Gabapentin, opioids and other drugs are continually dispensed for pain relief by physicians, even though these medications long term solve nothing for the patients who take them. On the other hand, opioids have fueled healthcare costs due to addiction and other long term problems caused by addiction. Patients have been discovering CBD which if found in hemp which relieves pain affordably and naturally without the side effects of medications that are designed to relieve pain.
Medical providers are often looking for other uses of approved drugs, which is known as off label use. Lyrica is an example as it was sold as a sleep aid in Europe and is now used for symptoms relating to fibromyalgia here, with questionable results when you speak to people who have taken the medication. Sometimes, physicians find that off label usage is more effective than what the medication was originally intended for. An example of this is Bristelle which is very effective for hot flashes (we have personal experience with this) which is actually a low dose of Paxil which is an anti depressive medication.
On the other hand, physicians not thinking outside their box of drugs, rarely take into account that their understanding of why their patients hurt is poor, and so is their ability to diagnose the musculoskeletal system. Currently, medical providers have about three hours of study in musculoskeletal diagnosis, as compared to chiropractors which have hundreds of hours of diagnosis and treatment methods for pain.
Current research suggests that most pain is related to movement and movement is related to function. Chiropractors should always be a first contact provider for acute and chronic pain according to what is currently understood and their methods improve movement. Medication, on the other hand, does not improve function or movement and many older patients are in chronic pain because their healthcare providers have advised them to take medication rather than see a chiropractor first. Ironically, many insurers have made it more expensive to visit a chiropractor which in the long run is safer, better for our health and can be more cost effective as recently revealed by United Healthcare’s Optum health division.
The NY Times recently looked into Gabapentin and found that after years of being dispensed, there was little evidence that it worked. Medical providers routinely searched for the next drug instead of the physical medicine provider who was the best option, although this is slowly beginning to change. Off label use is great for big pharma because it increases sales of the drugs they make. Unfortunately, healthcare providers are driving those sales, along with advertising on television and on other media. Drug utilization for chronic and acute pain will only decrease when providers such as chiropractors are covered better by insurance and patients are advised to see them first.
Gabapentin is a top selling drug with little evidence of effectiveness. Crazy, no?
Check out the NY Times article below
Millions Take Gabapentin for Pain. But There’s Scant Evidence It Works.
“There is very little data to justify how these drugs are being used and why they should be in the top 10 in sales,” a researcher said.
By Jane E. Brody
May 20, 2019
One of the most widely prescribed prescription drugs, gabapentin, is being taken by millions of patients despite little or no evidence that it can relieve their pain.
In 2006, I wrote about gabapentin after discovering accidentally that it could counter hot flashes.
The drug was initially approved 25 years ago to treat seizure disorders, but it is now commonly prescribed off-label to treat all kinds of pain, acute and chronic, in addition to hot flashes, chronic cough and a host of other medical problems.
The F.D.A. approves a drug for specific uses and doses if the company demonstrates it is safe and effective for its intended uses, and its benefits outweigh any potential risks. Off-label means that a medical provider can legally prescribe any drug that has been approved by the Food and Drug Administration for any condition, not just the ones for which it was approved. This can leave patients at the mercy of what their doctors think is helpful.