Why Your Injuries Aren’t Healing Properly

injuryOveruse injuries are something I see in my practice on an almost daily basis.  Whether it’s low back pain from running, shoulder pain from lifting weights, or neck pain from being in the wrong position for too long, most of us have experienced an issue related to muscle pain.  Most of us have been told what to do when it comes to dealing with the immediate trauma-rest, ice, compression, elevation, etc.  But what about the majority of you who aren’t getting relief weeks, months, or sometimes years after the initial trauma? What I’m finding is that the typical approach to soft tissue injuries (muscles, tendons, ligaments) is actually leading to further damage, and a long-term weakening of tissue.   [Read more…]

Heartburn Drugs Typically Not Necessary

gerdProton Pump Inhibitors (PPIs) such as Nexium, Prevacid, and Protonix, are some of the most widely prescribed drugs in the U.S. They are typically given to patients who complain of heartburn or reflux (GERD), who are then kept on the medication indefinitely. In fact, it’s not uncommon for many of the patients I see to think of being on this medication almost as an afterthought, because it’s so common in our culture. What they may not realize is that long-term use of these medications can lead to long-term complications, and may be doing more harm than good! When first approved by the FDA, the suggested use of PPIs was for 4-6 weeks, mainly for treating serious gastrointestinal issues, like ulcers and Barrett’s esophagus.  [Read more…]

Drug Overdoses Responsible for More Deaths Than Car Accidents

drugs, overdose, pain, acupuncture, naturopathic medicine, Connecticut  More Americans now die from drug overdoses than in car accidents, according to a new government report released Tuesday.

In 2008, poisoning deaths became the number one cause of accidental deaths in the United States and the leading cause of injury death in 30 states, according to the report from the U.S. Centers for Disease Control and Prevention. Ninety percent of these poisonings were linked to drugs, with a surge in deaths from prescription painkiller overdoses reported.

“During the past three decades, the number of drug poisoning deaths has increased sixfold, from about 6,000 deaths in 1980 to over 36,500 in 2008,” said report author Margaret Warner, an injury epidemiologist at CDC’s National Center for Health Statistics, who added that this trend is only expected to continue.

The authors of the report found a 90 percent increase in poisoning deaths since 1999, while deaths from car accidents have dropped 15 percent in the same period.

By 2008, nine out of every 10 poisoning deaths were due to drugs. In that year, some 77 percent of these deaths were unintentional, 13 percent were suicides and 9 percent were of undetermined intent, according to the report.

Over the last 10 years, these increases were seen among both men and women and in all age and race/ethnic groups, Warner said. In 2008, the highest rates were among males and those aged 45 to 54.

In 2008, more than 40 percent of poisoning deaths were due to opioid painkillers. That’s way up from 1999 when these drugs were involved in only 25 percent of these deaths, Warner said. “CDC has called this an epidemic,” she noted.

In 1999, there were 4,000 deaths related to painkillers, but by 2008 that number had tripled, to almost 15,000 deaths, according to the CDC.

These deaths also vary by state. Although it isn’t clear why drug deaths vary across the country, one reason might be the different laws states have for controlling the use of prescription painkillers, Warner said.

Deaths are an accurate way to get a handle on the size of the problem, because these are definitive data, Warner said.

Dr. Jeffrey Bernstein, medical director of the Florida Poison Information Center at the University of Miami Miller School of Medicine, said “we knew this was coming; it shouldn’t shock anybody. It’s disturbing though.”

More attention needs to be devoted to this problem, Bernstein noted. “It needs to be attacked from multiple angles and multiple levels in the way we have made headway in trauma,” he said.

“There are newer and better drugs and that’s great for treating people’s pain, but they come with a price,” Bernstein pointed out. “There is addiction and interactions with other drugs, and potential for overdose and misuse.”

The number of users and abusers of these drugs is much greater than those who die from them, Warner added. “This is the tip of the iceberg,” she said.

By 2010, 12 million Americans said they were using opioid painkillers without a prescription. In 2009, almost 500,000 emergency room visits were for abuse of these painkillers. This costs health insurance companies as much as $72 billion a year in direct costs, the CDC said in a November report.

Dr. Chris Jones, a CDC health scientist who was not involved in the latest report, said that deaths from opioid painkillers have “increased significantly over the last decade. We have also seen an increase in people who have nonfatal overdoses who are showing up in emergency departments.”

