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jjj Posts: 150
edited 06/11/2012 - 8:30 AM in Chronic Pain
Pain medications are involved in more than 20 percent of deaths occurring in the years after spinal fusion surgery for low back pain, reports a study in the April 1 issue of Spine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health, a leading provider of information and business intelligence for students, professionals, and institutions in medicine, nursing, allied health, pharmacy and the pharmaceutical industry.

The risk of analgesic-related death is highest among patients with degenerative disc disease (DDD) especially men aged 45 to 54, according to the new research, led by Dr. Sham Maghout Juratli of Wayne State University School of Medicine, Detroit.

Of 2,378 workers' compensation patients who underwent spinal fusion surgery in Washington State between 1994 and 2001, 103 had died by 2004. The researchers analyzed the cause of death for each patient who died.

Analgesics Involved in 21 Percent of Deaths

The rate of death within three years after spinal fusion surgery was 1.9 percent. Deaths involving pain medications were the single most common category, accounting for 21 percent of all deaths. Of 22 analgesic-related deaths, 19 were accidental overdoses and three were suicides. Overall, nearly one percent of workers who underwent spinal fusion died of analgesic poisoning.

Although other diseases like cancer or heart disease combined to cause more deaths, analgesic-related deaths were the main cause of potential life-years lost. That's because younger patients were more likely to die of analgesic poisoning, whereas older patients were more likely to die of other causes.

Workers whose back pain was primarily caused by DDD were at elevated risk of analgesic-related death nearly three times higher than those with other diagnoses. The risk of death due to pain medications was highest among men aged 45 to 54 who had DDD more than seven times higher than for other groups.

The risk of death in the first three months after spinal fusion surgery was 0.29 percent. This risk was highest for patients who were undergoing a second spinal fusion procedure.

The use of spinal fusion (also called lumbar fusion) is growing rapidly, despite a lack of agreement over which patients should undergo the procedure. This is of special concern because spinal fusion carries a higher risk of complications than other, less extensive surgical procedures. Although the initial risk of death is low, few studies have looked at the mortality rate beyond the first few months after spinal fusion.

The new results raise concern about the long-term risk of death after spinal fusion, especially deaths related to pain medications. The deaths reflect the high use of opioid (narcotic) analgesics by patients with back pain, despite the lack of strong evidence for their effectiveness.

"Analgesic-related deaths are responsible for more deaths and more potential life lost among workers who underwent spinal fusion than any other cause," according to Dr. Juratli and colleagues. They believe that initial efforts to reduce analgesic-related deaths should focus on patients with DDD, especially men.




  • this is another witch hunt. a way to make it seem like our pain is not real, and that unfortunately, for men in this catagory, you will have a harder time getting treatment for pain.
  • are you a pain patient? there is no info on your disabilities if any. you just put down an initial. this makes me a bit suspicious. like the previous poster, this is just another b.s. post on the dangers of pain meds. I have never heard of spine magazine and i have been in lots of back dr offices. just because it was published does not mean anything. statistics can be scued to fit a person's ideas. i know i have written papers for my master's. do they have a web site? are you a patient or a dr or whatever? this is mindless dribble to me and just another way to say that narcotics kill and do not help. dr sham is the correct name for this dr. all of this is a sham to this poster. maybe it is correct but so what.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • http://health.msn.com/health-topics/pain-management/back-pain/articlepage.aspx?cp-documentid=100236137

    This article was posted on several Medical websites this weekend. The study was not conducted by Spine Magazine, the results were only published there.

    "J" is a long time poster and not someone that I would consider a "quack" or "spammer" at all.

    Just food for thought...........

  • staand up for my long time spiney friend "J"...it was the article i was referring to a witch hunt, not the poster of the article!

    in all aspects of long term narcotic pain control, there must be balances, monitering, and frequent evaluations. when this is not done, you end up with the numbers that are seen in the study.

    this now opens a door for either better care guidelines ( =)) ) or stricter policies on doctors, pharmacies, and pain clinics, resulting in still fewer willing to treat those of us in honest pain! ~X(
  • but I will give J the benefit of the doubt regarding this article. Maybe he came across it and posted it in order to bring about dialogue on this hot topic. We have been getting a lot of subversive posts by questionable new "members" in the past and I do go out of my way to call them out.

