The way physicians treat chronic pain has evolved since I began treating all types of pain while serving in the Air Force. In the mid-'90s, we would prescribe copious amounts of opioids and non-opioids liberally.
Before my time, we discovered better sedatives and hypnotics, and we would frequently prescribe them for anxiety and other conditions (Valium). Some of my professors and attending physicians were told that these benzodiazepines were harmless, and did not cause overdoses or withdrawal.
This information was relayed to us, the new budding doctors. This, of course, would turn out to not be true. They do help people, if taken conservatively.
Before organized medicine dominated (insurances, medical associations with examination boards) morphine, codeine was prescribed for nearly anything. Someone could purchase cocaine and morphine derived products over the counter. Cough syrup, with codeine mixed in, would be available in the aisle, with no prescription need.
How could we forget the leeches and bleedings performed to treat everything? Many did not survive our rather unscientific and desperate methods, for lack of any other known remedies.
Fast forward, and we find ourselves in what is seemingly the golden age of “medical evidence-based medicine." No more leeches, thank goodness.
It is difficult keeping up with the changes. In some instances, physicians are allowed to use non-evidenced based treatments for types of pain, but not so much like the medieval days of early medicine.
For example, we can use ketamine, a type of anesthesia first used in battlefield hospitals in Vietnam, in the ’60s, for major depression, since the FDA enthusiastically approved it for recalcitrant (hard to treat) major depression. It may also help with pain at a lower dose.
What about medicinal marijuana for pain, seizures, anxiety, PTSD, and other ailments? State governments have approved it for medicinal uses, while the federal government is on the fence about it.
Have you heard of magic mushrooms? The government is allowing research into a mushrooms active ingredient, psilocybin, for mental health issues.
We have many arrows in our quiver or armamentarium to treat chronic pain. There is something for everybody.
Dr. Rodney Brunson is located at 201 Tilton Rd., Northfield, NJ 08225. Call (609) 484-7000 for more information.