Tag Archive | intractable pain

In The Spirit of the Olympics – Updated Link

Edited for correction. Thanks to the eagle eyes of two bloggers I have now corrected Tracy’s blog address. I am thankful for both of these two bloggers for catching the mistake, and saying something to me so that I could repair the problem. Thanks to both of you , you are my heroes today~ BB

In the spirit of the games and world-wide friendships that are occurring as I write and as you read I am creating this post.

Athletes and their entire team and support team have all been spending this time with one another and getting to know each other. Budding new friendships that may last them all their lives. There is so much to take away from the Olympics.

I’ve been celebrating the fact that watching the games this year has held a completely different and yet at the same time wonderful experience. Watching the same games as you are while knowing that we will soon be sharing thoughts and feelings has brought the games, the people, the countries home to me Knowing you that I do in the other countries that are also participating holds a completely different meaning for me. A meaning that I find brings me closer to you and where you live. It’s been maybe the most awesome aspect of the Olympic games for me this year.

In honor of the very games that are bringing us together I’d like to introduce you all to a new friend. She is recently new to blogging and WP. and she has already touched my life in a way that I’m still reeling over.

I’ve never created a post to introduce a sister or brother blogger before. I have focused a post a bit on another blogging sister but I was not introducing her like I am here with this blogger.

 

I am so pleased and proud to introduce to you…………Tracy, this sister blogger I have been so pleased to meet. You can check out her new blog and meet her as well at  http://ohwhatapain.wordpress.com/about/

Tracy is a sister living in the world of chronic pain like I am. Though I don’t make my health a key part of this blog most of my readers know what I deal with, and that I am thriving in spite of my chronic illness that creates endless chronic pain and fatigue. From reading Tracy’s blog it became apparent to me that Tracy is a youngster in the fight of living with chronic pain. I mean this in the nicest wat possible. It’s been 28 years that I have been living with this disease which the medical association finally has determined several years ago that chronic pain in itself is a disease.

I believe that like all things in this world that can alter our lives that if you can connect with someone who has been, and IS there this is the kind of support that iI find is priceless. I am not saying this to toot my horn. It takes a long time to come to terms with what has happened to you, what is, that is, happening to you every day. There are days that not even those who love you and are closest to you can understand, and there is not a thing that does not seem to irritate you. Making everything in your life and around you feel off-balance.

It also takes a little longer in accepting where you’re at in your life with your illness and then finding that balance that works. It’s not one that has to be perfect, just one that works for you and everyone in your small circle. Those closest to you are the ones who may feel the brunt of what you are going through. This is just one reason why a support community of those who know what you mean, know what you feel, and may even similar thoughts is so vital to good emotional balance. 

It’s true that for me when I first became ill having that camaraderie with other women who were going through the same thing helped in ways no one else could. It’s my hope that we can be a support to one another in any fashion we may need. But in particular my wish is that if you’re living with chronic illness, pain, and or fatigue I’d like to hear from you. Like with my new friend Tracy we will hopefully find ways to be there for one another in ways that no one else can. 

For Tracy; my wish is for you to have a bountiful blog filled with friendship and kindness from others. My hope is that you will find the kind of support albeit casual that I have. That casualness for me has taken on a whole new meaning, it means I feel like I am sitting with my blog friends in a virtual cozy room filled with pillows that cushion and green plants that nurture our air. A room with tea on the table in front of us, a home where we can share and feel safe doing so. My prayer for you is that you find the comfort and support I do in all your blogging experiences.  Best of everything my new friend~ BB

©tjhelser2012

Advertisements

A Better Outlook Looking In

It is important to me that I come this day after a pretty cheeky post about feeling sorry for myself  yesterday and say that all is not lost. Today my outlook about my life when I look inward is back on track. I’m not likely to go down that particular path for some time.

Finding the need to express my many thanks to my blogging family for the most incredible support is sitting on my chest right now like a huge elephant who is reminding how special each of you are to me. The words I read here after posting such a whiny message are stunning. So much love and support baffles me to be honest. I knew going into the post that it was going to be a pity party for one. I had to get it out myself, Like a festering wound if left alone it turns into an infection. I knew that trekking backwards was not an option. I thought about deleting the whole thing though.

