We continue to publish Boris Prilutsky, LMT, Blog. In this issue Boris discusses the important topic of pain medications and their impact on patients’ lives and therapists’ work.

Dr. Ross Turchaninov, Editor in Chief

INCREASING UNWILLINGNESS TO BEAR EVEN THE SLIGHTEST DISCOMFORT

By Boris Prilutsky, Los Angeles, CA

Running across this article, ‘Prescription drug abuse surged 400 percent in past decade’ I was amazed how resonant this topic was with my own thoughts; those that I was mulling over for a while and that were troubling me. A new White House study found a 400 percent jump in prescription drug abuse between 1998 and 2008. Experts blame a lack of monitoring programs as well as their fellow Americans for that.

“We are in a culture of immediate gratification and nobody will put up with even the slightest discomfort anymore.”  

From my perspective that is a very strange explanation. Technically it is not even an explanation, but a statement of professional incompetence when the lack of correct treatment is blamed on the patients’ unwillingness to couple with chronic pain. We are all aware of drug addiction and its terrible outcomes. Of course, “slightest discomfort,” according to terminology used in the White House report, are not life-threatening. Why in such case are people jeopardizing their health and even life by consuming “legally prescribed” opioids while they are in ‘slight discomfort? People know about the danger of opioids and still they are using them. We have only two possible explanations: people are generally stupid, or they simply don’t have any other option.

I think what pushes people to take drugs is the exhaustion and desperation due to constant suffering from chronic pain frequently triggered by a simple accumulation of everyday stress.

I have no doubt that similarly to illegal drug cartels, big Pharma knowingly pushed and encouraged the medical community to prescribe opioids to secure future multibillion-dollar profits. For the same opioids we lock people up for if they sold on the street, but we are OK when prescribing to the patient just to get him or her something and get them out of the medical office since there is nothing left to offer them.

A few months ago, I watched a TV show about the opioid epidemic in the USA. One of the guests was an MD from Ohio. I believe he had an important medical official position in the state. He clearly stated that: ”We didn’t know that opioids were so addictive. Pharmaceutical companies ensured us that it is safe to prescribe opioids.”

I couldn’t believe my ears! What did this SOB do in medical school? Did he completely miss pharmacology as a discipline during his studies? No, he was a classical liar. He and those of his colleagues who claimed that they didn’t know that opioids are addictive should not be in medicine to start with and I strongly believe that their medical licenses must be revoked.

Our modern life is a constant source of stress and worries from acts of terror, fluctuations in the economy, overwhelming social media to everyday worries at work and at home. So, stress crawls on us from all cracks of modern life constantly attacking us until it eventually triggers pain and other discomforts. It leads us to an obvious but critically important statement: Normal reaction of the human body to the physical or emotional stress is increased in resting muscle tone. Such an increase becomes the first steppingstone in formation of somatic abnormalities in the form of tension in skin, fascia, muscles and periosteum. 

Now let’s look at a possible option to control stress and anxiety. Yes, exercise, yoga and meditation can do that, but only to some level of chronic stress accumulation. If there is a significant imbalance between sympathetic and parasympathetic divisions of autonomic nervous system these tools have their limitations. Yes, some medication is prescribed. However, the most powerful tool to control level of stress and balance autonomic nervous system as massage therapy and it is very frequently missed on very important early but still reversible stages of stress accumulation.

Why then are massage therapists who are primarily responsible for controlling stress level and maintaining balance within autonomic nervous system are not actively involved in the fight with drug addiction? I think it’s because as an industry we failed. One of the reasons is that the massage therapy community is deeply divided, and detached from modern medicine. Therefore the general public as well as the medical community have a hard time choosing between thousands of alternative names used for massage therapy nowadays.

I regularly observe development of so-called ‘new’ modalities which promise breakthroughs in treatment while in reality they are re-packaging already existing and clinically tested methods and techniques or in many unfortunate cases ‘new’ modalities which don’t make any clinical or even physiological sense.

There are no doubts that we have to work with physical therapists and chiropractors, for the sake of patients, but if the massage industry as a whole can’t find even basic common ground and produces more and more professional division when everyone claims to be the answer we will continue to fail the public and we are going to be partially responsible for the “400 and much more percent jump in prescription drug abuse.”


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