House Calls

WIN 2019

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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h o u s e c a l l s { winter 2019 } 25 P H O T O G R A P H ( D R . M I T C H E L L ) B Y L I L I A M O N T E R O pleasurable and as important to survival as food or water. "When you start taking opioids, the body starts producing extra receptors," Dr. Frohock explains, meaning the next time you'll need a higher dose to achieve the same effect. "So, by definition, when you take an opioid, you become less sensitive to the drug over time," he says. In as few as seven to 10 days of taking an opioid to treat back pain, for example, you can begin to develop a tolerance for the drug. "The medical field wasn't aware of that when we first started prescribing these drugs," says Dr. Frohock. Dr. Mitchell notes the same: "Opioids were initially touted as non-addictive." AN EPIDEMIC BEGINS As pharmaceutical companies assured doctors and medical associations that their products posed a low risk for addiction, opioid prescriptions rose at a meteoric rate starting in the late 1990s. Patients were happy to ask for the quick-acting drugs, believing them to be safe for long-term use. "We saw a proliferation of opioid prescribing, without much evidence that pain was changing in severity," says Dr. Frohock. That escalating mechanism of opioids—the positive feedback loop of progressively needing more drugs to feel the same effects—is what leads a percentage of patients to become addicted and seek out increasingly stronger narcotics, such as heroin. Some synthetically derived opiates, like fentanyl, are many times more potent than morphine and are occasionally legally prescribed. But heroin, a semisynthetic drug derived from opium, has no medical use and has extreme potential for addiction. According to the National Survey on Drug Use and Health, only four percent of those who become addicted to prescribed opioids transition to illegal opioid use—but the vast FOUR CLASSES Breaking down the different types of opioids ENDOGENOUS: The human body actually produces its own opioids, called endogenous opioids, which include the endorphins that give us a euphoric rush when we exercise, have sex, or eat a particularly delicious meal. NATURAL: "Natural" opioids come directly from the poppy plant and tend to be less powerful than some of their counterparts manufactured in a lab. Morphine and codeine are two alkaloids found in poppy resin that are widely used for pain management. SEMISYNTHETIC: Semisynthetic opioids are a kind of hybrid between natural and synthetic opiates. Heroin, derived from morphine, is a semisynthetic opioid that is not recognized as having any medical use but is recreationally abused for the euphoric high it provides. SYNTHETIC: Synthetic opioids are created chemically in the lab and include methadone and fentanyl. A hundred times stronger than morphine, fentanyl is an opioid used for pain relief that is often illegally synthesized and abused. "Our goal is to not only treat pain, but to treat it better than we were before while reducing opioid consumption as much as possible." —DR. JEFFREY FROHOCK Dr. Kenneth Mitchell

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