Tuesday, May 31, 2016

Prince, The Anatomy of Opioid Abuse.

Before becoming a doctor, I worked my way through college as a
celebrity bodyguard. I protected several celebrities, musicians, pro athletes, politicians, and businessmen.  This position is one of intimacy, privacy and a look behind the lives of those we protect. We stand on the sidelines hyper-vigilant to everything around us. I am familiar with their lives, motivations, and how they think. 

The death of Prince has brought opioid addiction to the forefront
of our consciousness. Prescription drug abuse and overdose are cited as the suspect in this most tragic death. There are so many questions from so many people trying to understand his use of painkillers. Why did he use drugs? How can Prince a religious man, be a drug addict? Then the news turned ugly dissecting the life of Prince. Because of the drug use, Prince was being stripped of his greatness. When a
friend heard the news of Prince's death, he said, "I have no sympathy for him, he was a drug addict." Prince's accomplishments erased with these two words, DRUG ADDICT. A loser like the Beavis & Butthead characters on MTV, a doper, or best yet a “stoner.” Question after question, assumption after assumption, why did Prince “need” to take drugs? "What was missing in his life that he “had” to take drugs?"One reporter asked, “he had everything, and he took drugs, why?" They forget these artists are over 50 years old, still working and performing as if they were 20 years old. They don't do it because they have too; they do it because they love it.

It's been reported that Prince had significant back and hip injuries with associated arthritis. I read where surgery was recommended
but declined because of religious reasons. His complaints of unrelenting pain were legitimate and required surgery. 

Pain has been described as your mind running but your body is trudging through mud. Prince most likely took these medications to continue performing. He used everything at his disposal to keep his body running at the same speed as his talent. As I stated everyone successful works at levels past human endurance. When we are young and starting out we had the energy of youth to sustain our quest. They are running full speed ahead to the goal and we are enveloped in our journey. Good enough is something you will never hear from them. 

This schedule takes its toll physically and emotionally. But they ignore it because they’re sprinting to the goal; they don't look at the personal losses. Time relentlessly ticks away, and now you're working harder but slowing down. You realize the pain and exhaustion are getting in the way of working, do you stop, hell no! You find ways to energize yourself with every stimulant that can be found just to keep up with your desire. We use stimulants like Diet
Coke, Coffee, Red Bull to work past exhaustion. The unrelenting physical pain, anxiety, and insomnia are now a roadblock to success.  So Prince does what all people do, he goes to a doctor. Examinations were performed, tests and x-rays were ordered. Thousands of dollars in medical testing to confirm, yep you are in legitimate pain and you need drugs. The doctors tell him to slow down but that doesn't happen, we're aren't wired that way.

You take the drugs the doctor prescribes, and the pain is gone, which is the purpose of the drug in the first place. But professionals don't sit around; they go back to work, why, because they can. Better living through chemistry, we always say! 

The brain is hardwired to feel good, seek pleasure, and to navigate away from pain and danger to survive. This is aptly called the fight or flight response. The brain will consciously and unconsciously do anything to seek pleasure. Now the pain is gone, and the brain feels good. Studies show the brain likes it and wants more, so it creates more pain to get more drugs. But do we slow down and heal, NOOOOO we work harder, and longer because the drugs let us do what we like to do, work. 

Personally speaking, I never got "high" from painkillers; I got relief
from the pain. The lack of pain gave me a most needed boost of energy enabling me to work longer and harder. People like Prince don't call in sick; they have to be dying not to show up? Can you see Prince saying hey my hips and back hurt, I can't dance or jump, so I'm going to sit in this chair and just play. You the fan would be all right with that, NOT PRINCE. By all accounts, he wouldn't show up unless he was at the top of his game, medicated or not. And that's the point, they medicate so they can operate and perform at a level like no other.

After the death of Prince, the (DEA) Drug Enforcement Agency tried to lay blame on the doctors. When the one ultimately responsible for this tragedy is Prince himself. Why, he defied doctor’s orders to slow down rest, heal, recuperate, and stop performing. Yea like that was going to happen! In the defense of doctors, we are limited by the patient's cooperation or willingness to seek other treatments.  The patient is in charge, they describe the pain and the doctor responds with more prescriptions.  If the doctor doesn't prescribe or withhold prescriptions, he's negligent and open to discipline

The DEA is now restricting opioids for everything other than Cancer or extreme circumstances. As a side note, under Obama Care, doctors can’t limit opioid use to the less fiscally adept (poor people). But we the over achievers can't use the one drug that works because it killed Prince? So if we lay on the couch, stay off work, live on the system, that’s acceptable? But if we use the drugs to create, work, build, entertain, then that’s bad? So now we have to be sick in a socially acceptable manner? Seriously!