    Here's my take on this- Life is full of risks. Getting behind the wheel of your car has more risk than taking pain medicines or having spinal surgery. ANY medication has risks. NSAIDS kill people too. The manufactorers of them stand to profit if they can scare people out of using opoids when indicated by a doctor to treat moderate to severe pain.

    It is my choice to take narcotic pain meds to manage my intractable pain at the recommendation of a doctor, perhaps for life time because I don't want to be bedridden in agony. Everyday you hear about bogus studies about medicines or certain foods being good or bad for your health. You can't believe everything out there because another study will come out with a rebuttal. It happens all the time. The key to anything in life, I believe, is MODERATION...drinking, eating, etc.

    The statement regarding higher risk of death if you have DDD and take pain meds and have a fusion sounds like BS to me. I don't deny that more people suffer spinal surgeries complications due to increasing numbers of these procedure being done. Right now spinal fusions are done frequently in the US more than any other country. It is the preferred procedure because some patients don't meet the criteria for having artificial disc replacements due to multilevel disc degeneration.

    To sum this all up, I believe the choice of treatments for our back pain remains with us and our doctors and no one has a right to launch witch hunts because of misguided, hidden political agendas.
  • I was a bit unnerved by this article but I think it was posted just to see what people here would think about it. People who don't know J might get confused about this and I'm glad Hopeless-in-mn cleared this up. We all would stand to suffer if doctors refused to treat chronic pain patients, and when we hear about anti-narcotic use movements, it tends to make us worried about what will happen in the future regarding our pain management.
  • i would be dead ,as i could not stand the constant pain
  • I didn't know J is a she..Oops. Sorry J O:)
  • this goes to my concerns about people taking more than prescribed meds. in the past some have said they took large amounts of narcotics without their dr's knowledge but this could be the cause of deaths that i stated in the past. one needs to be under a dr care with narcotics and not up your dosage without dr knowledge. if dose does not work, you need to talk with your dr and let them know. sometimes i lose track if i have taken my dose at one time and if i am not sure i do not take a dose until my next time. also these meds tend to build up in our bodies. so moderation is the way with narcotics
    take care with them
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Somebody with our type of back problems can find it's too much to bear and take extra doses tragically resulting in death. Of course, the people behind these kinds of articles will twist the facts in order to use it for their own propaganda. I wish they would just leave suffering people alone. What would be next on their radar- doing away with pain meds for terminal cancer patients because they think they are addicting? Ridiculous!
  • The opening line in Spine Health reads: Looking for Some Back and Chronic Pain Support?

    I do not find this post supportive, at all.

    This post is also very misleading.

    First of all, was this study primarily based on the 2,378 workers compensation patients in Washington state?

    What about the rest of the general population in Washington state who have had spinal fusion and suffer from DDD? Where are those numbers?

    Washington state... well, I believe Washington state has a reputation of raining a lot with little sunshine? Lots of rain, high humidity, constant changes in barometric pressure, rare opportunities for opening your window and letting the sun shine in, rare occasions for outdoor walks ... does this kind of environment sound inviting for a person who is suffering from back surgery or DDD? I think, not.

    Basing a study solely in Washington state for us suffering from back pain, does not hold my interest. If anything, those who suffer from back pain in Washington state...
    DESPERATELY need to be on pain medication.

    Makes one wonder what the suicide rate, in general, is for Washington state?

    When you calculate the figures and percentages given here, it equates to .64% of people who actually died from either analgesic poisoning, pain medication overdose or suicide. There is a 20% given and a 21% given for analgesic involvement with this study of deaths. If you're going to throw out numbers and percentages based on human mortality, I want to see accuracy. Anything less, makes the study inconclusive.

    Where is a comparison study? A study that shows the other workers compensation patients, in Washington state, who are success stories from taking pain medications? Or, the patients who are STILL on pain medications in order have some quality of life?

    I could go on dissecting this post, but I'm not going to give my precious time by doing so.

    I will close with saying that pain medication which is prescribed to patients by their attending doctors for spinal fusions and DDD, is necessary. The doctors would not
    give it to us, unless we needed it and we do.

