Opiates for Fibromyalgia and Chronic Fatigue Syndrome

    What You Need to Know About Narcotics

    Fibromyalgia (FMS) and chronic fatigue syndrome (ME/CFS) have a huge number of symptoms. Pain is one of them, and very often patients need to take a variety of drugs to treat these conditions. All medications can’t be completely safe for a patient’s health, especially if you combine several of them. Therefore, it is worth getting more information about your medication.

    Doctors often prescribe opiate drugs to treat chronic pain. Opioids work by imitating a natural pain-relieving chemical – an opioid peptide, which our bodies produce naturally. Opiate drugs, similar to these natural chemicals, affect some receptors in the brain and spinal cord and relieve pain.

    Common Opiates

    Several opiates have been on the market for a long time, are generally inexpensive, and are available in generic form. Common opiates include:

    The most common opiates are relatively cheap and have been available for consumer for a long time. They include:

    • Tramadol
    • Codeine
    • Fentanyl
    • Hydromorphone
    • Morphine
    • Oxycodone
    • Hydrocodone
    • Oxymorphone

    In addition, some prescribed opiate medications may contain acetaminophen, for example, Tylenol. Other over-the-counter drugs that contain acetaminophen include:

    • Percocet (oxycodone/acetaminophen)
    • Ultracet (tramadol/acetaminophen)
    • Vicodin (hydrocodone/acetaminophen)

    If you have to take a combination drug, make sure you are aware about the risks of both constituents.

    The Effectiveness of Opiates

    Medics generally do not consider opiates to be very effective in managing FMS pain. Studies usually support that, but however opiates are still used for the treatment of FMS pain.

    There is no research on opiates about ME/CFS pain. Nevertheless, this disease has two types of pain: hyperalgesia (pain amplification) and allodynia (pain from normally non-painful stimuli). These two pain types also relate to FMS and here we can see some evidences.

    For instance, a 2014 study (Gaskell) didn’t find any published, high-quality trials of oxycodone for fibromyalgia or non-diabetic neuropathic pain. A 2015 study (Peng) examined how long-term opioid treatment in FMS patients affected them. This study concluded patients who were taking other drugs could see improvement in symptoms compared to those who were taking opiate medications.

    A Canadian study (Fitzcharles) states:

    We have no evidence that [opioids] improved status beyond standard care and [they] may even have contributed to a less favorable outcome.

    However, the situation is reverse, when you talk to people who use opiates to treat these diseases. Many patients complain that their pain is so severe that they can’t live without taking opioids. A lot of doctors do prescribe them. Another study that have been conducted for 11 years and ended in 2010 stated that opiate rate had grown up from 40% to 46%.

    So why does research show that opiate drugs are not very effective, while doctors continue to prescribe them anyway? It is hard to say why exactly, but there are two possible answers: the placebo effect and overlapping pain conditions. The placebo effect is a proved well-known phenomenon when people believe that a medication there are taking will help them although it is not intended to be used in their condition. Overlapping pain conditions mean that very often patients with FMS have many other diseases, and when they take opiates it helps them to control pain from something else, but not necessarily FMS pain.

    In spite of the fact that opiates help many patients to control their pain symptoms, medical community does not approve them for FMS and ME/CFS treatment. Besides, the regulations about opiate use continue to increase which provoked indignation among patients.

    Risks of Taking Opiates: Dependence, Overdose, Victimization

    Addiction to Opiates

    Opiates are narcotic drugs and may cause dependence. Media and law enforcement were particularly interested in this issue, which made many people worry about opiates. But, some researches demonstrate that the risk for dependence is not that high as it was thought. The risk is higher in patients who were previously addicted to other drugs though.

    Overdose of Opiates

    Overdose can be lethal. Sometimes it can happen when a person takes extra dose because the first one didn’t relieve the pain sufficiently. People who have been diagnosed with cognitive dysfunction (fibro fog) associated with FMS and ME/CFS may also have some difficulties with keeping the track when they took the medication and may influence on taking another dose sooner than needed.

    Moreover, drug tolerance may also contribute to the overdose of opiates. Very often, when people tale opiates on a regular basis for a long time they start developing a tolerance. When it happens, the opiates can become less effective than they were in the beginning. Your doctor may gradually increase your dosage. But, you should remember to take opiates only as directed without changing your dose on your own. Your body is not able to manage high doses of opiates.

