Advantages And Disadvantages Of Using Painkillers To Control Chronic Pain
Pain is generally divided into chronic pain and acute pain. Chronic pain is defined as pain that lasts longer than the average healing time and is usually diagnosed as chronic pain which persists or relapses for more than three to six months. Acute pain is caused by trauma, disease, or surgery. Generally moderate to severe pain.
Unresolved pain can significantly affect a patient's quality of life and treatment. It also can affect a patient's mental state and appetite, and further, these problems can directly affect the treatment effect. For example, cancer patients need proper nutrition and mental state to resist the erosion of cancer cells better, so that chemotherapy drugs can achieve better therapeutic effects. On the contrary, if the patient affects the appetite spirit due to pain, the physical quality will be lowered, and the body's resistance will not be enough to resist the cancer cells, which will eventually lead to the therapeutic effect not meeting the expected goal. A World Health Organization study (WHO) shows that people who have been in pain for a long time are four times more likely to get anxiety or depression than ordinary people. The American Medical Association points out that 'doctors are obligated to relieve pain for patients, and the American Nurses Association's position is that 'the nurse's responsibility for nursing care includes alleviating pain. ' Therefore, pain relief is an essential step in curing disease for patients. Recently, the pain has been widely accepted as the greatest threat to the quality of life; pain relief becomes the primary treatment in all treatments.
With the gradual development of science, experts continue to propose various adverse effects of pain on the human body. Physiological effects, such as therapeutic effects and multiple indicators, can be visually found. Postoperative pain that cannot be alleviated may result in increased vascular resistance to heart rhythm, increased circulating catecholamines (Circulating catecholamine is a hormone that may cause contraction and relaxation of blood vessels in the heart), leading to myocardial ischemia, stroke, bleeding, and other complications. In this way, the patient is at risk because of surgery, and the fundamental meaning of the operation is to help the patient eliminate the cause to save lives. Therefore, it is necessary to help patients use painkillers to control postoperative pain. On the other hand, failure to relieve acute pain in time may lead to changes in the pathophysiological nervous system, including peripheral and central neuronal sensitization and evolution into chronic pain syndrome. Chronic pain syndrome is a severe disease. If the patient does not make full use of the painkiller to control the pain, then this chronic pain can lead to a range of adverse consequences, such as physical, mental, family, and society. And chronic pain can lead to physical decline, immune dysfunction, loss of appetite and sleep quality, and many other consequences that affect the patient's body. Therefore, in a sense, chronic pain is the disease itself.
Chronic pain requires doctors to give painkillers because long-term chronic pain causes not only physical discomfort but also causes psychological problems — for example, depression and anxiety. Depression is a well-known mental illness with a very high mortality rate. If the disease cannot be adequately treated and cared for, the outcome of the patient is death if left unchecked. Although the anxiety disorder has no severe consequences of depression, it will reduce the patient's self-care ability, which leads to a decrease in the quality of life. Paice once pointed that 'in cases where the pain that is known to be unresolved affects all aspects of quality of life (QOL) and greatly affects the patient's treatment, the relief of pain depends on the ability of the clinician to assess all aspects of the patient, including the rational ability to use the medicine'. Therefore, it is indispensable to use painkillers to control pain in these cases, which not only improves the therapeutic effect but also prevents the patient from developing new diseases due to illness. Therefore, Brennan believed that pain management is an ethical behavior that stems from the core of biomedical science.
