>>Announcer: There once was a time when we
were truly free — free of worry… free of fear… far from doubt. That is strength. That is power. That is fearless. “Second Opinion “is funded by Blue Cross
Blue Shield. Which is committed to improving health care
accessibility and supporting more affordable community clinics where care is limited. Blue Cross Blue Shield Live Fearless.>>Announcer: “Second Opinion” is produced
in association with the University of Rochester Medical Center, Rochester, New York.>>Dr. Peter Salgo: This is “Second Opinion,
“and I’m your host. Peter Salgo. Today we’re joined by special guest, Cynthia
Scudo. Cynthia is here to share her personal story,
a story that may shock you.>>Cynthia Scudo: I was taught how to smoke
i.e. could convince myself that if I didn’t inject it, I was not really a heroin addict.>>Dr. Peter Salgo: Did you keep working?>>Cynthia Scudo: I did.>>Dr. Peter Salgo: You continued to work. You raised your family.>>Cynthia Scudo: Yep.>>Dr. Peter Salgo: How long did you smoke
heroin?>>Cynthia Scudo: About nine years.>>Dr. Peter Salgo: Nine years of heroin addiction.>>Dr. Peter Salgo: Thank you so much for being
here today with us, Cynthia. I know that what you’re gonna share with us
today is somewhat difficult to discuss, and I’m really grateful that you’ve joined
us. What I’d like to do is introduce you to our
“Second Opinion “Panel of Experts. They’re going to be hearing your story for
the first time. They are Dr. Anne Marie McKenzie-Brown from
Emory Pain Center. “Second Opinion” Primary Care Physician
from the University of Rochester Medical Center. Lou Papa, and Lou or Louis Baxter from the
Professional Assistance Program of New Jersey. Now, Cynthia, let’s get righto work. I want to know a little bit about you. I understand you’ve got, what, eight children?>>Cynthia Scudo: Eight children and I just
had my 20th grandchild last month.>>Dr. Peter Salgo: Congratulations.>>Cynthia Scudo: Thank you.>>Dr. Peter Salgo: And you live in Denver.>>Cynthia Scudo: I do, yes.>>Dr. Peter Salgo: And tell me about what
you do. What is your job?>>Cynthia Scudo: I am an Executive Assistant
to SVP of Sales fora credit-card Company, and I also kind of manage the Denver office.>>Dr. Peter Salgo: You started to experience
some pain when you were about 44 years old. Tell me about that.>>Cynthia Scudo: I started developing some
hip pain, and I went to the doctor. They did an MRI, which they said at that time
was inconclusive. I did a round of physical therapy for approximately
six weeks and tried some over-the-counter medication with no relief, so my next step
was a pain-management doctor.>>Dr. Peter Salgo: Well, let me be very clear. Did they ever make a diagnosis as to why you
were in pain?>>Cynthia Scudo: No.>>Dr. Peter Salgo: Lou, does that bother you?>>Dr. Lou Papa: No. I mean, there’s lots of times that we have
patients that have, you know, pain that we can’t find the obvious cause for it. We have things that may suggest it, but whether
there’s a smoking gun, sometimes we don’t have that.>>Dr. Peter Salgo: All right, but what happened
next, Cynthia? That’s important.>>Cynthia Scudo: So, my first appointment
with the pain-management specialist, I walked out with two 40-milligram OxyContin –>>Dr. Peter Salgo: Let me back you up, because
you jumped right to a pain-management specialist. You went to a doctor who took a look, couldn’t
find what was wrong and sent you right to a pain-management specialist.>>Cynthia Scudo: Correct.>>Dr. Peter Salgo: And that pain-management
specialist did what?>>Cynthia Scudo: Prescribed OxyContin my first
visit.>>Dr. Peter Salgo: OxyContin is a narcotic.>>Cynthia Scudo: Yes, it is.>>Dr. Peter Salgo: All right. Let’s go right to the panel. Does this sound like a good idea? To you?>>Dr. Anne Marie McKenzie-Brown: It does
not. It does not. Opioids are generally not the first line of
therapy for a pain that you’ve been having for the very first visit, and there are other
medications that can be used for pain that are non-opioid that might have been helpful
for you.>>Dr. Peter Salgo: And let’s stop right there. We’re talking about a word that some of
