South Florida Sun-Sentinel (Sunday)
CDC revises guidelines for prescribing opioids for pain
Q: As a retired RN, I have administered pain medications safely for over 30 years. Now I have Parkinson’s disease, causing horrific muscle spasms. I cannot sit or stand when these attacks occur but must lie down.
For five years, I have been taking hydromorphone (Dilaudid) as a last resort when all other attempts to ease my pain failed. I never took more than prescribed, and I never asked for early refills. My doctor encouraged me to take the pain med at first. Then last year, he began to say I needed to get off the opioid. Apparently, prescribing this drug could get a doctor in trouble.
What is going on here? I always believed that when I got old and sick, at least I would not have to die in pain. I cannot live like this. Because of my incurable brain disease, I spend most of the day in bed. Now I am ready to take my own life. Please help!
A: We are so sorry to learn of your tragic story, but there is hope for the future. In 2016, the Centers for Disease Control and Prevention issued a guideline for prescribing opioids for chronic pain. The agency urged doctors to cut back on prescriptions for narcotics such as hydrocodone, oxycodone or hydromorphone.
Public health authorities were concerned about the epidemic of opioid overdose deaths. We have received thousands of heartbreaking accounts much like yours from chronic pain patients whose access to medication for relief has been
limited.
Now, the CDC is revising these guidelines. First, they report that one in five adult Americans has chronic pain, and that may be an undercount. Pain has a devastating effect on quality of life and can contribute to suicide.
Second, the CDC acknowledges that implementation of its prior guidelines might have led to patient harm. The 2022 recommendations are designed to provide “compassionate, safe and effective pain care” for people like you.
Q: I’ve tried applying milk of magnesia to my underarms for the last two weeks. It worked from the very first application! I am allergic to many antiperspirant and deodorant products. This was like a miracle to me. There was no irritation at all. In fact, it was soothing. I have noticed, though, that I have had a lot of watery diarrhea since I started using this. Can the magnesium be absorbed into the skin? A:
It is conceivable that you are absorbing enough magnesium to cause you digestive distress. We
would suggest taking a “holiday” from applying the laxative to your armpits. If the diarrhea goes away and then returns after reintroducing topical applications of milk of magnesia, this remedy is not for you.
Q: I’m excited to try power pudding to ease constipation. Can I add it to food like potatoes or squash? I think that would disguise the taste. Then I’d drink the full glass of water. A:
Power pudding, made of unprocessed wheat bran, applesauce and prune juice, is a time-honored remedy for serious constipation. We first heard about this approach from a nurse taking care of patients after abdominal surgery. The usual instructions involve swallowing 1 tablespoon of this “glop” followed by 8 ounces of water. If you think it would be easier to tolerate this remedy disguised in food, that should also work. Always drink a full glass of water afterward.