We, opioid users, understand the consequences of our actions when self-medicating. Are we not the stewards of our own lives? Why can't we use prescription medications that allow us to continue working? We want to be left alone to function, create, thrive and pursue happiness?   It is naive to think we will stop using medications altogether. Without an alternative, people with pain will find other ways to medicate. We are hardwired to pursue happiness; it's a fundamental human right. It's written right there in the US constitution. And by all accounts Prince lived as he performed full speed. 
Was Prince a drug addict, maybe, but he used this tool to continue what he loved. He didn’t harm anyone, quite the opposite he touched the hearts, and souls of millions of people. Something so special, God only gives it sparingly to a select few. 

Wednesday, May 18, 2016

An Inside Look at Opioid Addiction, From an Ex Addict, by Dr. Allen S Miller

I am a subject matter expert on Opioid addiction as I was an Opioid addict. Because of this experience, a large workers compensation insurance company approached me to bring my protocols & products to support Opioid withdrawal and introduce Cannabis as an alternative to Opioids in injury management. In these discussions, I have realized there are significant misunderstandings when it comes to the face of Opioid addiction.
1996 Olympic Village, Atlanta GA
I am a Chiropractor, with a specialty in Sports Medicine, Industrial Medicine, and I am recognized in 9 states a forensic soft tissue injury expert. I mention this as I am not the visual you expect of Opioid addicts. I am a true type A personality and have led what some would call an amazing life.

I played baseball and football in High School, with moderate success, as frankly, I just didn't see the point to all the work. I was recruited to the LAPD at the age of 17, my father was an LAPD officer and being the son of a high-profile officer, it was thought that I would be a great fit for the department. During that same time, I was recommended and hired by then television star Dinah Shore as her personal security bodyguard and worked for her for several years.  Through that relationship I was referred other jobs to either right wrongs or reduce conflicts. This was a contact sport on every level and I suffered numerous injuries, broken bones throughout this stage of my working life. It culminated when I was protecting Jerry Garcia of the Grateful Dead. A young man high on PCP jumped on stage to get to Jerry. A fight followed and I was the one left standing with a knife wound in my back
Nigerian Olympic Track & Field Team 

several broken bones.  This was the first act, so the roadies gave me Percodan so I could finish the night. When I went to the doctor, I was immediately hospitalized where surgery followed, and I was, of course, prescribed Vicodin for pain. This was great as it enabled me to still work at the same expected level, without the inconvenience of pain; dysfunction. I enrolled in Chiropractic College, attended school during the day and acted as security for the owners of Herbalife at night, which continued for four years. Immediately following graduation, I traveled internationally for 10 years in Africa and Europe with Olympic Track and Field teams and was the Team Physician at the 1992 & 1996 Olympic. I was an avid horseman and competed in several equestrian sports, which led to breaking almost every bone in my body.

Team Penning 1988
 Because of the succession of injuries, I really never cycled off the drugs. I was up to 12 Vicodin a day to cope with the physical hindrance of chronic pain, and the restrictions that resulted. I always looked at my body as adventure suit, a tool, and a vehicle to compete.

All African Games Chiro, Egypt
The reason I give you this past history is that I want you to see the mentality of Opioid addiction. I never got "high" from Opioids; they provided me with an absence of pain. This absence of pain enabled me to work at the same level, without the debilitating effect of the injuries. Opioids enabled me to physically keep up with my brain, my desires and of course my lifestyle. Remember health takes a back seat to lifestyle and survival. Opioids made me a superhero; I could outwork anybody, and overcome significant physical barriers to accomplishing the mission at hand. The most important concept, I never took Opioids to combat pain; I took them to prevent pain from inhibiting my physical requirements, regardless of what they were. I pushed physical boundaries, and of course suffered more injuries, resulting in increased Opioid intake. This is the vicious circle of driven people with pain.