our viewers may not have heard — “opioid. “They come from opium. They are narcotics. They’re powerful pain relievers. Would you jump to that right off the bat?>>Dr. Louis Baxter: Absolutely not, and I’m
also very concerned that there wasn’t more done in terms of trying to find out what the
cause of the pain. When we find patients that have painful conditions,
one of the primary things should be to find out what is causing the pain.>>Dr. Peter Salgo: Well, that’s a good idea,
but here you are now. You’ve been given OxyContin, a narcotic,
and did you take it as prescribed?>>Cynthia Scudo: I did for about the first
two weeks.>>Dr. Peter Salgo: And then what?>>Cynthia Scudo: And then I realized through
an inadvertent double-dosing that the euphoric feeling was amazing if I added a little bit
more.>>Dr. Peter Salgo: So it made you feel good,
not just took your pain away.>>Cynthia Scudo: Oh, the pain was gone, and
–>>Dr. Peter Salgo: Even now looking at your
face.>>Cynthia Scudo: I can remember. I can still remember that feeling.>>Dr. Peter Salgo: So, what did you do? I mean, that’s something that drives a lot
of people to take these drugs. What did you do?>>Cynthia Scudo: I started taking them not
as prescribed. I took — I chewed them, I crushed them, I
smoked them, I…My second appointment, I was increased to 80-milligram OxyContin.>>Dr. Peter Salgo: So here we are with opioids. I think people are somewhat aware that the
narcotics can make you feel good. They also block pain. How do they work?>>Dr. Anne Marie McKenzie-Brown: Well, they
bind opioid receptors, and they can dull the sensation that comes along with pain, but
there are many other side effects along with it. I’m curious. Had you ever taken any other opioid before
this? Because starting out 40 milligrams of OxyContin
seems like a large dose. Did it make you sleepy?>>Cynthia Scudo: No. I’m a very functioning person on opioids.>>Dr. Louis Baxter: and the first-time experience
of euphoria for her is a big herald signal for those of us that treat people with addiction.>>Dr. Peter Salgo: Okay, so the fact that
someone is becoming euphoric on an oral dose of opioids –and you mentioned opioid receptors. Those are spots in your body where these drugs
bind.>>Dr. Anne Marie McKenzie-Brown: Yes.>>Dr. Peter Salgo: And when they bind to these
sites, they get rid of your pain, but they do other things, like cause euphoria in some
people. Is there a checklist that you might go through,
you say, “Uh-oh. This is a person who is not gonna be the best
candidate’ cause they are at risk for becoming addicted or getting the euphoria”?>>Dr. Anne Marie McKenzie-Brown: So, yes. In our practice, we do what’s called — and
there are many forms of assessment that you do, but there is basic assessment that can
be done. One that we use is called Opioid Risk Tool,
where we ask questions about your background, about your family history, history of substance
abuse, history of family history of substance abuse –various different things, treatment
for various different psychological conditions –OCD, depression — things like that that
may give us a clue as to whether or not you’re particularly susceptible to having difficulties
with opioids.>>Dr. Peter Salgo: Now, you had taken an
opioid before in your life, right?>>Cynthia Scudo: I have had C-sections, and
I was given Percocet at that time.>>Dr. Peter Salgo: And you didn’t get addicted?>>Cynthia Scudo: No.>>Dr. Peter Salgo: But there is a family history
of addiction.>>Cynthia Scudo: My mother’s a recovering
alcoholic of 25 years.>>Dr. Peter Salgo: Would that have been red
flag for you?>>Dr. Anne Marie McKenzie-Brown: Absolutely.>>Dr. Peter Salgo: And would that have absolutely
ruled out narcotics?>>Dr. Anne Marie McKenzie-Brown: No, but it
would have given pause, and going back to the original scenario where the very first
drug being opioids, it just does not seem like an appropriate first step.>>Dr. Peter Salgo: All right, so you’re on
narcotics, and you’re going up in the dose, and you told me now you’re crushing, you’re