In fact, there was a 98 percent increase in emergency room visits due to these painkillers between 2004 and 2009, he said. These emergency room visits are greater than those seen for overdoses of heroin and cocaine, Jones added.

The dramatic increase in deaths and overdoses from prescription drugs is due to a vastly increased use of these drugs by doctors. “Between 1999 and 2010, the sales of these drugs increased fourfold,” he explained.

“Part of this is an attempt to better treat pain. As we have seen the medical use go up, we have also seen the abuse of these products go up,” Jones said.

This doesn’t have to be as widespread of a problem as it has become. There are plenty of alternative methods that can be used to reduce pain, including acupuncture, naturopathic manipulation, and nutritional/herbal interventions.  The data here is pretty clear-the use of prescription painkillers is seriously risky business, and puts you at a much higher risk for long-term complications, especially addiction.  Please consider all other options before agreeing to take painkillers, and consult with your local naturopathic physician for the appropriate guidance.

Doctors and Drugs

U.S. doctors are too quick to reach for their prescription pads, according to a new report urging them to think more about side effects and non-drug alternatives.

“Instead of the latest and greatest, we want fewer and more time-tested drugs,” said Dr. Gordon Schiff, associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital in Boston, a non-profit organization that studies ways to improve safe practices in healthcare.

“We are really trying to promote a different way of thinking about practicing,” added Schiff, whose report appears in the Archives of Internal Medicine.

Nearly half of all Americans have used at least one prescription drug in the past month, according to the Centers for Disease Control and Prevention, and experts say overprescribing is rampant.

By definition, that means people are being exposed to side effects, sometimes fatal, without the benefits that would justify those risks.

“Often what is really bothering them is not cured with a pill, but rather through exercise, physical therapy, or diet changes,” Schiff told Reuters Health.

Yet many doctors are quick to prescribe a drug, partly because they have limited time to deal with individual patients or because they and their patients have been bombarded with ads from the pharmaceutical industry.

As for prevention and non-drug alternatives, Schiff said, “there are no drug reps coming to my office pushing that.”

In an editorial in the same journal, researchers describe how opioid painkillers like Vicodin and Percocet have become increasingly common without good evidence that they help patients in the long run.

The evidence of harm, on the other hand, is clear, write Dr. Deborah Grady of the University of California, San Francisco, and her colleagues.

In 2007 alone, for instance, there were nearly 11,500 deaths related to prescription opioids — “a number greater than that of the combination of deaths from heroin and cocaine,” according to the researchers.

Some four million prescriptions for long-acting opioids are written every year, with side effects ranging from addiction to constipation to sleepiness.

To counter some of this overprescribing, Schiff and colleagues urge doctors to think beyond drugs and to prescribe new ones much more cautiously.

When it first hits the market, new medicine has usually only been tested in a few thousand patients, often healthier and younger than the ones doctors see in their offices.

That leaves a lot of questions about safety, especially since patients often are taking several drugs at the same time. More than a third of people over 60 take five or more drugs, for instance, and the number of prescriptions continues to rise.

But Dr. Lisa Schwartz and her husband Dr. Steven Woloshin, both of Dartmouth Medical School in Hanover, New Hampshire, told Reuters Health it’s difficult for doctors to get unbiased information about new drugs.

“We need to be making this information much more easily accessible to doctors,” said Schwartz, an expert in risk communication. “There are billions of dollars being spent on new drugs with unproven benefits.”

Schwartz and Woloshin said one way to do this would be to have the U.S. Food and Drugs Administration, which approves new drugs, send out simple summaries about the medications.

They also emphasized that overprescribing, while real, goes hand in hand with underprescribing of drugs to high-risk patients.

“We have both problems in this country,” Schwartz told Reuters Health.

According to Schiff, patients also have a role to play.

“Patients need to ask critical and skeptical questions, too,” he said. “They really should learn about the side effects of the drugs they are taking and be on the lookout for them.”

Schiff’s “Principles of Conservative
Prescribing” study was funded by government grants supporting consumer healthcare education and healthcare quality research.

SOURCE: http://bit.ly/lwuNm0 Archives of Internal Medicine, June 13, 2011.