almost all lower-back pain caused by strained muscles, there are specific exercises you can do that will, in effect, cure the problem. You can get these exercises from almost any physician or physical therapist. Yoga instructors usually have their own set of back exercises, which are equally effective.
Treating Chronic Pain with Herbs. Two of the biggest problems in chronic pain are stress and tension: physical, emotional, and mental. When you hurt all the time, you tend to tense muscles all over your body, creating additional areas of pain. People who suffer from chronic pain often become anxious and fearful, and feel helpless, which is understandable. Waking up and going to bed with pain as a constant companion is a traumatic experience.
For that reason you can try the herb kava with the goal of relieving anxiety and tension, and secondarily to relieve pain. Sometimes a little herbal help in relaxation can help start you on the path to healing.
• Kava (Piper methysticum). This member of the pepper family grows as a bush in the South Pacific. Kava is a sedative and muscle relaxant. The South Pacific islanders, who use it in much the same way many people in North America use alcohol, describe kava as a calming drink that brings on a feeling of contentment and well-being and encourages socializing.
Kava is also a pain reliever and can often be used in place of the NSAIDs. In a European study, people with anxiety symptoms given a 70 percent kavalactone extract in the amount of 100 mg three times a day were found after four weeks to have a significant reduction in anxiety symptoms such as feelings of nervousness, heart palpitations, chest pains, headaches, dizziness, and indigestion, all with no side effects noted.
For over 100 years, scientists have been trying to figure out exactly what it is in kava that gives it sedative and antidepressant properties. Although they have isolated chemical compounds named kavalactones, which act as sedatives and antidepressants when given alone, an extract of the whole root has always worked better. Kava also has a different action on the brain from any of our other antidepressants or sedatives, possibly working in the limbic brain, the seat of our emotions. Used occasionally in medicinal doses, kava has no known side effects. In very high doses, it can cause sleepiness, and high doses over a long period of time can cause skin irritation and liver damage.
The FDA recently issued a press release cautioning against the use of kava because of “the potential risk of severe liver injury.” Virtually all prescription drugs and many over-the-counter drugs have the potential to harm the liver when taken long term in large doses. Acetaminophen (Tylenol) is a perfect example of a widely used over-the-counter drug that quickly becomes toxic to the liver when combined with other drugs or alcohol.
The kavalactones, and lactones in general, are toxic to the liver. However, it turns out that kava also naturally contains glutathione, a substance that protect
s the liver and is essential to its detoxification processes. The South Pacific islanders, who have used kava for centuries without problems, use the whole root and thus retain the benefit of the glutathione. In Western countries, kava is most commonly sold as a liquid extract of the root: some of the active ingredients are pulled out in a laboratory using alcohol or acetone, leaving concentrated lactones and no glutathione. Some researchers claim that low-alcohol or acetone extracts are safer.
Alternative Medicine Treatments That Work for Chronic Pain
There are dozens of safe, effective alternative medicine techniques for healing pain that don’t involve surgery or medication. Here are some that have been proven over time to work for some people:
Acupressure
Acupuncture
Alexander Technique
Biofeedback
Chiropractic
Feldenkrais
Hydrotherapy
Hypnosis
Massage
NLP (neuro-linguistic programming)
Prolotherapy (also known as sclerotherapy or reconstructive therapy)
Rolfing
TENS (transcutaneous electrical nerve stimulation)
One of the truisms of herbal medicine is that the whole plant usually works better than an extract. Kava is a perfect example of this. Kava is useful when used in moderation but can be harmful when overdone or combined with other drugs. It’s not a substance to use daily for an extended period of time. It would also be wise to avoid combining kava with alcohol and to avoid the highly concentrated doses offered by some manufacturers.
• St. John’s wort (Hypericum perforatum). This medicinal plant with a beautiful yellow flower has been used by the Chinese, the Greeks, the Europeans, and the American Indians for centuries to treat heart disease, anxiety, insomnia, and depression. In a study of 105 patients who had symptoms of mild to moderate depression, half the patients took 300 mg of St. John’s wort extract three times a day for four weeks, and the other half took a placebo. Some 67 percent of the group taking the St. John’s wort had positive results, compared to only 28 percent of the placebo group. Another study comparing St. John’s wort to two standard antidepressants, amitriptyline (Elavil) and imipramine (Tofranil), showed that St. John’s wort had a better positive result. This amazing herb has also been used in studies alongside the antidepressant SSRIs, such as Prozac, and found to be as effective. And you guessed it, those taking the prescription antidepressants suffered from drowsiness, constipation, and dry mouth, while those taking St. John’s wort reported no side effects.
Prescription Alternatives Page 33