smoking them. Right away, this is trouble. Did your family know you were in trouble?>>Cynthia Scudo: No.>>Dr. Peter Salgo: Okay. You hid it.>>Cynthia Scudo: I was very good at hiding
it.>>Dr. Peter Salgo: Then what happened with
your doctor?>>Cynthia Scudo: So, my doctor ended up not
practicing long in the state of Colorado, and a new doctor came in and took over his
practice, and she took a look at my dosages and the types of medication that I was being
given, and she said, “You are taking enough for three grown men, and I am not comfortable
with prescribing that, and I am cutting you back.”>>Dr. Peter Salgo: And your response to that
was?>>Cynthia Scudo: “I’m sorry. That’s not going to work for me.”>>Dr. Peter Salgo: Why not? What was it that terrified you about cutting
back?>>Cynthia Scudo: I was already getting dope
sick at that time.>>Dr. Peter Salgo: And that’s a term of art. What does “dope sick” mean?>>Cynthia Scudo: “Dope sick” means that I
have extended the time that was to take the opiate, and I was having physical reactions
now.>>Dr. Peter Salgo: You were withdrawing.>>Cynthia Scudo: I was withdrawing.>>Dr. Peter Salgo: I take it — Let me see
if I understand it — that the euphoric effect was wearing off, and you were getting physical
symptoms of withdrawal. What were those symptoms like?>>Cynthia Scudo: It was like somebody was
hitting my lower back with a sledgehammer. It was intense pain down my back, my thighs. It was — It was miserable.>>Dr. Peter Salgo: Now — I’m sorry. Go ahead.>>Dr. Louis Baxter: Peter, by this time,
the euphoric feeling has long gone. She hasn’t felt euphoria for many, many months,
if not years, and even when they are continuing to take opiate medication, if it’s not at
the dose that their body requires, they are actually dope sick while they’re actually
taking medication.>>Dr. Peter Salgo: There’s a medical phrase
–tachyphylactic. It’s an awful word. It means that you need more to get the same
effect. You’re getting used to the drug. Lou, do you prescribe narcotics for your patients?>>Dr. Lou Papa: Very limited.>>Dr. Peter Salgo: And do you watch for signs
or symptoms that she’s describing?>>Dr. Lou Papa: Yeah. I mean, usually what happens, for myself,
I’ve never prescribed a lot of narcotics just because of the risks that are associated with
them. I don’t consider myself clairvoyant, I just
always felt that way, but usually we use a fixed amount of medications. I let them know what the concerns. At a minimum, if I have to have somebody who’s
gonna need to be on narcotics to control that pain, as long as it’s not cancer pain, I get
a specialist involved, and usually they sign a drug contract, they have urine testing. There’s a lot more involved.>>Dr. Peter Salgo: A drug contract means I
agree with you this is what I’m gonna do with this drug. Did you ever have one of those?>>Cynthia Scudo: I did not.>>Dr. Peter Salgo: Would it have helped?>>Cynthia Scudo: Um…You know, that’s a good
question, and I don’t know the answer to that.>>Dr. Lou Papa: I think what it does is it
helps set up parameters that –Narcotics are a lot like antibiotics. You know, you got to use them appropriately. They’re not used in all situations, and you
better make sure you’re using the right one in the right place, and I think it sets up
the condition that this is how it’s gonna work. If it’s somebody who is drug-seeking, it lets
them know it’s not going to fly here, that you’re going to follow what’s appropriate
medical care, and you agree to that. And we have people say, “Okay.”>>Dr. Peter Salgo: And we’re going to break
in a moment. Is it fair to say before we go to our break
that the opiates are not, a priori, bad drugs, evil drugs, but that there are people for
whom they have problems?>>Dr. Louis Baxter: Yes.>>Dr. Peter Salgo Is that fair?>>Dr. Anne Marie McKenzie-Brown: That’s
a fair statement.>>Dr. Peter Salgo: So what’d I like you to
do –I know you’ve got more to your story. So I’d like you to stay here with us if you
would. We got a lot more ground to cover, but, first,
here’s this week’s “Myth or Medicine.”>>Announcer: According to the World Health
