Is It Really A Migraine

Would it be surprising to know that, even though migraines are considered to be a very common disabling medical illness, it is still a disease

that people do not understand? As discussed by the American Migraine Foundation, “Misconceptions about migraine don’t just contribute to the

shortage of medical professionals focused on migraine, but also have a real, human cost.” (AMF). What many do not realize is that migraines are

more than just headaches or signs of stress, they are uncontrollable and cause serious pain to those affected by them. Many often find themselves

lacking support from family and friends, and receive no sympathy from employers and peers for not being able to perform work.

A person suffering from migraines is not canceling plans or reducing their work performance simply because they have something that can be treated by some Tylenol or because they are stressing about something. They are suffering from “dizziness, nausea, vomiting, skin sensitivity, the lights, the smell, the sounds, and the inability to concentrate or think straight.” (AMF).

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WHY MIGRAINES ARE SERIOUS

The first is that migraines, or headaches in general, and treating them are not taught in medical school. According to the American Headache

Society, “In general, less than a couple of hours for the four years of medical school are dedicated to headache medicine education.” (AHS). Despite headache disorders being very common among the American population, the fact that these disorders and how to treat them are seen as a trivial thing to teach students. There are many doctors in the field who do not know how to properly treat migraines and could be making the situation worse. Migraine symptoms are very different from headaches. Headaches are only a symptom of a migraine. If doctors are treating their patients as suffering from headaches rather than the disorder, it can result in incorrect medication being recommended. In an interview, Jason Ebersole; a community college teacher with 25 to 30 years in various medical fields, stated that headaches are “not a symptom of an underlying condition.” If doctors are unable to realize that their patient has a migraine and not just a headache, it can possibly lead to the patient taking the incorrect form of treatment, the second problem in dismissing migraines.

As mentioned above, the second major problem in dismissing migraines that people who have them could be taking the wrong kind of

medication. While this issue is somewhat mitigated by the fact that most people see professional medical workers before taking the medications, according to the Mayo Clinic,

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“Heavy advertising encourages the belief that a “sinus headache” is a common problem. Thus people with migraine may believe that their headaches result from sinus problems.” (Mayo Clinic).

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            Many advertisements will show people experiencing headaches that prevent them from enjoying various activities. These advertisements are very popular and will pop up when watching television, streaming apps, and all over the internet; playing catchy music and showing people having fun once they take the medication the advertisement is showing. The problem is that the medications are not intended for migraines. They are meant to treat sinus problems and the headaches that result from that condition. Research has found that 90% of people who have frequent headaches and are taking these medications have migraines, nothing related to sinus headaches.

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MIGRAINE MEDICATION: GOOD OR BAD?

             While taking medicine meant for sinus headaches has seen some comfort and relief for a few patients, they will not provide proper treatment and it is strongly recommended by the AMF to use medications specifically targeting migraines where and when possible. Current migraine treatment is designed to reduce the frequency of headaches, taking the correct medications allows patients to not worry about the symptoms being as painful and disabling as they could be without the medications. The sinus headache treatments will only offer temporary relief, but will not reduce the frequency of the headaches. This is why it is important to not trivialize and dismiss migraines. Just because it may appear to be just a headache, it can easily be signs of something much more disabling.

             Now that the issue of dismissing migraines as serious is clear, it is time to look closely at the medications intended for migraine treatments and the benefits and risks associated to them. Migraine medications are broken into two groups: pain-relieving and preventive. Which group of medication is usually determined by the frequency and severity of the headaches, potential nausea when the headaches occur, and other health conditions a person may have aside from migraines. Both groups have their own benefits to them, but share several risks between them. Before taking any of these medications, see a professional medical expert or an experienced neurologist, as they will be better qualified to diagnose a migraine and make sure that the correct type of treatment is being used.

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PAIN-RELIEVERS

             The first medicine group, or the pain-relieving options, are meant to be taken as soon as the signs and symptoms of a migraine begin to occur. These types of medicines are usually meant to relieve the pain and severity of the symptoms. This category can include, according to the Mayo Clinic pain relievers such as Advil, triptans, and anti-nausea drugs, the latter of which is usually taken with pain medications, in order to treat potential nausea and vomiting (Mayo Clinic). Side effects in this category can include nausea, medication-overuse headaches, and some such as Lasmiditan can have a sedative effect on the patient.