Although pain is one of the greatest threats to the lives of patients, there are still various potential risks associated with the use of painkillers. One of the biggest threats is the adverse effects of these drugs. To date, multiple opioids and morphine have had adverse effects. Although this drug can help patients relieve pain, side effects may still affect the patient's body to some extent. For example, acetaminophen (is medicine for colds, fever, joint pain, neuralgia and migraine, cancer pain, and pain relief after surgery) has analgesic and antipyretic effects on the human body, but does not reduce inflammation. Painkillers were previously thought to be used in combination with opioids, especially for musculoskeletal pain. Still, recent studies have shown that the drug is very singular and has very significant adverse effects, especially for the liver and kidneys. With morphine, its active metabolite M-3-G (a substance produced in the body when using morphine) has an absolute chance of causing myoclonus, seizures, and hyperalgesia (increased pain), correctly when the obstacles are cleared due to renal insufficiency due to hydromorphone, methadone, and fentanyl. Therefore, most painkillers still require further exploration and research in terms of fair use. Otherwise, although the patient uses an analgesic to avoid unnecessary pain, the side effects of the analgesic are still produced in the patient. To a certain extent, this does not lead to the proper development of the patient's disease, but the patient's body will deteriorate due to the improper use of painkillers.
On the other hand, the adverse effects of using painkillers are addictive. It is well known that most of the painkillers on the market, including opioids and morphine, are drugs that are highly addictive to patients. In clinical practice, some patients may become addicted to painkillers when they use painkillers because of inappropriate measurement or long-term use of painkillers to control pain in some cancer patients. Especially morphine and opioids. In history, China was controlled by opium for some time. Because some countries want to occupy Chinese land, they try to use the drug to control Chinese people. During that time, many Chinese people were addicted to opium. Their body is mostly destroyed. It can be seen that the harm caused by opioid addiction is enormous. Therefore, if the clinician does not have perfect control of the dose of the drug at the time of prescription, once the patient is addicted to the drug, the harm is very significant. The first is that drug addiction can not only damage the patient's internal organs, such as heart and lung function. The second is that even if the patient's physical condition is cured, the withdrawal of the painkiller requires the patient's strong will. Once the drug is addictive, the chance of becoming addicted again is very high.
Furthermore, some patients are ultra-fast metabolizers of such drugs, which may lead to elevated serum levels and other adverse reactions. There was once a case of death due to ultra-fast metabolic (it means that some people will quickly absorb and decompose when taking certain medicines) painkillers. A baby died of breastfeeding during the breastfeeding period because his mother received pain control. Many doctors were puzzled by this case and finally showed that the mother was an ultra-fast metabolizer in the genotyping of the CYP 2D6 enzyme. It is difficult for doctors to control the drug dose of such patients, and such patients will have many more adverse reactions, such as respiratory depression (Inhibitory breathing refers to a sudden interruption of the inspiratory phase caused by severe pain in the chest. The breathing movement is suddenly and suddenly suppressed. A patient's expression is painful, and the breathing is shallower and faster than average) than healthy people during the treatment of painkillers. It is difficult for doctors to control the dose of such patients. During the use of analgesics, such patients will develop more adverse reactions than ordinary people, such as respiratory depression. In this case, the doctor must carefully consider the various adverse reactions that may threaten the patient's life and prepare for the rescue when prescribing.
References
- Brennan F. , Carr D. and Cousins M. (2007) ‘Pain management:a fundamental human right’, Pain Medicine,105(1),205-221,available:https://journals. lww. com/anesthesia-analgesia/Fulltext/2007/07000/Pain_Management__A_Fundamental_Human_Right. 37. aspx?casa_token=SCEPZlrQnekAAAAA:rSzRw5D6vzQvojnbDmAr49U_h48l29Xs8J4TOk0H5LDVvvJVo7q2v6ItqCB93hay2z4NpVkrgyuj-6mrzcw7-sRDzxRh_A.
- Paice J. , Ferrell B. (2011) ‘The management of cancer pain’, Cancer Journal, 61(3), 157-182, available:https://onlinelibrary. wiley. com/doi/full/10. 3322/caac. 20112.
- Sinatra R. (2010) ‘Cause and consequences of inadequate management of acute pain’, Pain Medicine,11(12),1859-1871,available:https://academic. oup. com/painmedicine/article/11/12/1859/1943985.
- Treede R D, Rief W, Barke A, et al. (2015) ‘A classification of chronic pain for ICD-11’, Pain, 156(6), 1003–1007, available:https://www. ncbi. nlm. nih. gov/pmc/articles/PMC4450869/.
