Less Pain, Fewer Pills: Avoid the Dangers of Prescription Opioids and Gain Control over Chronic Pain

Pages 34 and 35 talk about pain physicians and neurostimulators and are out of place with the rest of the chapter. Page 33 is a list about methadone risks that continues on page 37. 34 and 35 should be later in the book. This is a misprint.

I like this book, but with a few qualifications. I'm still processing it but have read through it once. She has a good deal of new (to me, as a chronic pain patient on opioids and having had 3 spine fusions over the past 15 years) information on the risks of opioids. The main objection to opioids boils down to this primarily: they can exacerbate pain via a number of mechanisms, and cause real endocrine problems. On top of that, one risks death by accidental overdose at doses above 40 mg morphine equivalent per day. Combining them with alcohol and other CNS depressants such as benzodiazepines can be fatal.She recommends lots and lots of pain psychology as one alternative, either self-administered through mindfulness and breath control, or optimally via visits to a pain psychologist. It's also recommended that one use physical therapy, exercise, walks, going easy on oneself, and finding pleasures in simple things. She has some very nice material and helps on avoiding "catastrophizing" pain, something any chronic pain patient will know about.A few things about this approach worry me. The pain psychologist at the clinic I've been going to for over 10 years now is billed at >$500/hr. Insurance pays for that once I've met my deductible. 500 bucks an hour. Let that sink in. For many sessions, on the scale the author might recommend, the price to me and to society (through my insurance company) is steep. Add to that paying for physical therapy, and all the helpers start to get very expensive. It makes pills look very inexpensive. Not ideal, but less time and money. This can be a stopper for a lot of people.Then there is the "tapping" and rapid eye movement therapy (EMDR) that is touted here. Now I've tried the tapping and when pain comes on it does indeed seem to calm my nervous system and slow down/mitigate the pain. But EMDR, to be done right, should be done with a trained psychologist. That's money..time..and no mention of any risks for a relative new therapy. Isn't it possible that EMDR could have some very nasty side effects? Ten years ago no one seemed to realize that opioids were such trouble. What will people be saying about EMDR in ten years?This book is helpful but I feel as if it's aimed at people who have a lot of time and money for psychological counseling, visits to therapy pools, massage, time to focus on their breathing, and to "tap" bilaterally. It seems aimed at people who are either out of work, working part time, on disability or unemployment, or filthy rich.The author recommends against obsessing about pain, yet later in the book recommends becoming "exquisitely" aware of what can cause a pain flare, and of adjusting ones' life and choices to mitigate the pain cost. But overall the gist is to get off the damned opioids, and it offers helps to that end. The helps are going to be expensive in time and money unless you can put them into effect on your own. They will work for someone who is able to take quiet time during the day. Young mothers of large families? I don't know what to tell them.Finally, ten years ago, everyone passed out the opioids and said "Here, take these. They help and you won't get addicted if you use them as prescribed". Ten years later everyone is now being told they are the devil for long term pain. I've lived long enough now to see this swing back and forth. What's the truth?

If this book was just about the dangers of opioids, I would certainly give it 5 stars for the author does a great job of detailing the many dangers and limitations of opioids from a medical, social and psychological perspective. But her knowledge of alternative treatments for pain is abysmal. She focuses on a handful of approaches to pain- as if a few treatments really represent the vast array of alternatives to opioids. And with regards to the treatments she mentions like breathwork- she obviously failed to explore many of the available breathwork methods- Holotropic, rebirthing, the valsalva wave. Ms Darnall, like her many friends who endorsed her book(my how they stick together) in pain care have failed to do much exploring of alternatives to pain care. No mention of the many types of neurofeedback- like ROSHI, LENS, Neuroptimal, beta reset, smr. No mention of some of the many acupuncture- pharmacopuncture,manaka, Denmai, kototama, masakazu, acupotomy, msat. No mention of ACE, noesitherapy or Perrin technique,Pinga technique, no mention of diet therapies like FODMAP or ketogenic diet. No mention of biomagnetic pair or the chiren, biomodulator or herbs like Dragons blood, syrian rue, artemisia,ayahuasca- to name a few. No mention of high intensity focused ultrasound, hydrogen infsions, hyperbaric oxygen, fasting,llt, or pemf. This book reminds of a report done in 2010 by the Overlapping Conditions Alliance-that indicated medicine has little to offer women in pain- so to does this book offer so few alternatives to pain then opioids.If the quality of pain care is a function of the depth at which you incorporate the alternatives and master them then Ms. Darnell and her pain specialists supporters have a great deal of learning to do before they can consider their work of high quality. I recommend that this pack of pain specialists that Darnall belongs to do what is right for the public by making a sincere attempt to explore and incorporate the great many alternatives to opioids that they have failed to consider. It is unfortunate that in this book that Ms. Darnall conflates the little she knows about pain treatments to being adequate. And because this book fails to consider so much of what is out their, as someone who cares about people in pain- i have to give this book a poor rating.

Ho letto molti libri sulla gestione del dolore cronico e questo è tra i più interessanti. Questo é molto diretto, i concetti sono facili da capire, gli esercizi semplici da attuare. Mi ha fatto riflettere molto sull'assunzione di farmaci per la gestione del dolore e sui modi per capire perché si scatenano gli episodi di dolore intenso, come prevenirli e come attenuarli.

Not Alternative Health Hoo-Ha real medical science based from Stanford University.