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Ambien should be replaced by talk therapy

Looking around the journals published so far in 2010, it’s clear the research community is finally beginning to challenge the assumption that America should be medicated. If you listen to the pharmaceutical industry and the doctors who are paid to stand up and promote drugs as the best treatment for any disorder, you will hear a consistent pattern of propaganda. All our products have the FDA seal of approval. The clinical trials show our products are safe and effective. The health insurance industry pays most of the price for our products (only a small co-payment element for you). Take our pills and get better. Indeed, when it comes to the top-selling sleeping pills, there are record numbers of prescriptions being written by doctors. The reason? Well, its not hard to suspect stress levels are increasing thanks to the recession. Unemployment is high. Credit levels have been reduced, There are foreclosures in every neighborhood. That’s bound to make sleep more difficult. What’s curious about the new records being set in the number of prescriptions is the additional financial burden this places on families when they can least afford it, and the implied assumption that sleeping pills can cure the underlying social and economic problems causing the stress.

The Journal of the American Medical Association reports talk therapy is more effective than sleeping pills. The research team gave the participants sleeping pills alongside therapy sessions and measured which had the better outcome. Because the talk asked why people were finding it difficult to sleep and discussed ways of resolving problems, people with the therapy sessions had better sleep than those on pills. This follows on research testing the effectiveness of cognitive behavioral therapy (CBT) which teaches people how to change their habit patterns to restore sleep. Therapists encourage people to avoid naps during the day, adopt a set routine for going to bed, and physically change the bedroom to minimize light and noise that might disturb sleep. When combined with techniques to address the cause of stress and relax, CBT has consistently been found to outperform sleeping pills.

When you look at the statistics, there can be little doubt we use too many sleeping pills. Add in the increasing use of online pharmacies which supply drugs without the need for a prescription, and the scale of reliance on sleeping pills is almost certainly worse than we imagine. Why should we care? Because all the sleeping pills on the market can cause dependence. As people continue to take them, tolerance builds and the pills actually become less effective. Increasing the dose confirms the dependence and can lead to unwanted side effects. Yes, ambien is one of the better pills and there are fewer problems with its use, but if your insomnia has been disrupting your life for six months or more, you should consider undergoing therapy first. CBT is clearly the best. To help you focus during this learning period, your doctor may offer the use of a sleeping pill. If you decide to accept, ambien is the best but you should only take it for a few weeks at low dose. The long-term restoration of sleep is going to come from the therapy. Although this is a short-term cost to meet, your life will improve with natural sleep and your finances will be better of without having to buy sleeping pills for the rest of your life.

Taking xanax reduces anxiety but does not cure the underlying cause

As is always the way when it comes to medical matters, the first step is diagnosis. The patient consults his or her regular doctor and, if a specialist’s opinion is required, there will be a referral to a psychologist. The patient is the primary source of information about symptoms – most of the symptoms will be obvious physical behavior including increased heart rate, faster breathing, sweating, etc. shaded by subjective factors offering an insight into what has triggered worries of this level of intensity. In deciding whether this is a true case of anxiety disorder, the anxiety must have become persistent and significantly affect the quality of life. A key factor is whether there is a genuine and continuing reason for the anxiety. If the anxiety is not completely rational, it will be considered a disorder. However, the diagnosis and subsequent decisions of treatment can be complicated if there are social or physical contributions to the anxiety state. If the person is going through a long-running divorce or finds the work environment stressful, it may be necessary to resolve those problems first. Only then can the doctor see whether the anxiety is sufficiently irrational to justify treatment as a disorder. Similarly, if there are serious health problems including alcoholism and substance abuse, it will be necessary to treat those conditions. It may well be that, as the health issues are resolved, the anxieties reduce. If the patient has been through previous treatment, it will be very important to review exactly what happened and, if possible, decide why that treatment was not successful. It would be a waste of everyone’s time to repeat what was done before. Then comes the decision on finding a balance between medication and psychotherapy. The pressure from the health insurance industry is to find the cheapest solution. Experience has shown the premium rates rising fast and, to maintain profitability as the number of people carrying insurance falls, treatment options costing the least are encouraged. Doctors, the clinics and hospitals are also coming under financial pressure. A lot of time and space is required to provide one-to-one psychotherapy. This forces the for-profit medical profession to prefer medication. Why is this a bad outcome? All the research shows therapy and counseling as significantly more effective than the use of drugs. Indeed, the only effect of a drug like xanax is to help the patient feel comfortably numb. Anti-anxiety drugs do not solve the underlying problems causing the anxiety. Their only purpose is to help keep the anxiety under control. But without the necessary therapy, patients have nowhere else to run and hide. They are effectively pushed down the route of dependence on drugs to live the rest of their lives with some peace. While this is great for the pharmaceutical industry because it now has millions of customers depending on its drugs, it is completely against the interests of the patients. They have the continuing cost of the drugs as a drain on the family budget, and the threat of withdrawal symptoms adding to their psychological difficulties if they attempt to stop. This is not to say that xanax is in any way a bad drug or that people should not take it. But it was only designed for short-term use. Potentially taking it for years is not in the patients’ interests.

More about pain management

Let’s assume we could talk the health insurance industry into paying for treatment focussed on the patient and not on the profitability of the hospitals and the pharmaceutical industry. What would a pain management department look like and how would it treat its patients? First off, it would concentrate all its energies on two quite different functions. Before you can identify the best treatment for a patient, you must diagnose the underlying cause of the pain. The most experienced diagnosticians in the hospital or clinic must therefore work on each patient, using whatever reasonable tests are necessary to reach a reliable diagnosis. The second function is to switch the emphasis on the types of treatment made available. At present, hospitals are run for profit and so base all their treatment decisions on what generates the most profit. In other countries, there is an evidence-based approach. Researchers identify which treatments are the most cost-effective for relieving the patient’s problem and only those treatments are used regardless of the level of profitability.

Once the hospital has a reliable diagnosis, it moves to the treatment phase. This may be an interventional procedure to repair damage or relieve the cause of pain. In the case of surgery, there are new less invasive methods. Where surgeons have the experience and the evidence shows good outcomes are likely, they should be used. If invasive procedures are not recommended or require follow-up, we move into the area of physical therapy, psychological counseling, cognitive behavioral therapy and general support services. Here the team aims to teach each patient how to cope with the new physical limitations and the reality of persistent pain. All the research both in the US and in the rest of the world shows these services are the most likely to improve the patient’s quality of life. pain management is as much about the patient’s attitude and emotions as it is about the treatment given. Then we get into all the alternative therapies. Again there is excellent research evidence showing that acupuncture and some homeopathic therapies produce excellent results. If there is such evidence available, the hospital or clinic should supply it. Finally, the doctors need to give detailed advice to patients about what drugs to use and when to use them.

In all this, the pain management department is aiming at a simple target. It wants the best long-term result for the patient without relying on the use of drugs. Although there will be some reliance on painkillers like tramadol during the early part of the treatment program, pain management assumes dependence on drugs is a bad thing. People should learn how to make the best of life without relying on pills. So you can buy tramadol online for use in the early stages but be prepared to learn how to management and control your pain without its help. In the long term, this saves you from the continuing cost of having to buy the drugs and it also makes you a stronger person. Ignoring all the stereotypes about the stoic people who live with pain, people with the strength of mind to manage their own feelings and emotions generally make better lives for themselves. People who see a pill bottle as the only solution are weak, passive and rarely make anything of their lives.