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One thing we haven’t talked about so far and that is narcotics. And everybody who you talked to is going to have a different opinion about this. So there’s a disclaimer. This is one man’s opinion sitting in front of a camera talking about narcotics and back pain. There was an enthusiasm probably in the last 10 to 15 years for the use of narcotics in chronic low back pain. But let’s rewind it a little bit. Let’s start with acute low back pain. Yes. If the back pain is excruciating and you’re sitting there at your doc’s and you’ve had three days of it or four days of it or two weeks and it’s just excruciating, acute narcotics are very reasonable treatment in order to make life more tolerable. Just like if you’d had a broken arm, you don’t want to hurt. So for that acute low back pain without leg pain, acute low back pain with leg pain, narcotics are reasonable treatment. For chronic low back pain, the pendulum has really swung five years ago, seven years ago, 10 years ago, people were given narcotics. And it seems to take more and more to get less and less. In other words, it’s like having a key that fits one log, and that’s the way it is with narcotics today. And then tomorrow we need two keys because now we have two locks, and the next day we need four keys because now we have four locks that we have to do. And so this is the tolerance of narcotics. Not many medicines in our armamentarium are like this, but seemingly and sort of on a very simplistic basis as our body sees more narcotics, it makes more receptors, that needs more narcotics. And so that’s this ever increasing spiral.
