Home > Psoriatic Arthritis > …a tiny dose of morphine

…a tiny dose of morphine

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For years Morphine has been a “back of the cupboard” “painkiller of last resort” “fit only for the dying” sort of a drug.

Recently we have had to appreciate that a whole class of painkillers– the non-steroidal anti-inflammatories, can do bad things to aging kidneys, making them hard to use in severe arthritis (which is precisely where you might want to be able to use them). So the poor punters are left with paracetamol plus or minus a bit of codeine. This seldom works, but it’s rare that a patient will welcome the offer of a tiny dose of morphine to help give back their pain control.

Which is a shame.

http://drjestscaseblog.blogspot.com/2009/09/sister-morphine.html

This post interested me, it was written by a UK GP. Pain control in arthritis is difficult, no doubt about it. I doubt many people with arthritis get prescribed morphine. If I was in enough pain would I want it? Hell, yes! Well as long as the constipation can be controlled, that’s no fun either. Why can’t these things be easier?

Bandolier also have a lot of good links on evidence based medicine and arthritis.

http://www.medicine.ox.ac.uk/bandolier/booth/booths/bones.html

What painkillers work best?

http://www.medicine.ox.ac.uk/bandolier/booth/painpag/Acutrev/Analgesics/Leagtab.html

Another Bandolier article I liked is called “Mindstrecher – ranking chronic diseases”

http://www.medicine.ox.ac.uk/bandolier/band83/b83-7.html

It is based on this research

References:

  1. MAG Sprangers et al. Which chronic conditions are associated with a better or poorer quality of life? Journal of Clinical Epidemiology 2000 53: 895-907.

The point of the research was to try and work out what diseases have the most impact on your quality of life. The results are based on data from lots of different people (and lots of different research).  Of course, your life is much more important to you than any of the scientists studying pain and what matters is your own personal “quality of life”. However, it is nice to see some scientific evidence that arthritis hurts!

It took me ages to find this article, I could remember the graph but not the details, I ended up doing a google image search on the bandolier website

“pain  site:http://www.medicine.ox.ac.uk/”

and found it on the 12th page of results!  My brain is funny, I wish I could remember the actual information, rather than the pictorial layout of the graph, but there you go.

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Categories: Psoriatic Arthritis
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