The Pain Antidote Interview

01, 2015 byJoe Schoenmann

When people are in pain, they seek remedies which is usually a painkiller.

Stopping pain from surgery or a headache or a sprained ankle is one thing, but when the pain lasts weeks, months or even years it becomes a bigger problem.

According to the Centers for Disease Control and Prevention, 46 people die from an overdose of prescription opioid painkillers each day in the U.S. The CDC reports doctors in Nevada write an average of 94 painkiller prescriptions per every 100 residents, which is about the national average.

Dr. Mel Pohl, local doctor and addiction specialist, told KNPR’s State of Nevada he has a different approach to tackling pain.

“There is no pill to really treat chronic pain,” Pohl said.

He said for acute pain like headaches or incision pain from surgery opioids can work fine but used over a long period of time they cause more problems than they solve.

“Folks who have lifelong pain tend to develop this whole symptom complex and opioids really aren’t a good treatment because they don’t deal with the entirety of the problem,” Pohl said.

One of the problems is the body starts to tolerate the opioids and higher and higher doses of the drugs are needed to tackle the pain.

“They tend to backfire in a great many cases,” the doctor said.

Besides the body developing a tolerance, opioids cause a rebound effect, according to Pohl. He said the body responds to the constant presence of painkillers by increasing the chemicals that cause more pain.
“The treatment for that is to take them off the pain killers and enable the body to restore its own natural endorphins, which are capable of decreasing pain,” he said.

Besides getting off opioids, Pohl recommends moving, especially for people who have avoided moving because of pain. He said it is a way to break a hurtful cycle. People don’t move because it hurts, muscles and tissues atrophy in that area, it becomes more difficult to move and the cycle worsens.

“What happens to people in pain is that they’re afraid to move because it hurts when they move and they think they’re doing damage in fact they’re doing way more damage by being sedentary and staying in bed,” Pohl said.

At the Las Vegas Recovery Center, where Pohl practices, there are physical therapists, trainers, and yoga instructors all focused on getting people moving again.

Ending the opioids hold on the body and getting a patient moving again are only part of the effort. Pohl said so much of the pain problem is in a person’s head.

“’My back is killing me’ is a lie. It’s just not the truth,” Pohl said.

It is not that people aren’t experiencing pain but their emotional response can drive up the pain, according Pohl.

“My belief and my understanding from the work that I’ve done is that 80 percent of the experience of pain is in the brain and is related to thoughts and emotions and that’s what you have to deal with if you want to get better,” the doctor said.

In his work at the recovery center, Pohl said he deals with some of the most difficult cases of pain and addiction, but when people complete the program they report a 30 to 40 percent reduction in pain.

Pohl acknowledges many people will not find complete elimination of pain, but they will be able to manage the pain.

“We want people alive. We want them to function better. We want them walking around and participating in their lives,” he said.

Pohl's book "The Pain Antidote" outlines the principals of dealing with chronic pain without medications. He said the approach is holistic, taking in the physical and mental aspects of pain.

Guests: Dr. Mel Pohl, author, "The Pain Antidote"

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