Organization, opioids are responsible fora high proportion of fatal drug overdoses around
the world, and when someone dies, it‘s often thought they die quickly and alone. Is this true? Do people die immediately when they take an
opioid overdose? Is this myth or medicine?>>Dr. Gloria Baciewicz: People dies immediately
when they take an opioid overdose. That is a myth, and I will tell you why. I’m Dr. Gloria Baciewicz, Addiction Psychiatry
Division Chief at the University Of Rochester Medical Center. We often think that when people take an opioid
overdose, they die immediately, even instantly, and this can, theoretically, happen, but often
you have minutes to hours before respiratory depression becomes severe enough to stop the
person’s breathing and lead to death. Those few minutes or hours present the window
of opportunity for family or friends to assist the person –to call 911 or use a naloxone
or NARCAN Kit to reverse the opioid overdose or to do basic first-aid measures. And that’s Medicine.>>Announcer: not sure if it’s Myth or Medicine? Connect with us online. We’ll get to work and get you second opinion.>>Dr. Peter Salgo: And we’re back with Cynthia
Scudo. She is a mother of eight, grandmother of 20.How
you survived eight kids and 20 grandchildren. Congratulations. You have my undying respect.>>Cynthia Scudo: Thank you.>>Dr. Peter Salgo: But you became addicted
to opioids because you were prescribed them for your hip pain, and then you got a new
doctor who cut back your dose.>>Cynthia Scudo: Correct.>>Dr. Peter Salgo: and you left your doctor’s
office and did what?>>Cynthia Scudo: I drove right to a Youngman’s
house that I knew dealt heroin.>>Dr. Peter Salgo: All right. How did you — I think our viewers right now
have stopped, and they’ve said, “Wait a minute. “You are a middle-class person living in
Denver. How on earth do you know somebody who’s a
heroin dealer?>>Cynthia Scudo: Eight children. Stands to reason one of them was going to
be hooked up with some people in high school that, at that time, I didn’t approve of,
and yet that’s the first person who I thought of.>>Dr. Peter Salgo: So you go to a heroin dealer. Why heroin? Why not try to get more OxyContin? That’s the drug you were on.>>Cynthia Scudo: Yes. OxyContin’s very expensive.>>Dr. Peter Salgo: Okay.>>Cynthia Scudo: An 80-milligram pill is $80
— a dollar for a gram. I could sell one pill, which wasn’t even
one dose for me, and get enough heroins for two and a half days.>>Dr. Peter Salgo: All right, what I’m hearing
here — and I do want to move on — but I think it’s really important for our audience. I heard not only that you were going from
OxyContin to heroin, but that you were selling OxyContin.>>Cynthia Scudo: Correct.>>Dr. Peter Salgo: I mean, this is a two-for. You’re dealing and you’re using.>>Cynthia Scudo: Exactly.>>Dr. Peter Salgo: and so, did you go through
with it? You went to the heroin dealer?>>Cynthia Scudo: I did. I did.>>Dr. Peter Salgo: What did you do? How did you use it?>>Cynthia Scudo: I was taught how to smoke
it. I could convince myself that if I didn’t inject
it, I was not really a heroin addict.>>Dr. Peter Salgo: Is that fair?>>Dr. Louis Baxter: Yes, it’s very common,
and that is probably the biggest problem that we have with heroin today is that it is so
pure that people do not have to inject it. They can; in fact, smoke it, and it does not
have to inject it makes it easier for a person to transition.>>Dr. Peter Salgo: That’s awful, if you will.>>Dr. Louis Baxter: It’s terrible.>>Dr. Peter Salgo: I mean, it doesn’t matter
if you’re smoking it, injecting it, snorting it, its heroin, right? Its narcotics.>>Dr. Anne Marie McKenzie-Brown: That’s correct. What I’m not hearing about so much now is
your pain. Where did the pain come into the picture? Or is the pain now becoming the background
and now the sensation that you get from the drug is more in the forefront? Is that what we’re hearing?>>Cynthia Scudo: Exactly. The pain at this point was a footnote, something
that I didn’t even think about anymore.>>Dr. Anne Marie McKenzie-Brown: Hmm.>>Dr. Peter Salgo: Now, is she the face of
