To Chronic pain patients

A note from Dr. Yee to our chronic pain patients:

Opiate dependence is a disease, a chemical imbalance of the central nervous system, not unlike depression.

In other words if a patient does not get the opiates they need, they get very sick. Chronic pain patients will get "hooked" or become dependent on opiates given enough time. They will develop tolerance and not really understand if they are treating their underlying pain problem or physical dependence.The real problem with chronic opiate therapy in treating non-malignant pain is that it just does not work that well and unfortunately doctor's end up creating a second iatrogenic disease.
There is a growing body of literature that shows high dose opiates actually cause hyperalgesia.

Most pain doctors have seen this, but it is often not recognized.During the day when an opiate dependent patient takes their medication, there is a high likelihood that they are really treating their withdrawal rather than the underlying pain. It is very easy to confuse the general body aches and low back pain symptoms of early onset withdrawal with the original underlying condition. The same phenomenon occurs with chronic headache patients. If a patient takes a pill and it makes them feel better, they assume the pill is good, as does their doctor. Here in lies the problem with chronic opiate use, and understanding what is really being treated.
Anesthesia Assisted Medical Opiate Detoxification, commonly known as Rapid Opiate Detoxification, reverses the chemical imbalance of opiate dependence. This is a medical treatment, it is humane and effective.

The hyper sympathetic response to withdrawal is blocked with alpha-2 agonists, patients are induced and maintained under heavy ICU sedation, intubated, and an accelerated withdrawal is precipitated with an opiate antagonist. Patients are asleep for 1-2 hours and stay in the hospital for about 3 or 4 days. Chronic pain patients can be humanely and effectively detoxified from their opiate medication with out the long drawn out withdrawal syndrome that can last from weeks to months. This gives the patient the opportunity to see what life is like without drugs.

Patients are expected to be in no more pain after treatment than they are, on all the opiate medications. Often time's patients actually report having less pain off the drugs, supporting the hyper-algesic literature.

Respectfully,

Thomas Yee, M.D.

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