    Symptoms of opiate overdose may include:

    • Dizziness
    • Black out
    • Nausea
    • Vomiting
    • Decreased heart rate
    • Breathing issues
    • Cold and damp skin
    • Muscle spasms

    Seek medical help immediately if you have the symptoms of opiate overdose.

    Also, it is possible that over time opiates may intensify pain. This effect is known as opioid-induced hyperalgesia. Some studies have shown that opioid drugs can lead to an increased sensitivity of some types of pain.


    It is not a good idea to disclosure the fact that you take opioids to a lot of people because you may be at risk for victimization. Pay attention to that and try to protect yourself.

    Opiate Side Effects & Interactions

    Opiates, as any other medications, may cause side effects. Common opiate side effects include:

    • Nausea and/or vomiting
    • Incresed fatigue and sleepiness
    • Dry mouth
    • Dizziness upon standing (due to drops in blood pressure)
    • Problems urinating
    • Constipation

    Look for possible side effects, as well, as for interactions before taking the drug. Side effects may vary depending on a manufacturer. You can always learn more about your particular drug at your pharmacy or on manufacturer’s website.

    Using opiates together with some other types of drugs can lead to very bad side effects, including death. Opiate drugs interactions include:

    Don’t forget to inform your doctor about all the drugs you take, including over-the-counter medications. Your doctor will pick the best option for your particular case.

    How to Reduce the Risk?

    To reduce the risk you should only take your opiates as directed; carefully follow the instructions and recommendations given by your doctor. If you combine drugs, ensure that they are safe if taken together.

    You can use your phone to help you to keep a track of the drugs you take. It can facilitate taking drugs on time and lower the risk of overdose. You can also consider asking a family member or friend to help your monitor your medications.


    How to cure toe fungus quickly and easily

    Toe fungus or blackened toes can be painful and very unappealing.  The cause of this condition can be a number of things like crushing a toe or dropping a heavy object on it.  Foot fungus normally starts with a black line on the nail and can spread throughout the nail plate.  The nail plate is the surface under the toe.  Fungus under the nail is nothing but blood that has been trapped, therefore, causing a fungus due to coagulation or old, spoiled blood.


    There are oral remedies like Lamisil and Diflucan that can clear up this condition, but with the economy being so bad, doctor visits can be unaffordable.  In addition, the prescription may take a long time to work.   Oral remedies have also been known to cause liver, kidney, and gastrointestinal problems.

    In order to cure toe fungus topically, the remedy must penetrate the toe nail.  There are very few remedies that can do so without putting a hole in the nail with a sterilized needle.  Yet, if one is squeamish, poking a whole in the nail may take some doing.  Even though this may be helpful it is not necessary.  Iodine can penetrate the nail due to its properties.  The molecules of iodine are so small that is can slide under the nail without losing its consistency, get directly to the fungus, and eventually kill it.  This is not an overnight remedy, patience is needed.    Most people think of iodine as a red liquid, but there is clear iodine too.

    In most cases, iodine can be found at Rite Aid or similar stores.  It comes in a small brown bottle and even comes with an eyedropper, making application cleaner and easier.  It should be applied to the infected and uninfected toes every four hours.  As the toes begin to lighten, application times can be spread farther apart.  When the fungus is being released from the toe, there will be black specs or gook in the creases of the nail. That is the fungus coming out.  If the toe must be covered with a shoe, use a band aid to keep the iodine close to the skin.  Every few days, the toes can be wiped with a cotton ball apple cider vinegar, which will also aid with the fungus.

    Tea tree oil

    Another remedy is tea tree oil.  The use of tea tree oil on nail fungus has been so astounding that doctors recommend it over medications.  The microbial properties of this natural remedy allow it to penetrate the nail plate, like iodine.  The only difference is that tea tree oil can be a little bit more pricy than iodine and will need to be aided with tea tree soap or shampoo.  It may be a tedious process; therefore, the patient must be adamant about getting results.

    The application process of tea tree oil is the same as iodine, place on infected uninfected toes, but the foot has to be washed with tea tree soap a few times a day.  Although this remedy is majorly effective, it may be a problem for someone on the go.  In either process, clean towels must be used to wipe the toes.  The patient may even want to cut the toenails to make nail penetration easier.

    In short, these remedies have been known to work great.  There are numerous websites online that share the same enthusiasm.  Whether you have been fighting nail fungus for a few months or ten years, these remedies will make a difference, in a pleasant and timely manner.