heroin in America today? I mean, look. When I grew up, heroin was a street drug. It was people down and out, being used in
inner cities, if you will, and now we’re talking to a woman who’s got a job. Did you keep working?>>Cynthia Scudo: I did.>>Dr. Peter Salgo: She continued to work. You raised your family?>>Cynthia Scudo: Yep.>>Dr. Peter Salgo: How long did you smoke
heroin?>>Cynthia Scudo: About nine years.>>Dr. Peter Salgo: Nine years of heroin addiction. And she moved there from a prescription drug. Is this the new model? Is this the new heroin addict?>>Dr. Louis Baxter: Yes, this is what I see,
and this is what I treating my addiction medicine practice.>>Dr. Peter Salgo: Wow.>>Dr. Lou Papa: That’s what I see in my practice,
the people that come in.>>Dr. Peter Salgo: When I told our audience
they might be shocked, this is where I thought we’d wind up. This is shocking, I think.>>Dr. Lou Papa: It’s the boy, girl next door.>>Dr. Peter Salgo: It’s the boy, the girl,
the mom, the grandma next door. What about your family? Did they know you were smoking?>>Cynthia Scudo: They did not.>>Dr. Peter Salgo: How did you keep that from
them? You’re smoking heroin.>>Cynthia Scudo: I would make sure to smoke
it either in my car in parking lots off the property or –I could not get through a night
without having to smoke, so I would wake up like clockwork, 2 o’clock in the morning,
and I would creep downstairs to the basement, and I would stand on top of the toilet with
the vent on and smoke so I could get back to sleep.>>Dr. Peter Salgo: But what about while you’re
at work? Did you need to use it periodically during
the day?>>Cynthia Scudo: Oh, all day. I would drive off two blocks away from my
work and sit in my car and smoke and go back.>>Dr. Lou Papa: So, what did that do to your
work performance? What did that do to your family? They must have noticed a change in you.>>Cynthia Scudo: No, they attributed any
changes to the OxyContin, which I was still taking, along with Oxycodone and Valium and
Soma and Flexeril.>>Dr. Peter Salgo: So let me get some data
now. If we’ve identified this new group of heroin
users, you know the numbers. What percent of people who’ve moved to heroin
did so off of prescription drugs?>>Dr. Louis Baxter: More than 60% to date.>>Dr. Peter Salgo: More than half?>>Dr. Baxter That’s right.>>Dr. Peter Salgo: They start off with something
like OxyContin, and the next thing you know, they’re using heroin. And is the use of heroin going up, down? What’s happening here?>>Dr. Anne Marie McKenzie-Brown: It seems
to be going up.>>Dr. Peter Salgo: Why? Why?>>Dr. Louis Baxter: Because it is cheaper,
and itis pure. In the old days — And when I say “old days,”
I’m talking about the 1970s and 1980s; the heroin was sort of trashy, if you will, in
terms of purity. But today it is very, very pure, and people
find it an easy transition to go from pain-prescription meds to heroin.>>Dr. Peter Salgo: Now — I’m sorry. Go ahead, Lou.>>Dr. Lou Papa: Plus there’s been a clampdown
on physicians, that we have to –It’s much more difficult to prescribe narcotics. We’ve been educated and re-educated and
re-educated to reduce our use of narcotics. There’s been a lot of effort to go after
the pill-mill docs, so access — not only is the price good, it’s perfect if you’re
a drug lord. The price — you know, they drop their price,
and plus the access to your competition is disappearing.>>Dr. Anne Marie McKenzie-Brown: Well, now
there’s a prescription-monitoring program where we now have access to opioid prescribing
and going to various different doctors to get prescriptions from different pharmacies,
and so that avenue is getting more difficult now, which is making it easier when you go
off the grid.>>Dr. Peter Salgo: I mean, that’s sort of
the doctorate of unintended consequences. As Lou pointed out, people are going after
pill mills and doctors overprescribing narcotics and one of the unintended consequences is
they’re driving people toward heroin. Now, did your family ever suspect, did they
