At addiction treatment centers across the nation, more and more individuals are being seen for opioid addiction. Opioids are pain medications including morphine, codeine, oxycodone, methadone, fentanyl or hydrocodone. These pain-killing drugs are addictive and even when prescribed correctly, can be dangerous. It is recommended that opioid therapy should be used only as part of a multimodal approach for specific severe pain management and not prescribed for chronic conditions such as headaches, back pain, or fibromyalgia. According to a position paper published in Neurology, the medical journal of the American Academy of Neurology (AAN), “serious side effects with prescription opioids outweigh the benefits in chronic, non-cancer conditions.”
Dr. Gary Franklin responded when the Patient Safety Subcommittee requested a review of the science and policy issues regarding the growing public health epidemic of prescription opioid-related overdose and deaths in the United States. The review of previous studies showed that while opioids may provide short-term pain relief, there is no substantial evidence that their use maintains better function or pain relief over extended periods. Furthermore, study data indicates that “50 percent of patients taking opioids for at least three months continue use and are still on pain medication five years later.” Extended use increases the serious risk of overdose, dependence or addiction, but does not improve pain relief.
Dr. Franklin, MD, MPH, research professor in the Department of Environmental & Occupational Health Sciences in the University Of Washington School Of Public Health in Seattle and a fellow with the AAN, said in a press release:
“More than 100,000 people have died from prescription opioid use since policies changed in the late 1990s to allow much more liberal long-term use. There have been more deaths from prescription opioids in the most vulnerable young to middle-aged groups than from firearms and car accidents. Doctors, states, institutions and patients need to work together to stop this epidemic. More research and information regarding opioid effectiveness and management is needed, along with changes in state and federal laws and policy to ensure that patients are safer when prescribed these drugs.”
A recent study in a large health maintenance organization was the first to report a relationship between prescribed opioid dose and overdose, “with a nine fold increased risk of overdose at doses exceeding 100 mg/d MED compared to doses below 20 mg/d MED in patients with chronic pain.” Another large cohort study has found “the majority of opioid overdose deaths occur in the home, and few appear to be intentional.”
There are very effective therapies for pain relief without the use of high-risk drugs. Cognitive–behavioral therapy, acupuncture, structured exercise, spinal manipulation, and mindful meditation have all proven to be moderately effective in treating chronic low back pain, as an example. Not all treatments are effective for everyone, but they are inexpensive, non-addictive and certainly worth a try on their own or in combination.
There is effective treatment both for pain syndromes and for opioid abuse. Please see a health care professional to discuss your options before you or someone you love becomes an overdose statistic.