    Woman using laptop

    iPledge for Isotretinoin Users: What Should You Know About This Program?

    iPledge is a computer-based program, where any patient in the United States, regardless of gender or age, should register before using Accutane or any other medication containing isotretinoin. The program was designed for both patients and medical workers, and its main goal is to prevent women from getting pregnant while taking isotretinoin.

    Isotretinoin and Pregnancy

    Isotretinoin comes with a range of serious side effects, including severe and even life-threatening birth defects, as well as the risk of miscarriage and premature birth.

    The use of this anti-acne medication during pregnancy may result in abnormalities of the face, eyes, ears, skull, central nervous system, cardiovascular system, and thymus and parathyroid glands of the baby.

    It is important to keep in mind that even a single dose of isotretinoin can be extremely dangerous for an unborn child and cause unpreventable harm.

    Isotretinoin and iPledge Program

    The iPledge program is a product of the U.S. Food and Drug Administration (FDA) created to avoid the risks of potential birth defects and other pregnancy-related adverse reactions of isotretinoin drugs by reducing the chance of fetal exposure to the medicine. This is done through a special system of checks and balances.

    Registration in the iPledge program is obligatory for everyone using isotretinoin, no matter what their age or gender is. The same applies to doctors prescribing the medication, as well as pharmacies dispensing it.

    Before prescribing you isotretinoin, your dermatologist must give you the full information about the use, the risks and potential side effects of the drug. Besides, you will receive all the instructions regarding the iPledge program. Before receiving the prescription, you have to make sure you understand and agree to all terms of the program.

    iPledge Qualification Requirements

    Getting informed about isotretinoin and all the possible side effects it may cause is the first step of the iPledge program. In order to be able to receive the medication, you will have to meet certain requirements for iPledge program qualification. These requirements include using two methods of contraception or restraining from sexual activity during the treatment course, visiting a doctor once a month, submitting to regular blood tests as needed, and, for women of childbearing potential, having negative pregnancy tests each month.

    As soon as you are enrolled in the program, you will receive an iPledge ID card. The identification number provided in the card is needed each time you get the medication from the dispensary.

    Isotretinoin is normally given in doses enough to last only one month. You will have to meet certain criteria each month later on, in order to get your refill. You will also have monthly appointments with your doctor, where your information will be entered into the iPledge system and your negative pregnancy test will be verified.

    Before dispensing isotretinoin, your pharmacist is also obliged to verify that you meet all the criteria. This is done via the iPledge system website or over the phone. The pharmacist can only give you the medication once he obtains authorization.

    Besides, according to the iPledge, your prescription can be picked up with a certain time frame. Women of childbearing potential missing the pick-up deadline have to go through the monthly qualification procedure once again.

    iPledge Criticism

    The iPledge program has already been criticised by some patients and doctors considering the program and its qualification requirements too cumbersome and difficult to adhere. Besides, there are patients viewing the monthly pregnancy test requirement as a potential disruption of their privacy.

    Moreover, some patient privacy concerns have also taken place due to the fact it is still quite unclear how exactly patient data is stored in the iPledge database.

    To sum up, although there are certain concerns and criticism regarding the iPledge program, the rules remain the same: anyone taking isotretinoin is required to register and submit to this monitoring. Besides, the program has actually shown to be effective in preventing birth defects and other serious side effects caused by isotretinoin.

    Woman using asthma inhaler

    Asthma Inhalers: Are There Any Generic Alternatives?

    Unfortunately, there is only one generic alternative available on the market.

    Today’s market offers only one generic asthma inhaler known as Xopenex HFA Generic. This is a rescue inhaler which is used only during an asthma attack. Generic Xopenex provides the same level of effectiveness as its non-generic version, but is available at a lower cost. The active ingredient of this inhaler is a generic form of levoalbuterol, the same as in non-generic Xopenex. Levoalbuterol is a good substitute of albuterol for those who are sensitive to the latter and experience an increased heart rate or shakiness after the intake.

    In case you prefer using a non-generic inhaler, your prescription should be given specifically for the non-generic one. This is to ensure your insurance covers the cost, as some of them may default to the generic formula.

    Which Non-Generic Inhalers Are Available?

    There are two categories of asthma inhalers: rescue inhalers that are used during an asthma attack and controller inhalers used on a daily basis to manage asthma symptoms.

    As mentioned earlier, Xopenex HFA Generic, containing levoalbuterol, is the only generic rescue inhaler available today. Most generic albuterol inhalers have been withdrawn from the market, since the switch from CFC-based propellant inhalers to HFA-propelled ones. Nowadays, albuterol can only be found in various brand name inhalers, such as Proventil, ProAir, and Ventolin.