ever confront you on this?>>Cynthia Scudo: Nope.>>Dr. Peter Salgo: Nothing?>>Cynthia Scudo: Nothing.>>Dr. Peter Salgo: So, you got help. What finally drove you to get help?>>Cynthia Scudo: I got out of the shower and
passed a full-length mirror and actually stopped and took a look at myself, and I was weighing
in at about 93 pounds, and my skin had a green tint to it, and although I had been praying
for death for the last few years, something hit at that moment, and I realized I was actually
dying.>>Dr. Peter Salgo: Who did you tell? What did you decide to do?>>Cynthia Scudo: Funny. I didn’t tell anybody. My mother — I think a recovering addict has
this radar, and she knocked on my door that same day that I had looked in the mirror,
and looked at me, and she says — She knew. She says, “Have you had enough?”>>Dr. Peter Salgo: So she did know.>>Cynthia Scudo: She did. She knew. Intuitively, she knew.>>Dr. Peter Salgo: How did she know? Mom radar?>>Cynthia Scudo: She’s a mom. She’s a recovering alcoholic.>>Dr. Peter Salgo: So, you decided to detox. How did you do that?>>Cynthia Scudo: I went to a recovery facility
where they helped me with the Suboxone Detox from the heroin.>>Dr. Peter Salgo: Let’s stop right there. What’s Suboxone Detox?>>Dr. Anne Marie McKenzie-Brown: Buprenorphine
and naloxone combined.>>Dr. Peter Salgo: Those are another word
salad. What is that stuff?>>Dr. Anne Marie McKenzie-Brown: So, it’s
a combination of an opioid and an antagonist to be able to decrease the amount of narcotic
that you take without having the reactions of coming off the opioids.>>Dr. Peter Salgo: So it’s supposed to give
you a softer landing?>>Dr. Louis Baxter: Yes. These are a group of FDA-approved medications
for the treatment of substance-use disorders. We have them for alcohol. We have them also for opiates.>>Dr. Peter Salgo: So, you took these drugs. You had a great time in detox, no?>>Cynthia Scudo: Yeah — no.>>Dr. Peter Salgo: No.>>Cynthia Scudo: No. The softer-landing part was not my experience. It was a crash landing. It was six days of throwing up every 15 minutes. I lost nine pounds in six days detoxing, and
a great memory.>>Dr. Peter Salgo: Louis, is this common?>>Dr. Louis Baxter: No, not at all. Actually, detoxification can be a well medically
managed process, and I feel very sorry that you had to go through that process. That was common years ago.>>Dr. Peter Salgo: But no more?>>Dr. Louis Baxter: But no more today.>>Dr. Peter Salgo: And they combine psychotherapy
with all of this?>>Cynthia Scudo: They — Yes. We started learning coping skills, because,
obviously, if the drugs were the solution to my problem, I had to figure out what my
problem was.>>Dr. Anne Marie McKenzie-Brown: Yeah, but,
you know, kudos to you for sticking through, because it sounds like it was a very unpleasant
process for you, and you could just as easily had said, “You know what? I’m done with this. I’m going back to what I know.” But that speaks to –that’s a testament to
you and your will to get better.>>Dr. Louis Baxter: And that is the absolute
problem with many people that go in to seek help. If they are not treated with state-of-the
art protocols and medications, opioid withdrawal is very difficult to withstand. But there are protocols and there are medications
that are developed now that can make that process less onerous.>>Dr. Peter Salgo: Does the chemical detox,
just stopping the drugs, does that work unless there’s also a support psychotherapy and all
kinds of other support?>>Dr. Louis Baxter: No, it does not, and
that’s what the problem is, is that many folks do not recognize that a full treatment experience
has three steps. One is detoxification –getting the medication
or the drug out of the system. The second is rehabilitation counseling, where
you learn about the disease, learn how to cope with problems so that you don’t have
to pick up the next drink, drug, or fix, and then the third is ongoing maintenance, which
includes Medication-Assisted Therapy in some instances, but certainly ongoing counseling
and follow-up with Twelve-Step recoveries.>>Dr. Peter Salgo: One quick question. Could this all have been averted if her doctor