This habit continued for a few decades, then a terrible thing happened, my doctors, because of public scrutiny, could not prescribe this level of pain meds anymore, and I had to cycle off.  I looked to using Cannabis as a vehicle to beat Opioid addiction and found it exhausting. When I sought information I got advice from people that had no idea of the intricacies of Opioid addiction. These "experts" thought that the Opioids were used to "zone out", not function, and escape reality. To the contrary I used them to function in my fast paced world.  I found very quickly that there were no organize methods to eliminate the Opioid use, with Cannabis. I tried everything from Edibles to Vapes, to Oils, CBD, THC, everything, and nothing worked to recreate the abilities that I could perform on Opioids.  

This is an important concept; I am physically limited by numerous injuries, arthritis, nerve damage to frostbite, etc. but desire to work at the same level I have always worked. As my physical abilities decreased, I utilized more Opioids to fill the gap. After trying the traditional medical model for pain management, I found one thing glaringly clear, they don't have a clue on how we view or use Opioids.

What I discovered through my own experience is there are three parts to Opioid addiction and they must be addressed to fully eliminate them from use. The first
consideration, pain, Cannabis is great in eliminating physical pain. However, it slows you down, relaxes you,  and that’s just great! Not for me, I need to run at 100%, it was the pain that disabled me it was the physical limitations that caused pain. The body tries to protect you when you're injured, it reduces your ability to move, walk etc. all those things you need to play the game. Which brings me to the second consideration in Opioid addiction, adrenalin. As stated, most Cannabis kills the pain but slows you down; I can't have that I need to run full speed. So I had to find another "natural" cannabis and natural solutions to perk me up so I could run at the same speed that I thought I needed to not just survive, but also excel. I sought solutions from two sources; the first source was MaGooch Cannabis infused olive oil www.gbmagooch.com. Their product, “Gravity Lock” killed the pain without slowing me down. The second solution came from Dr. Stephanie King, DC of Dedicated to Health Medical Group, in Pasadena CA www.dedicatedtohealth.com formulated nutraceuticals that increased my energy levels to the same levels as the Opioids I ingested.

The third consideration is fear of pain, this is important, because people like me, other weekend warriors, the walking wounded in the business community, are scared to death they will look anything other than strong. Why the weak are killed and eaten, or worse loose the fail. We are alphas, we are the leaders, we are paranoid, we are injured, and we revel in the mystique, we do things that others wouldn't dare.

The significant problem with the natural approach Opioid withdrawal is time. Opioids work fast, if impaired I can be up and operational within the time it takes to drink a cup of coffee. It took me 6-8 months of cycling off Opioids and introducing Cannabis and Nutraceuticals to my regime, which was an eternity to me to reach my perceived level of work. Remember, my biggest fear is that I will not be able to function and looked upon as weak. This is significant fear, our job is our identity, our strength, and it reinforces our ability to succeed. This has to be replicated in Opioid addiction, and the patient has to be supported and reinforced in this process. As I learned, the patient must learn to re-trust their body, trust it won't fail, and they will be able to compete as well as succeed in their lives.

In conclusion, I never got "high" from taking Opioids; I enjoyed a lack of pain and limitation. I took Opioids as a preventative to pain, I never took them after I got the pain, and I took them so I wouldn't feel the pain. To effectuate Opioid withdrawal, there are multiple natural and prescription products that will allow the patient to let go of their Opioid dependence.

So the three things that has to be considered in eliminating Opioid use,

1. Pain is secondary to dysfunction, so eliminate the pain. Cannabis is great for this part of the equation. The physical dysfunction must be addressed and treated.
2. Depending on the number of injuries, injury severity, there is usually a form of associated neurologic damage that must be addressed. This is sometimes misdiagnosed as a sleep disorder, yes sleep is a factor but is most likely related to symptom related complexes such as restless leg syndrome, referral pain etc.
3. Implement Natural remedies or Pharmaceuticals to increase the patient's "energy" to be competitive, it's an important element in the equation. This is imperative or the treatment won't result in a withdrawal from Opioid use.
4. Counseling is imperative to stay consistent with the patients' ability to assimilate into his world and succeed. Micro changes in diet, exercise, nutraceuticals, and prescription meds must be monitored for the first 6-8 months to micro manage success.

The limiting factor in this equation is ease of use. Opioids and other prescription meds are easy to use; in most cases one pill will do the trick. When shifting to a natural non-prescription model, it takes time, trial and error in finding the right combination of nutraceuticals, CBD or Cannabis and proper nutrition and lifestyle. It can be achieved and has to be micromanaged for the patients benefit.

Dr. Allen Miller now council’s patients, industry, and insurance companies on Opiate addiction, and the substitution of Cannabis and other nutraceuticals for Opioids in acute injury management.