    Do diabetics ever die from insulin overdoses? Is it because of their gender and age? Are concerns raised about the long-term risk of death after diabetes is diagnosed?

    We need our medication, just as a diabetic person does.


  • Very well put, Tammy =D> If these naysayers had to walk a mile in our shoes, they'd be the first ones screaming for Oxy like effing babies. :>
  • I live in Washington State,i am on pain meds and will be on for a long time,i am not a canidate for surgury,i think the study is a bunch of crock,i live in Seattle,i have lived in Seattle my whole life,it is a beautiful city....
  • I have seen pictures and hope to travel there someday. I
    do feel for you though with the weather.

    High five, Meydey. :)
  • Is the weather that miserable that it brings additional pain to chronic sufferers? I always thought of visiting Seattle because it's so beautiful and the coffee's great ;)
  • TTLC said:
    The opening line in Spine Health reads: Looking for Some Back and Chronic Pain Support?

    I do not find this post supportive, at all.

    This post is also very misleading.

    I could go on dissecting this post, but I'm not going to give my precious time by doing so.

    I did not find the post itself offensive at all. I cannot speak for the original poster but i read "interesting, what say you?" Simply posting an article that has been widely distributed on many internet sites over the weekend.

    I love the support here but also log in for the information.

  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,732
    out there for those who choose to read them. But statistics can be used and even perceived differently by the people who conduct them.
    I always wonder who compiled the stats, and why, what was their motive, If any. Who paid for the study, what is it ultimately going to be used for.
    Do they hope we will die, so they won't have to pay anymore ?
    One interesting stat. I was told about. Was the huge divorce rate in people who had back surgery.
    I know I took that off topic. But if you've had back surgery and you've managed to keep your marriage together. You need a pat on the back!
    Good luck, Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • The closing word in the original posting is "thoughts".

    I expressed my "thoughts", just as everyone else has and will.

    I, personally, found the post to be not supportive. That does not mean
    others will feel the same as I do? I respect everyone's opinion, even
    though I may not agree with them.

  • i want to just say that i am in no way afraid to die when taking pain meds as directed by my dr. in fact they improve my quality of life greatly, dont know where i would be without them.
  • I have total confidence in my PM doctor that he will take care of me and safely prescribe medication or spinal injections so I can function better.
  • if any of you get bored, watch intervention and celebrity rehab. the overall message is people will die if they take narcotics, alcohol, or other drugs. i once saw an intervention episode where the guy was on oxycontin due to back pain and post surgery pain his family started an intervention saying he would die if he continued to take oxy. he walked out of course, but came back in and went through rehab due to pressure from his family. of course they were afraid he would die with oxy. over and over these articles and shows present the whole world with the message that all drugs are bad and you will die. of course abuse of these may kill you but they are here for a reason, to help pain. it seems everytime we turn around there is the media stating that we as pain patients are bad, weak people with a disease and we will die from narcotics. this artice was just another example of this to me. i have not problem with the poster, it is the article that i have problems with
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • There is a 20% given and a 21% given for analgesic involvement with this study of deaths
    Analgesic involvement only means that there were pain medications found in the lab work of the deceased..which would be 100% normal if the deceased had suffered from back pain,surgery,or any number of spinal problems.

    I'm familiar with Wolters Kluwer Health,and it's my opinion that they manipulate their studies for their own profit.They are after all,a leading provider of information and business intelligence for students,professionals,and institutions in medicine,nursing,allied health,pharmacy and the pharmaceutical industry.

    It's not too difficult to see where this might be going.Only a couple weeks ago they had a 'study' that was equally misleading.I'll look for it after while-I'm off for a nap...
  • I didn't know about their reputation, but solidly confirms that they're full of it. What a waste of effort and print. I sure hope no medical professional in their right mind buys into this crap. What do they stand to gain from attaining a ban on all narcotic medication? They will eventually hurt themselves in the process. God forbid they develop chronic pain like us.
  • On another note-just because a death certificate says:ACCIDENTAL or SUICIDE,does not make it a fact.It is only the coroners educated guess whenever pain medications are the cause of death.

