Warning About Using Narcotics to Treat Migraines

ByABC News
March 7, 2006, 3:28 PM

ANN ARBOR, Mich., March 7, 2006 — -- For six years Lori Messinger suffered crippling headaches.

"I was crawling out of my skin in pain," she said.

Increasingly heavier doses of narcotics -- powerful painkillers in the same class as morphine -- were prescribed. But she said the headaches just got worse.

"I had no life," said Messinger. "I couldn't be a mother to my three kids."

She would end up in the emergency room two to three times a week -- for even more narcotics.

"Not one shot of morphine but two shots of morphine," Messinger said, "and it didn't work. And he [the doctor] told my husband, 'I've given her enough to knock an elephant out.' That's what scared me."

Headache clinics across the country have seen a flood of patients with similar stories, headache sufferers who have grown dependent on narcotics like Demerol and codeine but are still in agony.

"We see how difficult they have become to treat," said Dr. Joel Saper of the Michigan Head Pain and Neurological Institute. "We see the disasters, we've seen the physical dependency, the desperation."

A recent survey of 30 managed care plans showed nearly 70 percent of prescriptions written for patients with headaches are for narcotics.

Specialists are now sounding the alarm. Narcotics, they said, are an unproven and risky treatment for headaches and should rarely be used.

Dr. Stephen Silberstein, president of the American Headache Society at Thomas Jefferson University Hospital in Philadelphia, said long-term use of narcotics can actually magnify headache pain and could render other treatments ineffective.

"Not only does it deplenish your own natural painkillers," he said, "but it destroys parts of the brain that are responsible for fighting pain."

Narcotics bring other risks. They can cause hormonal changes and intense physical dependency.

Still, many pain-management specialists insisted there were many headache patients who, if carefully selected, will do well on narcotics -- patients for whom no other drugs worked.

"If you end up with 20 or 30 people out of 100 benefiting when so many things haven't worked in the past, and the impact of this illness is so severe, why would you view that as a negative thing?" said Dr. Russell Portenoy of Beth Israel Medical Center in New York.

But headache experts believe the risks of narcotics are too great.

"We think we've just begun to see how big and how bad a problem this is," said Saper.

They said patients should exhaust all other options before turning to the drugs that are now the most prescribed for headaches.

ABC News' Barbara Pinto filed this report for "World News Tonight."

For more about migraines and promising treatment options, go to http://migraines.org.