The Benefit of Extended Release Meds for Chronic Pain vs. Instant Release

Overview: 

• Extended Release Narcotics used to be known to be the pills of choice to abuse, but Extended Release Formula's have changed to prevent abuse
• Extended Release Narcotics may still be abused but the likelihood is lesser than before.
• Doctor's who once used to be skeptical of Extended Release Narcotics need to understand that changes in the formulations have reduced the high-dosage pills potential significantly for intentional abuse
• Narcotic Pain Medication is still the only major solution to chronic pain and must be accepted as such.
• Patients are likely to become dependent, whether they abuse or not.
• These pills are still just as likely to cause a physical addiction as before
• However, these pills are no longer the primary form of pills to be abused and their strong anti-abuse, tamper proof properties make them desirable for a patient long-term.
• Chemical Dependence is inevitable so continue research. Tamper-proof pills is a good start thanks to prior research.

Suppose it is 2002. Your friend's mother has a bottle of Oxycontin that says 80mg. You want to get high, really high, and quick, and you don't want anyone to notice anything missing. What do you do? You break this pill in half, take the very thin and easy top coating off, and take the pill. You are higher than a kite.

Fast-forward to 2015. Same scenario. Only this time, you find it nearly impossible to break the pill. When you do, you don't find just some top film.. It all seems like a film. So you put it in a soda, shaking it up. The pill ends up being a gel-like substance. You wait for days and days. And it remains. You take it anyways. As much as you have altered the pill, it works like an extended release pill. In fact, since you tampered with it, it's weaker, as antagonist chemicals- those that block the effect, are now initiated.

This is how the Extended Release form of Medicines have changed. And it is making a huge difference to people. The pill is being used correctly, and an Oxycontin 80mg does its job... It releases into your system slowly, over 12 hours. The same is true with most opiate/opioid extended releases, including morphine. These pills can't be abused like they used to. You want to inject Oxycontin or Morphine ER? Good luck, because when it hits that water, the powder you spend awhile grinding up forms into a ball that can't be! You want to snort it? Sorry, it's going to gel up too, so that quick instant effect you're seeking won't happen.

Amazing. This is Oxycontin now, The third picture to the right is the former formulation of Oxycontin. It could be abused and injected. The new version, seen on the bottom is injection-proof. Such technological changes have made Extended Release Pills lose their identity as quick, easy to abuse pills.

The reason for the stigma.... Higher doses. Oxycodone, the ingredient in Oxycontin, still has an immediate release with none of these properties. It comes in a max dosage of 30mgs however. Morphine Sulfate, however the form, will generally gel up now. This is because Morphine is significantly stronger and works profoundly more effective in your body if taken differently from just popping a pill.

People have however despised extended release formations because they come in greater doses and historically have been abusive. This is still the case, but it's been changed. Abusers now will not reach the high there once was. And this technology is saving people from abuse, when they try their first Oxycontin and feel nothing but what they are supposed to: pain relief! This technology is making it possible finally for younger patients to get medication they need, after years of pain doctor's significantly limiting their possible list of patients out of fear that abuse among them will ruin their practice. These newer formulations are helping abusers with chronic pain finally get relief, knowing that it is done the right way. 

Instant Release Narcotics should always be given to those on Extended Release Forms, however. Extended Release is great for a day to day offer of chronic pain management. But chronic pain sufferers generally have flare ups. Whether it's due to walking more than usual, doing a task you normally don't, changes in the weather, whatever it may be, if you're on an ER med you are likely to feel intense pain still and need the instant release form. Which is why there is Oxycodone HCL and Percocet and not just Oxycontin, why there is Morphine Sulfate 15mg IR, etc. The good news however is that this does not have to be the primary way of taking medication, resulting in a lesser need of instant release tablets! In a more subtle way, it also reduces the need for higher doses. 

New Technology Calls for New Principles and Thinking. The genuine dislike of narcotic medications due to their abusive properties is dangerous to perceive as it sacrifices the pain relief many of us younger folks need. Opiates and Opioids ARE related to heroin. Heroin is an opiate. But right now, opiate/opioids are the only class of analgesics that can drastically reduce pain. It is a reality that doctors must accept. The newer extended versions of pills that were commonly seen on COPS and in documentaries as used by the adversary character to harm their credentials no longer exists. Therefore, thanks to this new technology, doctor's need to stop hating extended release, which many do in light of history. 

The Need to Research for Newer Pain Relief Techniques is Dire, because Addiction to Painkillers Still Exists. This is the reality. Even extended release pills may be strong for someone who hasn't touched them, leading them to still abuse them. Abuse among pain pills is not gone. Just the primary method of taking Extended Release to get high is. Opiate/Opioid pain meds are still addicting. An ER version is just as addicting to your body as an IR. The addicting properties harm many people who had no intention. They never would have abused pills, or so thought. They have still never met a drug dealer. They still believe that abuse is bad. Yet they're unknowingly doing it themselves by taking those extra pills here and there.

Abuse is not the main concern as chemical dependence, however.  Data still agrees with me that humanity is still precocious and even knowing that an opiate medication may be addicting, they don't ever abuse. They may become dependent and even know they are, but accept it as they are not breaking any laws. They know the pain relieving effects outweigh the pain. They know their doctor knows. They knew from day 1 what could happen, but in the long-term process accepted it. There is no harm in this thinking so long as people aren't abusing. There is no alternative to opiate/opioid medication in regards to pain relief. I have taken them for 5 years and know that to get off, I have to work with my doctor. But shall I be free of pain, like any good established pain management, I will be tapered correctly and legally, humanely and ethically just as I would understand dependence is ethical in many circumstances. Dependence to a medication, especially an opiate/opioid can be intentional and known beforehand and is the primary concern and skepticism doctors have of giving these medications. However, by building trust with our doctor's and through slow evolution of our health care including a tamper-proof version of a pill, we are making steps to medically feel better and be better. We have to encourage continued research so that one day a non-abusive, non habit-forming painkiller will be out there!