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PREVENTIVE

             The second group that may be prescribed to treat migraines are preventive medications. These are medications that are meant to lower the frequency of migraines. Doctors will usually prescribe them if the patient reports frequent headaches that either last a long time, or are severe in terms of pain. The medications in this group include antidepressants, blood pressure-luring medications, and Botox injections. (Mayo Clinic). Treatments such as these three are not only designed to ensure the frequency of migraines are lowered, how long the symptoms last, and how severe the migraines can be. Side effects that are associated with preventive medications can include nausea, dizziness, and weight change.

While these medications do not have the benefit of being a magic cure for migraines, they are still designed to combat and treat them. That is why it is important to make sure the patient is suffering from migraines. By taking the correct treatment and having the word of a professional medical person, the medications can help the patients make sure they are not disabled by the severe symptoms, and be able to enjoy time with family and friends; as well as not worry about their work experience, that they otherwise would not be able to. Even though there is no cure for migraines, these medications are a good step in the right direction. Now that the benefits of migraines are clear, it is time to look at the risks as well.

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THE HARSH TRUTH

             The harsh truth about medication of any kind is that too much of a good thing is a bad thing. The risks associated with migraine medication can still be serious if they are being used incorrectly. A major risk of migraine medication is known as medication-overuse headaches. According to the AMF, “Most OTC medicines are suspected of causing Medication Overuse Headache (MOH) if taken consistently for more than two days a week.” OTC medications, or over the counter, must be treated with caution and discussion with a doctor. While headaches are a sign of a migraine and are the most common complaints, a MOH will make the situation worse. A common mistake that people make is that they usually take two or more OTC or prescribed medications and may ingest more of the medications than they should be. This can not only lead to an MOH, which will make the migraine headaches much more severe, they can also result in overdoses. This is why it is important to have a doctor prescribe the drugs.

Say a person is looking to treat their frequent headaches, but does not go to a doctor or cannot afford to see one. They instead turn to OTC medication in order to solve the problem. Instead of having a prescribed amount to take, the person instead takes the medication until they feel the effects of their headaches begin to go away. While this is great for the person in the short run, in the long run it can cause numerous issues. Without a doctor to ensure that the person is taking the correct amount of medication, the person can induce an MOH, making their headaches much worse than they had initially intended and may cause an accidental overdose. This is not the only risk to using medication, however.

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THE OPIOD ELEPHENT

             It is now time to discuss a major elephant in the room regarding a risky medication. When a person decides to look at the list of pain-relieving medications, they may see a certain, dangerous type of drug, opioids. While opioids are listed as a type of medication, there is a reason why it is not prescribed in a vast majority of cases. Both Ebersole and the Mayo Clinic have stated that opioids can be used to treat migraines, but insist that it be used as a last resort. Ebersole states that, “Opioid medication should only be used if no other treatments are effective.” The Mayo Clinic doubles down on the statement, adding that “they can be highly addictive, these are usually used only if no other treatments are effective.” (Mayo Clinic). Unless specifically prescribed by a doctor; and only if tall medication treatment and medication have been ineffective and under strict medical supervision, do not take opioids. Even though they may provide relief against migraines, they are not worth the risk due to how dangerous they are.

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It cannot be stressed enough that opioids have become one of the most dangerous drugs, and for good reason.

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             They are mainly used to treat pain and, according to the World Health Organization, includes heroin, morphine, codeine, fentanyl, methadone, tramadol, and other similar substances.” (WHO). Opioids have become infamous for being a very addictive drug, making a person become dependent on them even if they are used for a short term, and can easily induce an overdose. These drugs alone are directly responsible for majority of overdose death in America alone. But why are opioids so dangerous and so addictive? It is due to how it affects the brain.

             The main reason why opioids are considered to be very dangerous is how it triggers certain reactions in the brain. By triggering what is known as endorphins; what allows a person to feel calm and can help in easing pain in the body, opioids essentially trigger pleasure in the brain. When the feeling subsides, the person affected by it will want to feel those endorphins again, and fall down the opioid trap.

The problem is that, after taking several doses, the body will stop producing endorphins. Once the endorphins stop, that “feeling good” feeling will also stop.

This is where the opioid trap begins to work its curse.