I’m grateful today that I did not delete the whole thing, I am grateful today that as much as it pained me emotionally to not participate in the going ons of celebrating my country’s Independence Day I am not in pain physically today. And because of the freedom to write what’s on my mind with no worries of persecution or censorship I realized that I was actually very much celebrating in my own way. Celebrating my own freedom to write from my own person and not be concerned with the outcome is pretty amazing when I think about it today.

So back in my saddle again this Baroness finds herself once again playing the “Glad Game” Being Pollyanna has always been a trait of my own, something that has gotten me through times of chaos that truly have an effect on life. Finding a reason to be glad about something is not too far-fetched from who I am, yesterday was the abnormal for me. I don’t often cry in spilt milk.

This Barfooted and happily contented Baroness wants you to know how much she adores the friendships and loves she has found here. You all are the most astonishing people, and she thanks you from the very bottom of her heart and deepest reaches of her soul.

You’re The Best! I’m most grateful for you being a part of my world. Thank you again Dear friends!

 

~

©tjhelser2012

Wonders Never Cease.

That call came through!

After a good week of pure frustration I heard from the doctor’s office finally late yesterday afternoon. Seems there was a cancellation on the doctors Emergency Room schedule and it was offered to me. I gladly jumped on this offer with both feet before the elusive scheduler could even tell me at what UnGodly hour we would have to be at the surgical center in the morning. It didn’t matter. We were going to be there with bells on. I am at least.

The bells will be only temporary of course; as all jewelry must be removed, sans my wedding ring which I make them tape up every time. It’s been off my finger three times in our 42 years of marriage to date. I am extremely sentimental and believe strongly in symbology; meaning in this case that the ring staying on our fingers represents to me the unbroken circle of our vows. Of our marriage. I was not into taking my rings off any time I chose, willy nill.  I recall seeing aunts and cousins take their rings off for a number of reasons. Sometimes that reasons being out of anger. Seems like arguments were worth removing their rings, or leaving them beside the sink to wash their hands or dishes, often rings ending up down the drain getting knocked in accident. Sometimes not. My rings have come off once on our 20th anniversary when we renewed our vows, we had our rings cleaned and an engraved inside. Then on our 35th anniversary my husband D. took his grandmother’s ring, which she left me, and had the diamond removed from its center stage. My original wedding band was split in two, (I know the engraving is still there albeit altered now) and a third band added to it so there would then be a wide enough base to hold 6 prongs. The third time I have had the ring off was to have a prong fixed that I had somehow bent. I cherish this ring even more. Now because of its added financial value which is huge (now I know what they mean when they say a diamond is girl’s best friend) but the sentimental value is priceless. My band alone which we bought as a matching set back in 1970 held its own unique value, now with D’s grandmother’s diamond (which I never owned before) makes it a family heirloom. That to me makes it the most valuable materialistic thing I own. There is so much love in that small circle that it’s value lies out of this world. 

I digress. I’m sorry.

Obviously some nervous energy shining through the story about my rings.

I am to arrive at the surgical center at 9am this morning Pacific USA time. I am a tad nervous and am feeling grateful that I am set up for  light sedation this time. No arguments from me. The first test injection I thought despite being nervous I’d be tough and not need the offered sedation. By the time they were actually ready to take me back to the OR room I was not doing so well. Despite using mediation and prayer which usually is enough for me I had worked myself up so that even my blood pressure and heart rate were both racing up the scale. Dr Swift popped in again to se how I was doing and talked to me about the sedation. Told me it meant nothing if I needed it. It did not make me less than because I used what was obviously going to help in this situation. I told him it honestly had nothing to do with trying to be tough, not really. Just that if there was no need for more chemicals why automatically accept taking them just because. But in my own anxiety I had lost sight of my own rationale.

I accepted the mediation which after a very short time entered my blood stream. I could immediately feel the warm blanket of its chemical effect and immediately relaxed. I realized then that they had bumped another [patient ahead of me to allow time for the medication to work that it was not just about me. That I was affecting the running of the operation rooms systems. I will not make that mistake again.

Checking in, putting their gown of the latest fashion on, Tied in back please. Thankfully D will be with me to help tie my gown, to hold my hand, to talk with me and side track my focus of attention. I am no way as nervous as I get when I am being given a general anesthesia, being given just a local, light sedation means that post procedure the recovery time required before being allowed to go home with my driver D. They make sure you have a driver, know their name, and make eye contact with them. I was recently in that role for my husband D,  he had his arthritic thumb operated on.  And is doing well thank you.

Shall I just bring my sleeping bag and teddy bear?