    When it comes to controller inhalers, these are only available in brand name form. The market can offer such brand name inhaled steroids as Flovent, Asmanex, QVAR, Alvesco, and Pulmicort. Besides, there are inhalers combining inhaled steroids and long-acting bronchodilators, which are available in brand name versions including Advair, Symbicort and Dulera.

    Asthma can also be managed with a help of such devices as nebulizers. These are used for both rescue and controller therapies and can be found in generic forms. Albuterol nebulizer, for instance, is only available as a generic formula

    Pulmicort Respules, an inhaled steroid that is used as a controller therapy for asthma treatment, can be found in the generic form. Its active ingredient budesonide is available as a generic nebulizer solution.

    Getting Your Inhaler at an Affordable Price

    In fact, brand name asthma inhalers might be quite expensive. However, there are several ways to get your prescription at a more affordable cost. First, you can ask your doctor if they can offer you any samples or discount coupons. Another option is to consult your insurance company and see what the prices of other medications are. In case your insurance can cover the cost of a certain medication, ask your doctor if your prescription can be changed to that. Finally, you can visit the manufacturer’s website and check if they offer any savings plans or discounts for patients who cannot afford the medication.


    What Really Causes Acne: 6 Common Myths

    Such a skin disorder as acne can be a huge problem for many people, especially teenagers. However, acne is not limited just to those going through their puberty period. Many adults, children, and even babies can be prone to acne as well.

    Simply put, acne is a disorder of the hair follicle when oil and dead skin cells become trapped within the pore. The condition is characterized by the presence of pimples, blackheads or whiteheads spread over the face, neck, chest, back, and upper arms.

    Since there is no precise cause of the disease, there are numerous misconceptions regarding acne causes and development. A lot of things we believe to cause acne are actually myths. We have gathered the most common of them illustrating what’s true and what’s not to help you understand acne better.

    Myth #1: Not cleansing your skin causes acne.

    Lack of hygiene does not cause acne. As mentioned earlier, acne is the hair follicle disorder resulting from the combination of several factors, such as excess oil, dead skin cells, abnormal shedding of the skin, and certain bacteria.

    And since acne is not caused by lack of cleansing, you cannot cure it by frequent cleansing, either.

    Myth #2: Chocolate, pizza, and French fries can cause acne.

    There is no evidence for the relation between acne and diet. Eating chocolate, pizza, or French fries, even if it is unhealthy, will not cause it.

    In fact, acne breakouts are rather influenced by bacteria, than food. Propionibacteria acnes (P. acnes) are the bacteria responsible for inflamed acne breakouts. When the number of bacteria in the follicles grows out of control, it results in redness, inflammation and the formation of pus.

    Myth #3: Blackheads are the result of dirt trapped in the pore.

    This is a common mistake: the black top of a blackhead is not dirt.

    A blackhead, a more common name for an open comedo, is an accretion of dead skin cells and sebum forming a plug in the pore. The top of this comedo is not covered by the layer of dead skin cells. When exposed to the air, this oil impaction changes color to dark brown or black, due to a chemical reaction.

    Therefore, you cannot wash blackheads away. However, using some over-the-counter products with salicylic acid, or prescription medications like topical retinoid may help to remove them, and prevent them from forming, too. In addition to that, blackheads can also be safely extracted during facials.

    Accutane, a decent representative of the category, is a highly effective anti-acne agent used in serious and moderate forms of acne. The drug comes in the form of capsules, it’s a non-invasive treatment option that can be used as an alternative in those cases where other meds are useless.

    Myth #4: Masturbation or having sex cause acne.

    This hypothesis is rather one of the tricks parents would use to prevent their youngsters from having sexual relationships.

    In fact, acne development has nothing to do with your sexual activity. It’s worth mentioning that having sex will not cure your acne either.

    Myth #5: You cause acne by touching your face.

    You might have heard this many times, but it is actually a myth. Touching your face with hands might be unhygienic since your fingers are not likely to be super clean all the time. However, this will not cause acne development.

    Hormones, excess dead skin cells, bacteria in the pores are the ones to blame. And even if you stop touching your face forever, you will still break out in pimples if you are prone to acne.

    Myth #6: Acne is contagious.

    As mentioned several times before, there are certain factors “required” for acne development: retaining of dead skin cells within the pore, excess oil and acne-causing bacteria. None of these can be caught from someone else.

    Therefore, you will definitely not get acne by shaking hands, touching or kissing someone with acne.