    It's known to the police,Drs,coroners,etc.,that anyone taking pain medications--especially anyone who might take antidepressants,or has ever taken them-are easy targets for unfortunate situations,and many of these deaths are listed on death certificates as ACCIDENTAL overdoses,because cause of death is impossible to know without a note(suicide) or a confession(murder) in a person who takes these types of medication.
    This is another reason that I don't talk to people(in RL-real life)about my medication.I know how terribly paranoid that sounds,but I've heard and seen some horrific things in my life.

    If a persons liver has stopped metabolising their medications they will also overdose and possibly die.

    That study is incredibly irresponsible and misleading-but there will be people who take it as gospel truth..and that is just wrong.
  • I don't know what their goal is..but these pharmaceutical companies are always doing studies and making one another look bad,so that their meds look better in comparison.If they can sell more of another med (their med) it makes them money.I doubt any one study could affect the entire narcotic industry in any major way,but imagine a few million changed minds could line some pockets.

    I don't think they really expect the Drs who might read their crap to believe it--they all know the game.It's people like us,who buy their meds that they want to read and believe their trash..problem is,we never know anymore what is true or if they are just trying to make a buck.

    I am really paranoid-lol.
  • Food for thought and that is why i posted. Michael, very nice to see you again
    Jon: i don't put all my illnesses under my name because i already now them, and really so do my friends here at SH.

    Jim: also interesting about the divorce stats

    The article was not suppose to be supportive, but it gave information, like it or not.Yes patient take pain meds after surgeries and also secondary surgeries according to article. Perhaps ppl make mistakes, perhaps it simply hits there system wrong. There are risk wth meds and well as ever surgery, i have or you have. That is a fact of live.

    I simply found it interesting and thought i would share, and ask for thoughts.I find who wrote article also intersting, however if it were to open the eyes of one person then that would be a positive thing

    And just cause you know a pain doc does not make you a pain doc.Or give you the right to make call on people you don't know of there medical history's. That is part of being a proactive patient. participating in your own health and recovery. Discussing with YOUR doc's not someone else's, that is pure negligent to me. Once again my thoughts only
    Here is just some of my history Jon:
    head on MA 06, neck fusion07, Several mini strokes, 3 brain surgeries, brain aneurysm, tachycardia..........feel better now And still doing it a day at a time, and always looking for a giggle and remembering just how lucky i am, truly blessed
  • thanks but in my little brain, when i see a poster with just an initial and nothing else then post an anti pain med article, i get a little suspicious. probably my fault for being over reactive. but so little info posted by you made me wonder what is this about. some posters print negative posts and don't put anything down. this is my fault for being suspicious but hopefully you can see where i am coming from. i did not know who you were or what was going on with you or if you had some sort of anti narcotic agenda. thanks for clearing this up. if you notice most posters put a name or handle and a brief history of their disabilities, that way readers know where they are coming form
    take care
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • The article was thought provoking and nothing at all wrong with posting it.Sometimes we want,enjoy,or even need to(us long term CP sufferers)do more than post about our own pain-and reading this kind of thing--or ANYthing is better than not reading..if you know what I mean.

    I certainly don't feel it's nessecary to put all of my ailments or surgeries in my signature line either..it's not a contest after all.It's pretty obvious that we are all here at S~H for reasons that don't all need explained.

    Regardless-I was only trying to add my thoughts regarding the subject.
  • Many here at Spine Health DO NOT put all there ailments under there signature line. I am very aware and as i said my friend here also now what is going on with me and support me, and encourage me through my new normal.
    If you really take the time to look many don't put it all down, and to be honest i am so much more then my ailments.
    And I agree this is not contest. I come here to forget them personally

    I also am not the only member with a single initial for a screen name. Funny to, i did not find the article to be anti drugs, just a study of findings that concerned drugs and back surgeries and multiple surgeries.

    I have been a member here for almost 2 years and because you personally don't know me does not mean i have any agenda. Simply put i shared an article. The SH I use to know was one of support and seeing members through, not seeing through people. Attacking seems to be the new norm, shame, maybe think twice before you hit send?
  • I did not attack you,nor did I say a thing about your SN,or imply that you had an agenda.

    As I recall I complimented the post as thought provoking.It still is.
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