The nurses at the surgical center were laughing with us last time we were there,.Teasing me. Between D and I we will have been there at the surgical center 5 times in less than a month’s times, so the nurses were teasing me by laughing and offering us a Family Rate; and why did I not just bring my sleeping bag and stay. Thy all are beginning to feel like friends. I’m not sure what that means.

Ring of Fire.

This morning as I enter the actual cold sterile operation room where will be the two nurses I know now, and an anesthesiologist,  And Dr Swift.  All dressed in matching attire, Dr Swift wearing his rad looking glasses that are magnifying glasses at what strength I have no clue. The music in the background has already been requested. Not by me. But by my Johnny Cash loving doctor. Today the entrance song has been promised to be Ring of Fire by Johnny Cash.

Naturally!

I fell into a burning ring of fire

I went down, down, down and the flames went higher

And it burns, burns, burns, the ring of fire

The ring of fire

~lyrics: Johnny Cash

Gotta love his sense of humour!

Thanks again for all your support everyone. Know that I will use it in medication and prayer. Between the power of both those very meaningful showers of love and the use of chemistry I am going to be better than fine. I am in Good Hands by being in God’s Hands the entire time. This is what I have been needing to have done and from here on out my life that has felt in limbo comes out of that cocoon to life full force again.

I can hardly wait.

~

©tjhelser2012

Still Waiting…..and Waiting….On The Man

For those of you who also follow me on other blog FullCircledMe @ fullcircledme.wordpress.com/ please know that I will be reblogging this same post there. (so if you an alerted twice know it is the same post) I want, and even maybe need to share this on both blogs. Only you followers of both blogs will have the benefit to the post I have initially posted about this at FullCircledMe. I just realized that could be a bit of an issue.  We’ll see, I am always up for an experiment.

I am so not the patient person that I wish sometimes I was. Like today

I am waiting and have been waiting for ALL of my life for a phone call. Okay, not all of my life, but certainly the past say… er… 5 to 6 weeks. And definitely the last 3 weeks I have been waiting. And the call I am waiting for involves a pretty important man in my life right now.

But still I am waiting….and isn’t there a song?

The phone call I am waiting for and that is making me a bit wicked because of its failure to ring is from a surgeon. A neurosurgeon to be exact.

After much hullabaloo to get into see this physician I then went through a two-part series of injections into the cervical nerves affecting my ability to function, and my pain levels that I deal with daily. The two-part test injections were performed, I was given the okay to go ahead by the doctor who agreed to the procedure, and my insurance company. Last week I was told by his medical assistant that my pre-auth had come through, I was just had to wait for his surgical scheduler to phone me. Cool.

If I seem like I am little  too excited to have this procedure done,… you’ve got good instincts. I am impatient and I need to have this done. My life feels like it is limbo right now. But I waited for the Elusive Scheduler to phone.

I am still waiting…

I am waiting to have a Radio-frequency Ablation (RAF) done.

Some of you may be asking yourself what is an RAF and why would she be waiting to have one done.” The what it is in some detail is inserted for your convenience if you are interested towards the bottom of the page. The why I will briefly explain only as I have been living with unacceptable pain again from my spine in the neck for  the last two years. It has also in the past nine months started to affect my range of motion, and ability to function. I have been in Physical & Occupational Therapy for pretty close to a continued time of over one year. The pain is affecting my life to the point where I am unable to find any position to be comfortable in except the pile of different pillows on my bed that allows me to lay against them, and they surround me like a nest. The pillows offer the soft support I need.ave even purchased two pillows from www. My Pillow.com that are the best pillows I have ever had. I purchased one and within one week knew I had to have two. They should be a medical write off but I am not sure yet.

I also have Connective Tissue Disease and Fibromyalgia which creates a hyper sensitivity to almost anything touching skin and my muscles. There days when even the spray of a shower hurts I know that my pain levels and inflammation levels are sky rocketing. I have a lovely shower head that D bought just because it can be adjusted to even almost just a dribble. The setting I that I like is just like a gentle rain which is why he bought it for me, but there are days when even that is just too much.  Like the past week. Our poor cat, Truman has no clue that while he is walking across my body with his sweet little white booted paws he is hurting me with each lingering step. It’s all I can do on some days not to help him along just a little bit. 

Because the pain levels have built to a point where I am needing stronger pain medication, I am not sleeping, unable to do a lot of physical activities because right now it is excruciating painful to have my left arm hanging at my side, and that I also am unable to raise it above my head, are the reasons why I am waiting to have this procedure done. 

