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Thursday, Jan 24 2013 11:00 PM

KIM SMITH: Help curb fatal drug abuse with alternative techniques

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    Kim Smith

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Media reports of an epidemic of prescription pain medication abuse and fatal overdoses have prompted calls for action from health care regulators and California legislators.

Responding to a series of stories in the Los Angeles Times, the leader of the California Senate, Darrell Steinberg, D-Sacramento, is calling for state funds to increase California Medical Board investigations.

Other legislators are proposing to require county coroners to report all deaths attributed to prescription drug use and to require use of a nationwide database to track doctors' prescribing patterns.

Across the U.S., fatal overdoses of such prescription painkillers as Vicodin, OxyContin and other narcotics have risen sharply in the past decade. Some victims have obtained these medications through illegal means, such as raiding pharmacies and family medicine cabinets.

But the rise in drug use and the fatal overdoses also can be blamed on some negligent physicians who for a variety of reasons abuse their prescription privileges.

Consider my friend, whose elderly mother suffered from chronic pain. Whenever she asked, the woman's doctor would add another pain medication to her regimen. At the time of her death, the woman was taking a Vicodin tablet every six hours; wore a Duragesic patch; sucked on fentanyl lollipops for "break-through pain"; and ingested an assortment of other pain-related medications.

When my frustrated friend expressed concern that her mother was being overmedicated, the doctor explained that his patient requested the medication and he did not want to anger her by denying her request.

This doctor's motivation may seem benign. But others are using their prescription pads clearly for profit. Physicians promise to "do no harm," when they take the Hippocratic oath. But some doctors are doing more than harm. They are causing deaths.

Legislators across the nation are right to be alarmed. Their calls for increased monitoring of physicians and control of prescription medications are appropriate responses.

But doctors and patients also must take steps to reduce the need for pharmaceutical responses to pain. Research is opening the door to less dangerous and more natural, effective pain-relieving strategies.

Just recently in the journal Frontiers in Psychiatry, medical researchers at the University of Michigan documented their progress using low-dose electric stimulation to certain parts of the brain to release an opiate-like substance that is considered to be one of the body's most powerful painkillers.

"Instead of giving more pharmaceutical opiates, we are directly targeting and activating the same areas in the brain on which they work," the lead researcher reported. Therefore, "We can increase the power of this painkilling effect and even decrease the use of opiates in general, and consequently avoid their side effects, including addiction."

For the past several years, I successfully have used neurofeedback to treat a variety of health issues, including chronic pain.

Consider the warning issued this spring by the Army Surgeon General's Office to regional medical commanders about the long-standing use of prescription psychotropic drugs to treat post-traumatic stress. An April policy memo warned that some of the drugs -- or "cocktails" of drugs -- could intensify, rather than reduce combat stress symptoms and lead to addiction.

A July 2010 Army report noted that one-third of all active-duty military suicides involved prescription drugs. Combined with alcohol abuse, the long-standing protocol for treating post-traumatic stress could be lethal.

This is not to say that commonly used psychotropic drugs, in conjunction with counseling and therapy, should be abandoned. But what is needed -- and what is now being recognized by military officials -- is the combination of a variety of treatments.

The Department of Veterans Affairs is spending about $5 million on a dozen clinical trials and demonstration studies of other techniques, including meditation, acupuncture, yoga and therapy dogs to help veterans manage stress and depression.

I use neurofeedback, which trains brain function based on information derived from an electroencephalogram to treat veterans with post-traumatic stress. The process has resulted in fairly rapid improvements in sleep problems, pain, anger management and substance dependency.

The epidemic of fatal overdoses and prescription medication abuse cannot be cured just by passing more laws. The cure is found in developing and accepting new, safe and effective methods to address our health care problems.

Kimberly Smith of Bakersfield is the neurofeedback clinician at Neurofeedback Train Your Brain (www.kerntyb.com).

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