Can you get off your pain control medications?

If you have been on long-term pain medications you may have come to the conclusion that getting off them is not as option. As a continuation from previous articles in this series on holistic alternatives to prescription medicines, let’s look at ways to get off prescription drugs used for pain control. Regarding infections, it is important to know when you can safely deviate from using a prescription antimicrobial and when you should not.


Pain is normal after injury or surgery. It is also an indicator of a persistent underlying disease condition. But when pain becomes chronic it becomes another discussion entirely.

Let’s take for example, the most common chronic pains in American adults: low back pain, headache/migraine pain, neck pain, knee pain, or other musculoskeletal pains. In 2011 estimates were that nearly 100 million American adults suffer with a chronic pain condition, costing society approximately $600 Billion annually. [1] As you know, the easiest way out of chronic pain is to take a strong pain reliever. But that is not the only way; and it leads down a rocky road.

I have some insight into pain. I suffered abdominal pains for many years before I finally decided to complain, which led me to the diagnosis of ulcerative colitis at age 12. Years later, pains returned (during the stresses of medical school and residency training) and eventually I underwent a major two-stage surgery at the age of 33. Although I was back to work (early) at three weeks post-op, it took nearly six weeks to get off the narcotic analgesics and six months for 95 percent of my physical pain to subside. In two years I was completely pain-free.

Currently I experience chronic low back pain, but I would much rather do all possible to reduce strain, improve healing, consume nutrient-rich food and lower stress than to become dependent on a strong pain reliever pill. I recently purchased a hand-held percussion-action massager by Homedics which works amazingly well for me.

Musculoskeletal pains are created from your daily actions, positioning, diet (yes diet!), thoughts and feelings. While everyone’s chronic pain experience is unique, it is important to recognize that once you’ve addressed the physical causes, then you must also address emotional and/or psychological contributors to chronic pain. This does not to mean it’s “all in your head.” Rather, I am referring to the nervous system involvement of your chronic pain experience. Let me give you some case studies to illustrate.

I think of my aging mother who suffered mid-back pain for many years as a result of osteoporosis and resulting spinal fractures. The pain led her to surgery, and soon after a slow but steady recovery. Her pain gradually reduced as she visited the gym and focused on her healing. She stays active mentally and physically with minimal use of pain relievers intermittently.

In contrast, this week I met a much younger patient in clinic on huge daily doses of narcotics (over 420 mg per day of oral morphine equivalent) for his intense pain of 30 years that he claimed was a result of a leg injury and surgery. He even had a large scar to “prove it.” Any suggestions of healing his pain condition in order to wean down his narcotics triggered a long monologue of reasons why this would be impossible for him.

It is understandable that he has real pain, but he has become caught in a viscous cycle in which the drug increases his sensitivity to pain. Therefore, it is now mostly a psychiatric condition with only a small residual musculoskeletal component. Clearly his dysfunctional thoughts and feelings have greatly contributed to his pain experience and his perceived need for higher and higher doses to “get out of pain.”

The statistic that 77 percent of chronic pain sufferers report feeling depressed [2] to me means these people are not receiving (or choosing) the mental, social and emotional support they need to heal. My personal view is that chronic pain offers each of us an opportunity to learn something about ourselves (will we give up or will we pursue healing) and others (i.e. compassion).


Infections are greatly minimized when your immune system is strong. The following are most useful to maintain a strong immune system: nutrient-rich food consumption, consistent exercise, peaceful and positive emotions, and minimal allergies (a sign of underlying inflammation). It is true that infections from viruses, bacteria, fungi and parasites resolve most effectively with the use of a prescription drug. If you are one who hates to use prescription drugs for infections, then it is important for you to know when to avoid them and when not to. Your body will spontaneously heal most all viral infections, many bacterial infections, and some fungal infections. Let’s consider these individually. I’ll leave parasitic infections out of the discussion.

Viruses causing upper respiratory infections, pharyngitis, gastroenteritis, chronic skin conditions (e.g. warts), and even influenza are almost always self-limiting and only require supportive care such as rest, fluids and symptom control. Chronic viral infections are a different story, however. These include human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and sometimes Epstein-Barr virus (EBV), herpes simplex virus (HSV-2), and cytomegalovirus (CMV) are worth using prescription drugs.

The key with bacterial infections is to know what type of infection you have and what symptoms indicate that it is progressing out of control. You don’t want to mess with using natural treatments for bacterial infections of internal organs such as your brain/spinal cord (meningitis), heart (endocarditis), lungs (lobar pneumonia), abdomen (ruptured appendix, pseudomembranous enterocolitis), kidneys (pyelonephritis), or deep extremity tissues (necrotizing fasciitis, septic joint, osteomyelitis) because they all have quite a high incidence of death or loss of limb if left untreated. However, you can use supportive measures (e.g. topical heat, ozone, silver solutions and rest) for certain bacterial infections such as those of the as middle ear (otitis media), throat (pharyngitis), and skin (self-limiting cellulitis, small abscesses).

Fungal infections can also be inhibited by a healthy immune system. However, don’t be afraid to use safe anti-fungal creams or fluconazole while you eliminate sugar (called the yeast diet), eliminate antibiotic use (which allow competitive yeast to flourish), and go on a liquid cleanse (this fights infection quite amazingly).

In these articles I’ve looked at ways to get off prescription drugs used for diabetes mellitus, heart disease reduction drugs (cholesterol and blood pressure), stomach acid disorders, asthma and COPD, depression, anxiety, psychoses, chronic pain, and infections. In my final December article I’ll share with you my ideas for a model integrative medicine practice here in San Diego, CA. I have hopes that your feedback and suggestions will assist me to prepare the kind of services that you and others like you would benefit from most.

To healing without prescription drugs whenever possible,

Michael Cutler, M.D.
Easy Health Options

Other articles in this series are:
Getting off prescription drugs
Holistic alternatives to prescription drugs
Treating depression, anxiety and the pychoses holistically

[1] Institute of Medicine of the National Academies Report. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, 2011. The National Academies Press, Washington DC. ((page 5)

[2] 2006 Voices of Chronic Pain Survey. (American Pain Foundation). Accessed online 12/11/2014 here:


Dr. Michael Cutler

By Dr. Michael Cutler

Dr. Michael Cutler is a graduate of Tulane University School of Medicine and is a board-certified family physician with more than 20 years of experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder of the original Easy Health Options™ newsletter — an advisory on natural healing therapies and nutrients. His current practice is San Diego Integrative Medicine, near San Diego, California.