In the late 1990’s I had these same symptoms, which led ultimately in 2000 to having a Cervical Fusion Arthoplasty. This that is creating the symptoms that I am dealing with now 12 years later are not from my fusion. I am told it still looks “great”; that the hardware which is made of Titanium is intact and in good shape. For me who had jaw implants that failed in the late 80’s this was extremely reassuring. But I did not expect anything different as this implanted material was researched ad nauseam before the surgery was even agreed upon. By myself.  I was told that my neck is “wearing out” above and below my fusion. This is the least invasive technique that may give me some relief available.

The history behind what got me to where I am at today is on my other blog if you’d like to know more: www.fullcircledme.wordpress.com/

So as the spine in my neck is “wearing out”, “the arthritis is spreading into the thoracic regions; and the thinning inside the bones of the spine which is “cervical stenosis”: are all happily doing their things.

And I am still waiting for HIS phone call.

One phone call. It has been a week since last I heard that “someone will be calling you to schedule a date and time for this procedure.”  Did not happen! No phone call yesterday. Okay I thought it is a holiday.

So at 9:01 AM this morning I was on the phone. I left another message, feeling now that I almost  am having to beg to have this procedure done. Begging while praying all the time that Dr Swift’s support staff in his office start doing some supporting. I have a hard time with patience and tolerance when it comes to a job not being done with some sense of professionalism and with organized consistency. I am not the most patient person right now. I admit it. And usually this is not a big problem with me. I was surprised really when about just an hour and half later my phone call was returned.

Finally!

Another person’s whose name I never have heard before calls. Ellie tells me that they just received the pre-auth this morning.   Really?  was feeling just a bit cheeky now after all this absurdest nonsense just to get an appointment. I responded to her that I find it interesting that apparently one hand is not talking to the other in her office – because I was told the same thing a whole week earlier. She was quiet.  I was ticked.

I would much rather have someone tell me a mistake had been made than to act like I, or they, do not know what ANYONE is talking about. Pretending to be dumb when something goes awry must be being taught to the people in business school these days. While I was calling her out she started to back pedal, finally discovering that to tell me that the pre-auth just showed on her desk sounded plausible she stuck with that.

Yeah, that was the ticket. and in the mean time I tell her that…

I am still here waiting….

I agree with her that is likely what happened, and let the petty argument go. I, after all need these people to at leat not hate me, to not be annoyed with me when I come in for the RAF. I kind of would like the surgeon and his staff to have a favorable attitude towards me. I am thinking this would be a good idea. I can find a way to let  those who are in the know at said clinic  be aware of the circumstances that surrounded this fiasco on another date. For now I need to keep peace. After I have a brief and gentle blow out on Ellie’s dime I hear her tell me that she is going to give The Scheduler, another Elusive Scheduler, a note on her desk to expedite the scheduling process and to get me scheduled as soon as possible. I pray this is so.   I asked her what this meant for me?  This week?  Next week? Another three weeks?

I know….. I know…, rather cheeky. Maybe it was not necessary. I’ll never know.  I explained as best as I could ( without storming out loud to her  all that I was thinking to myself) that it had been an unbearable & unreasonable three weeks out the last two years that the pain and other symptoms like numbing hands and fingers had been going on. That my life is at a standstill it seems because there is so much I am unable to do. I tried as hard as I could to stay assertive and not become tearful. I told her just how frustrated I have been, and trying to get even further along with what I need to share, that if having to wait for another week I will then be at a breaking point and the clinic’s credibility with me is going down hill fast!

All the while….I am still waiting..

I believe Dr Swift has a right to know what has gone on in his office. Such like the issues I had when trying to get my first appointment. How can what they don’t know about get fixed?  I wonder though if this might be a sampling of why Dr Swift is picking up his lily pad and moving to another pond. I’ve heard from everyone I speak to about him that HE IS THE MAN! He is the man worth waiting for. So I am praying for more patience, ..ahem…. maybe I should be saying praying for patience.. any patience would do at this point….

While I am still obviously still waiting!

