Knowing when a treatment is “risky”

Imagine this situation.

At a healthcare visit you received a prescription for a new medication. You talk with a friend, who says that you should worry about the long-term effects of this medicine. Then you hear of two people who took the medication. It helped one person, but the other person had to stop it because it did not help.

What should you do? Your healthcare provider prescribed the medicine because it is helpful for people with pain, but will the treatment help you?

This article gives you some things to consider when you weigh the risks and benefits of treatments for chronic pain.

Every medical treatment has potential risks

Pretty much every treatment has potential risks. Even aspirin, considered by most people to be a “harmless” drug, can be dangerous for some people.

The Food and Drug Administration (FDA) is responsible for approving new drugs. Part of that responsibility includes evaluating research studies to make sure that the medication is safe and effective for a certain condition. Not all of the side effects, especially long-term side effects, can possibly be known when the FDA approves the medication. On occasion, drugs that have been prescribed for a long time may be taken off of the market because of problems that are discovered years later, once many people have been exposed to them.

Medications are approved for a specific condition or a number of conditions, but they can be prescribed and used for other conditions as well, depending on your healthcare provider’s judgment. The information sheet that comes with your medication from your pharmacy lists the most common side effects and symptoms of serious complications that might occur.

Some other “non-medical” treatments, such as herbal preparations, are not required to go through the rigorous process that is required by the FDA for medications. Manufacturers may claim they are safe and effective without doing the research studies that medications do to prove they are as safe and effective as using other treatments.

You can’t always know how a medication will affect you before you try it. Sometimes, side-effects appear early, but then go away after a short period of time. Even when you are told that a drug has a two-fold risk for you (meaning you would be twice as likely as most people to experience the side effect) that doesn’t mean it will happen. It may mean that you are among the ten out of every 10,000 people with the side effect, instead of five out of every 10,000 people. You may or may not think this is a risk worth taking.

To have the information you need to make a decision about a new medication, ask your healthcare provider or pharmacist:

  • Were the treatment studies for this medication done on people with my medical condition?

  • Were these studies with many participants?

  •  Were any groups of people found to have higher risk due to their gender, age, race, or other medical conditions?

  • What are the most common side effects of this medication?

  • What are the known long-term risks of this medication?

Treatments should have benefits

You can assume that your healthcare provider would not prescribe a treatment for you unless there is an expectation of some benefit. Some treatments may not have large-scale studies that support them, but can still make you feel better. This is the case with many complementary treatments, such as music therapy or aromatherapy, which provide a sense of relaxation or well-being. Most treatments prescribed for pain are meant to reduce your type of pain, and to increase your functioning and quality of life.

Weighing risks and benefits

Weighing the risks and benefits can be easy when a treatment is needed to stay alive or lengthen your life. With medical conditions like chronic pain, sometimes the choices are less clear. Factors affecting your decision may be:

  • Expected benefits and risks

    A treatment such as a pain medicine may reduce your pain and help you walk farther, but it may also make you too sleepy to do most things. Your healthcare provider can tell you whether this side effect usually gets better over time. Ask your healthcare about the risks specific for you. Do you have a condition that raises your risk for certain treatments? What are they?

  • Other options

    Ask your healthcare provider about all the choices available to you. Also ask what happens if you do nothing.
  • Your personal values and preferences

    You may have no problems taking medications by mouth, or you may “hate taking pills.” Perhaps you prefer non-medication treatments, such as acupuncture, and want to try that first.

  • The time and expense compared to the benefit

    You may want to try a treatment, but the time and expense are big factors for you. For example, you may decide to try self-management strategies for sleep disturbance before you take a medication or seek an evaluation in a sleep lab.

Weighing the risks and benefits of treatments can be tricky. Get as much information as possible. Think through your options thoroughly. Don’t be afraid to ask questions. When you and your healthcare provider talk about the risks and benefits of your treatments, you will both feel more comfortable with your decision.

References

National Institute of Neurological Disorders and Stroke. (2008). Pain: hope through research. Retrieved June 19, 2008 from http://www.ninds.nih.gov