In a study published in the June 2010 issue of the Journal of Addiction Medicine, researchers from the University at Buffalo (State University of New York) revealed that prescription opioid painkillers such as Oxycontin, morphine, and codeine are potential gateway drugs. An alarming number of people who were legitimately prescribed these medications after surgeries or injuries turned to street drugs such as heroin once prescriptions ran out because the illicit drugs were easier to get a hold of and more effective.
Folks, extended use of oral drugs to relieve pain just doesn’t make sense. Chronic use of aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs) can cause gastrointestinal ulceration and bleeding, and are responsible for as many as 16,500 deaths per year in this country alone. “Safer” COX-2 inhibitors are somewhat easier on the GI tract, but they are linked to increased risk of heart attack and death from cardiovascular causes. Tylenol (acetaminophen) can damage the liver, especially when used in conjunction with excess alcohol. And as this study illustrates, opiates are addictive with a significant potential for abuse.
Topical drug application, however, is another story. This delivery system has two major advantages over the oral route. First, you’re able to target the affected area, so you get faster relief. And second, systemic absorption is minimal, so you don’t have to worry about these dangerous side effects. The topical drugs we’ve had the most success with at the Whitaker Wellness Institute are ketamine, an anesthetic that curbs pain, and ketoprofen, an NSAID that reduces inflammation. They’re mixed into creams that patients simply rub into the painful area several times a day. I also like to throw in a little dimethyl sulfoxide (DMSO) to help with absorption. (This certainly isn’t a requirement, but in my experience, DMSO just seems to make the topical drugs work better. I recommend a 70 percent concentration for topical use.)
I’ve personally used this therapy successfully for low back pain, and we’ve had positive reports from patients suffering with sciatica, arthritis, fibromyalgia, sprains, and strains. The best-studied application, however, is for relief of neuropathic pain—deep, often intense pain caused by damage to or dysfunction of the central or peripheral nervous system.
I’m not suggesting that topical pain relievers are a slam-dunk for all difficult pain syndromes, but I can tell you that we’ve had good results at the clinic. Furthermore, the relative safety of this therapy warrants a trial for most everyone with neuropathic or musculoskeletal pain. Most physicians are unfamiliar with the topical use of ketamine and other painkillers. If you’re suffering with acute or chronic pain, I recommend that you talk to your doctor about the benefits of this safe, effective therapy. If he’s not open to prescribing these topical medications, find a doctor who is.