~

If you are interested in knowing  more:    

Main article: Radio frequency nerve lesioning      [ Resource: Wikipedia.org ]

RFA, or rhizotomy, is sometimes used to treat severe chronic pain in the lower (lumbar) back, cervical, (neck) and upper back, where radio frequency waves are used to produce heat on specifically identified nerves surrounding the facet joints on either side of the lumbar spine. By generating heat around the nerve, its ability to transmit pain signals to the brain is destroyed, thus ablating the nerve. The nerves to be ablated are identified through injections of local anesthesia (such as lidocaine) prior to the RFA procedure. If the local anesthesia injections provide temporary pain relief, then RFA is performed on the nerve(s) that responded well to the injections. RFA is a minimally invasive procedure which can usually be done in day-surgery clinics, where the patient is sent home shortly after completion of the procedure. The patient is awake during the procedure, so risks associated with general anesthesia are avoided. An intravenous line may be inserted so that mild sedatives can be administered. The major drawback for this procedure is that nerves regenerate over time, so the pain relief achieved lasts for only a short duration (6–24 months[12]) in most patients.

Still more information and details can also be found at:

http://en.wikipedia.org/wiki/Radihttp://en.wikipedia.org/wiki/Radiofrequency_ablationofrequency_ablation

Resource:

http://en.wikipedia.org/wiki/Radiofrequency_ablation

©tjhelser 2012

Six Word Saturday May 12, 2012

Wordle: fibro aware

Today I dedicate my Six Word Saturday to a cause that touches my world deeply. There is a lot to learn, to be learned, and answers  still to be sought out. The best thing we as laypersons can do to help is just keep the conversation going. Keeping the awareness alive and on the fore front of research monies being spent a cure will one day be a reality. Right now we don’t even have a definitive diagnostic test.

For more information and so you too can speak about this disease with some authority please go to:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001463/

Thank you so much for even coming this far!

 

©tjhelser 2012

Okay Chicken Little…Happy Palm Sunday To Us All!

Someday’s the sky may feel like it should be falling on you; yet you are able to raise your arms up-stretched enough to say, “Okay Chicken Little Get outta my way!”

And yet on those rarest of days when it seems like you are unable to stretch your arms to the heavens fast enough there is a special kind of magic that can happen as long as your eyes are cast above.

I wrote in a prior post that my typical attitude is not one where I tend to look only inward. That pity parties for one are not my norm. I’ve too much to be grateful for to have even the most discouraging thoughts or events derail me. I am blessed in ways that many are not even able to dream of.

It upsets and disgusts me to find that I alone let myself succumb to this self-pity. And please, please know I am only saying this out loud now as a way of an affirmation. Today is Palm Sunday and there is a reason for even this lesson on this Holy Day.  My prayer is that if should I see myself heading in this downward spiral I’ll stop, and let myself out of the pity party ride for one before I get so sucked into the force pulling out is harder than anything I’ve had to do.  Seeing myself now, pulling myself out again will not seem like too much effort. That is when I know I am in trouble. When the wallowing starts to feel good.

Blessedly I do not get to the wallowing poin as I headed to this weekend. As I said I do not often find myself struggling emotionally with myself. Never Spiritually. But this weekend as I began the pity party for one I was setting up for was starting to feel kind of good. The old woes me was looking kind of attractive against its alternative.  Attractive because in the state where I was headed it was just so much less effort than raising my arms, so much faster than looking for healthy gratifications (always was a kind of instant loving person when it comes to gratifications)and playing into the devil’s advocate if you will, is just so much less investment.

Yet with all the taking the easy ways out, the lazy way of doing things, and looking for the path of least resistant I found mysel withf my usual smile turned upside down. Isn’t something wrong with this image?

 And because I could so easily lie my finger point against a dozen or more aspects that created small hills in my life I made the clear choice to find myself feeling sorry for myself. It seemed the easiest amount of work and God knows I was certainly overworked this past week, right?

Finding the reasons why I was a but sullen this stormy wet weekend could have been all about finding blame and justifications somewhere else. Or many someone or some where else’s. Yet there is only one truth finder who I have to account to along sids my God….

 That would be moi!

It’s also very easy to fool some of the people… some of the time… and because it is imperative for myself and for my spirituality that I never try to fool myself. ( I’m not sure I can) I’ve actually never tried for very long before because I become quite anxious. And the anxiety always has to do with the lack of honesty from within myself. ‘

Trying to fool myself has never met with a good outcome. Even when it involves circumstances that I am not seeing clearly; whether it be beliefs, actions or events in life where the actual truth is yet hidden because of ignorance of mind or heart. Or because my body is revolting. It’s always another lesson to behold. Even though at times there is not one bit of conscious acknowledgement that the thing(s) amiss are things that can recognized, it’s apparent on every level that something is missing. And is So Wrong.

