Pain medications in high doses suppress breathing. Many chronic pain patients on chronic opioid therapy (using narcotic medications on long term) tend to develop sleep apnea. This is a condition of difficulty breathing at night.
This condition is further complicated by using many sleeping pills at night. Many of the medications used in chronic pain have a central nervous system suppressing effect. It
means they can slow down activities of brain and brain stem
(where breathing center is).
As the chronic pain patients have different physical, psychological and energy related issues, different medications would be prescribed to deal with these various issues. The concept of multi-modal therapy works on using medications effecting different receptors for getting better effect in pain management.
Over time, the body may develop tolerance to the effects of these medications and higher doses may be needed to gain the same level of desired effects. The issue is that we may not build the same level of tolerance to the side effects of medications, most importantly, the respiratory suppression side effect.
Building higher levels of side effects and using multiple medications with similar side effects can add up the risks. What can make the matters worse is that some of these medications may have synergistic side effects. It means that the resulted side effects may be much higher than just adding them up.
The synergistic side effects of high doses pain medications and multiple sleeping pills can be a killer.
Each year there are many pain patients who stop breathing for these reasons while they are sleeping.
There are a few things that you can do:
- The most important thing is to make sure that all your doctors are up to date about your current list of medications that you are using now. Each doctor may prescribe one or more medications and be unaware of what others are prescribing.
- Make sure you carry an updated list or get a pharmacy print out to your doctors at your different appointments.
Do not expect 100% control of your pain through increasing the pain medication doses. This can only lead into higher risks.
Do not make a cocktail of different medications, combining high dose opioids and multiple sleeping pills. THIS MAY BECOME YOUR LAST SLEEP.