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             At this point, the person taking the opioids will enter what that Mayo Clinic calls, “tolerance.” When a person reaches a tolerant state, they begin to think that in order to keep feeling good and treat their pain, they need to increase the doses. This is the point where the opioid trap truly infects a person.

             Due to medical ethics and strong morals, doctors will make it difficult to either renew the prescription or increase the dose, often rightfully refusing to. However, this can result in a person further falling into the trap by turning to illegal sources. This is where the addictive nature of the opioids can turn a person who wanted to simply find relief from their headaches to potentially breaking the law just to feel the rush of endorphins. Sadly, this mistake on behalf of the infected person can and will be their last. A common, illegal drug that the infected person may find in their quest to find the endorphins is fentanyl. Fentanyl, according to the Mayo Clinic, is a very potent dose that can be laced with much more powerful opioids. The infected, having found their object that will allow them to feel the endorphins once more, does not hesitate to infect their body. Once they do, they feel the endorphins kick in, or feeling nothing at all as the overdose kicks in.

             What is it about opioids that can make overdoses much more common? It is usually how they are brought into the body. The most common way is that the infected person crushes the opioid into smaller pieces, usually to snort it or directly inject it into their body. Once they have done so, that is when the curse is complete and the infected person is gone, falling victim to the drug that will not allow them to live without it.

That is why opioids are so dangerous. Even if the intent is to provide relief from the migraine symptoms, it is so easy to fall under the curse. Addictions can leave a person feeling as though they must have it just to survive. If a person takes opioids without proper medical recommendation or supervision, it is not a question of “can this person avoid becoming addicted,” but “when will it happen?” That is why there are at least three, very important things to think about if a person is to be prescribed with opioids.

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WHAT IF OPIODS ARE PRESCRIBED

             The first thing is that all options have already been exhausted. Be absolutely certain that all treatments and medications have been unsuccessful in dealing with the migraine and only if the medical expert is certain that is the case.

             The second thing is that the prescription is for a very low dose. Most medical experts, if they need to prescribe opioids, will only do so for very low dose. This can help ensure that the more harmful effects of opioids are lessened, and the doctors can manage how much a person should take before the prescription becomes too dangerous.

             The third thing to think about is how strict the medical supervision must be. Be honest with the doctors and make sure to report any harmful side effect. Most medical experts will do everything they can to ensure that there really are no harmful effects from the opioids, but having a patient be honest and open can help in both the short term, and the long term. While opioids may help in relieving the pain, the risks and consequences of these drugs is too costly to consider for any doctor or patient and is not worth it in the end.

             The important message that can be taken away from this discussion is, and this can not be stressed enough, see a medical professional before taking medications of any kind. This will help make sure that the headache the patient is experiencing is actually a migraine and not another condition that the patient may have. It also allows the professional to prescribe appropriate medication meant to help the patient. Depending on how severe the migraines are and if the medications have any effect, the professional may change the prescription to something that may have a bigger impact. If the professional does have to prescribe the use of opioids, it will be under strict medical conditions that must be met, and allow the professional to personally monitor the health of the patient to ensure that there are no harmful effects from the opioids. Even though there are risks to using medications, the benefits behind them must not be ignored.

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IN CONCLUSION

             This is why it is also important to not casually dismiss migraines as just simple headaches. By dismissing the migraines, the person suffering from certain symptoms will not get the help they may need. Instead of visiting a doctor and taking the medication needed, the person may instead try to power through the migraine. Considering that migraines are usually considered to be a major disabling disease in the medical world, this can backfire on the person and make the situation worse than it may already be. The number of Americans who suffer from migraines is, according to the AMF, to be over 36 million Americans. This number should not be scoffed at for failing to power through a simple headache.

            Hopefully this discussion on migraines has caused people to reconsider how harsh migraines can be to those who suffer from them. It is not their fault if they are unable to make family events or need to take a day off of work. Hopefully this discussion has also influenced how people may feel about certain medications. While majority of the medications are safe to use, remember to make sure that you are taking them as the doctor requires you to, especially a certain dangerous one that can result in permanent and harsh consequences if you fail to do so. That is why is it so important to look at the seriousness behind a migraine. By looking at why it is so important, you may not only find it easier to deal with your migraine and trust in the medication, but you could literally save lives by doing so.