This was me this first weekend of April. It was my April Fools Day. Maybe because I was the one trying to be the fooled.

Never is it a good way to start a weekend, a month or even a goal, when one’s intent is to be self-centered. And that is where I was at. I’m admitting this because it’s important for lessons to be learned. It’s one thing to find a hurdle to have to jump, it’s quite another to be enjoying the hurdle that you’re unable to jump just for pity’s sake. And I am admitting to myself and out loud that come this Sunday morning I was digging my heels in where I would have been doing better by raising my own ankles off the ground.

Can’t say why but I need not have this answer. Just realizing that I was enjoying the pity party for one was a real shock. I am so not this person. It did not add to my pride in any way.  So why? Do I really need to expend all that energy into trying to analyze why? Or is it enough to Let Go, Let God?

I think it’s quite enough. That I recognized what I was doing, where I was letting myself go to is going to be enough. I am in no need of the “where of’s” or” why’s” as long as my intent is moving forward. To let myself stay in wallowing in the mud sling is not the intent of the Walk I choose to Walk. I could get all hung up in the semantics of the why…. skidding my wheels into other wheels…. I’ve done this, been there. Actually I have spent years spinning wheels into wheels and getting no where real fast.

This late Sunday evening is finding me content. The feelings of all those passing emotions I don’t always understand have found their place once again in God’s very Loving Hand’s. Whatever the reasons for my sense of vulnerability and mis-guided need for a pity party for one are back in the places they belong. On the book sheld where The Our Life Lessons belong, and only come down off the shelf for  moments during discovery of our ultimate destinations.

I’m grateful for this weekend’s lessons. I’m most satisfied tonight that in the end where I was going was never different from where I need to be. It just seemed so for a bit. There were moments this weekend when I just knew Chicken Little was running… running frightened at the prospects of what was falling from the sky.

And then there was the BIG Fantastic Moment of clarity – Of God’s Guiding light of clarity. The moment when I knew no fear. Knew that I was finding all that I needed once I stopped looking only inward. I knew that answers that leave me contented come from looking beyond myself.

I watched as my Sunday night swelled into evening prayer’s, crowned with God’s Goodness, and thrust back into the purity of Spirit & Contentment.

Thanks dear family,framily, friend’s & readers, thanks for bearing with my rambling struggles too.~

 I am reminded gracuiously that I am one Blessed Barefoot Baroness

©TJHELSER 2012

Concurrent Use Of Alcohol & Opiods Find

μ (Mu)-Opioid receptor. Based on OPM 2iql & 2i...

Concurrent Use of Alcohol and Sedatives Among Persons Prescribed Chronic Opioid Therapy: Prevalence and Risk Factors

,

,

,

,

,

,

Received 29 July 2011; received in revised form 14 November 2011; accepted 20 November 2011. published online 30 January 2012.

Abstract

Taking opioids with other central nervous system (CNS) depressants can increase risk of oversedation and respiratory depression. We used telephone survey and electronic health care data to assess the prevalence of, and risk factors for, concurrent use of alcohol and/or sedatives among 1,848 integrated care plan members who were prescribed chronic opioid therapy (COT) for chronic noncancer pain. Concurrent sedative use was defined by receiving sedatives for 45+ days of the 90 days preceding the interview; concurrent alcohol use was defined by consuming 2+ drinks within 2 hours of taking an opioid in the prior 2 weeks. Some analyses were stratified by substance use disorder (SUD) history (alcohol or drug). Among subjects with no SUD history, 29% concurrently used sedatives versus 39% of those with an SUD history. Rates of concurrent alcohol use were similar (12 to 13%) in the 2 substance use disorder strata. Predictors of concurrent sedative use included SUD history, female gender, depression, and taking opioids at higher doses and for more than 1 pain condition. Male gender was the only predictor of concurrent alcohol use. Concurrent use of CNS depressants was common among this sample of COT users regardless of substance use disorder status.

Perspective

Risks associated with concurrent use of CNS depressants are not restricted to COT users who abuse those substances. And, the increased risk of concurrently using CNS depressants is not restricted to opioid users with a prior SUD history. COT requires close monitoring, regardless of substance use disorder history.

Key words: Chronic opioid therapy, alcohol, sedatives, concurrent, substance use disorder