did something differently right at the very beginning?>>Dr. Anne Marie McKenzie-Brown: Absolutely.>>Dr. Lou Papa: Well, I mean, I think what’s
gonna be important is this was years ago, and we all have to remember that the drugs
were very heavily marketed, that the way that we looked at pain, we had a much lower pain
threshold. In fact, we were told we were being bad doctors
if we didn’t prescribe narcotics for any pain, and that the myth of “addiction” was
overblown. I remember that early in my practice, so,
in many respects, there was this different mind-set way back then.>>Dr. Peter Salgo: Cynthia, how long now
have you been off heroin?>>Cynthia Scudo: This last April, I celebrated
five years.>>Dr. Peter Salgo: Your fifth anniversary. Congratulations. I think we can all do this. It’s hard, and I am so, so pleased you chose
to share your story with us, and, of course, with our viewers and with our panel. Thank you so much for being with us today. So, to end our show, here’s this week’s
“Second Opinion 5.”>>Patrick: Hello. I’m Patrick Seche, and I am here to tell
you five early signs of an opioid use disorder. The first sign is taking an opioid medication
for anything other than for which it was prescribed. If you have severe acute pain from an injury
or accident, the opioid medication is intended only for the pain from that event. You must discontinue use of that medication
once the pain is at a level you can tolerate and dispose of the unused medication in an
appropriate manner. Next, is using a larger amount of the medication
than indicated on the prescription. If the amount prescribed does not seem to
be sufficient for your level of pain, you must return to your healthcare provider for
further assessment. Third is taking other people’s opioid medication. Opioids are very potent medications and should
only be taken under the direction of a prescribing healthcare provider. You should never take pain medication that
was not prescribed to you. Another early sign of an opioid use disorder
is taking opioids for recreational purposes. The risk of becoming addicted to opioids when
you use the to feel good or to relieve stress is extremely high. And the fifth early sign of an opioid use
disorder is combining opioids with other medications or substances. Also, taking an opioid with alcohol or medications
such as benzodiazepines will put you at extremely high risk for an overdose, and it is important
to note, death can occur from an opioid overdose. And that’s your “Second Opinion 5.”>>Dr. Peter Salgo: Well, thank you so much
for watching. And remember, you can get more second opinions
and patient stories at our website at You can continue the conversation on Facebook
and Twitter. We are live every day with health news. I’m Dr. Peter Salgo, and I’ll see you
next time for another “Second Opinion.”>>Announcer: There once was a time when we
were truly free –free of worry…free of fear…far from doubt. That is strength. That is power. That is fearless. “Second Opinion “is funded by Blue Cross
Blue Shield. Which is committed to improving health care
accessibility and supporting more affordable community clinics where care is limited. Blue Cross Blue Shield Live Fearless.>>Announcer: “Second Opinion” is produced
in conjunction with U.R. Medicine, part of University of Rochester
Medical Center, Rochester, New York.


  1. wow this is what is gonna happen to so many people due to what big pharma , the DEA , the dr,s protocalls. He said their is a camp down on Dr,s . So lets just say the undertakers are going to cash in .Maybe if you can afford a funeral polar that would be the market to be in. This is a God Damn shame . Thanks Government, big pharma , FDA , all you agency;s have done nothing but fail us and now you dare to take away the one thing that may help this epidemic. KRATOM.. #imakratom and another footnote here NO detox is done comfortably because suboxone is a drug and you DO have to get off of that . Do NOT fall for it . This is just more ways to sell meds . I wish this woman happiness . Nice job 5 years clean.

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