Health Tips for a Better Life

There’s been a very confusing and rather sad development in some parts of the country. Whereas you would always hope the words, “pain management clinic” would mean a place devoted to helping people deal with pain, the words now quite commonly label a front for pill mills. For example, in Florida where the regulations are somewhat lax, you will often see clinics with queues of people gathering outside. The mission of these people is simply to collect their supply of legal highs – the prescription drugs abused to produce a pleasurable experience. Many of these clinics come and go within a few months as enforcement officers catch up with them. It’s a tragedy in slow motion as our society grows ever more dependent on drugs, both street and prescription.

If you go to other countries, pain management clinics are always respectable and usually attached to the larger hospitals. As a point of contrast with us, only five of the courses to teach the next generations of doctors make “pain” a compulsory subject. This means only a tiny percentage of our new doctors qualify with any formal academic or practical training in pain management. In other parts of the world, it’s a specialism in its own right with every college and university teaching course having pain management on the curriculum, usually as a compulsory subject. This feeds knowledge and understanding into every level of the profession, matching it with academic courses for nurses, therapists and the others who team together to provide the healthcare services.

The result is teams of people with expertise in pain management based in all the main hospitals and also providing outreach services to people in the community. This outreach can be simply by telephone contact or by regular visits. In other words, foreign health services do not abandon people when conventional doctors have run out of options. Teams of multidisciplinary experts take general responsibility for each individual. They discuss all the options with the patient. This begins with a practical assessment of the ability to work and live in the home. This usually involves visits to the workplace and home to consider what changes might improve the quality of life. It may be, with proper physical therapy and directed exercises, the patient can rebuild strength and resume work. This is vital both for self-respect and to keep a paycheck coming in. Changing the design of the home can also vastly improve morale by enabling the patient to move around more easily and adjust to new physical limitations. Then it’s down to the cognitive behavioral therapists to teach coping strategies to help people get the best possible results.

When you put all it together, this patient-centric approach has all the evidence showing how effective it is. When the patient feels the hospital cares, investing time and effort into improving the quality of life, most people do improve. Our healthcare service simply prescribes more Tramadol and sends patients away. Under the circumstances, it’s hardly surprising so many of us end up with a drug problem. Of course, Tramadol is one of the better less-addictive drugs but, even when you take lower doses, over time dependence builds up. It’s just delaying the onset of the problem. Proper pain management with less use of drugs is better.

It’s always sad when a great story fails to stand up to the historians. We all like Longfellow’s version of the ride but, it seems, he was only one of many and never uttered the now famous warning about the Brits. Unfortunately, the modern warning will stand up to the test of history. It’s a matter of fact that there was a Boom in births between 1946 and 1964. Worse, it’s also a matter of fact that the so-called Hippie generation is more heavily into street drugs like marijuana and the legal highs of prescription drugs than any other group in the US. Ask anyone connected to the federal Substance Abuse Administration and they will tell you the same story. The number of people aged 50 and more who abuse drugs is rising fast. Why should this matter? Well, the healthcare service includes drug-treatment programs that are supposed to help people through the pain of withdrawal and to teach coping strategies for life after dependence. As the population ages, a wave of people who have consistently used a significant range of different substances is going to begin encountering health problems. You cannot abuse these substances indefinitely and avoid the adverse physical consequences. The expectation is that the treatment programs will collapse unless, at a minimum, the number of treatment facilities doubles over the next five to ten years. Worse, the older people are, the more expensive it is to treat them.

What is the main health problem going to be? As bodies age, everything slows down. In particular, the liver and kidney lose efficiency and do not clear drugs from the blood stream as quickly. If older people are also starting up new treatments, say for high blood pressure, the drugs could interact and cause major adverse side effects. There could also be problems for physicians as they try to diagnose diseases and disorders. For example, there is clear evidence that the long-term use of marijuana causes some memory loss. How is this to be distinguished from the memory problems stemming from the early onset of Alzheimer’s? At present, there is no clear evidence as to how often physicians ask their patients about substance abuse. Just as important, there is no evidence about how honestly patients answer questions about their sometimes illegal drug use. It is obvious to the federal government that there should be routine screening of all patients aged 50 or more. This would cover the spectrum of substance abuse from alcohol and nicotine to painkillers. All patients should be counselled on the need to quit. But patients may fear admissions of illegal drug use may end up on their records. At the least, this will damage their reputation, but it could result in prosecution.

In terms of prescription drugs, the most often abused are the anti-anxiety and treatments for insomnia, mainly ambien. There is a reflex in physicians when their older patients report problems in sleeping. This is an expected aspect of growing old. People lose their jobs. They start feeling socially useless. This leads to stress and some depression which interferes with normal sleep patterns. Only a few physicians are trained in geriatrics. They neglect to ask about lifestyles and just write the standard prescription for ambien. While none of this changes the facts about ambien which remains the best of the drugs to treat insomnia. It should alert all Boomers about the need to review lifestyle with their physicians and, if possible, cut down or quit nonessential drug use.