Neurologists Say Opioids Not Optimal for Most Chronic Pain
According to new scientific research, if you take opioids for chronic pain unrelated to cancer (e.g. low back pain, migraines) the risk of addiction, side effects and/or overdosing outweigh the benefits.
In September, a physician’s group revealed their findings, showcasing that using opioids in the long-term might not be that beneficial. This discovery has changed the American Academy of Neurologist’s opinion on opioids, calling for closer tracking and looking into alternative approaches.
The group pointed out that even in cases where opioids were benefiting patients, doctors need to do better at watching dosages. They also need to be screening for substance abuse, depression, and general misuse of this powerful narcotic. This isn’t the first time such a discovery has been made, but it has renewed the push for more restraint when it comes to prescribing opioids.
While not the first group to argue this point, it is the first time guidelines based on research have been put on the table. The researchers lay out in a clear guide who might benefit the most (and least) from long-term opioid use and exactly what a physician should do when tracking these prescriptions. If adopted, new tactics for managing codeine, methadone, hydrocodone, morphine and oxycodone may follow.
The official position of the American Academy of Neurology also encourages doctors to work closely with officials to shift outdated policies from the 1990s which made it fairly common to prescribe opioid-based pain medicines.
The research suggests adding stronger monitoring programs which will include a virtual database so doctors can instantly see what drugs a patient has been prescribed in the past. It’s noted that such systems are “currently underfunded, underutilized and not interoperable across state lines or healthcare systems.”
High Tolerance, High Risks?
Just like any drug, a person’s tolerance goes up the more they use it. This means they’ll need higher and higher doses to get the same painkilling result. This leads to misuse, abuse and a higher chance of overdosing.
Those most vulnerable to overdosing are aged 35 to 54, and opioids now kill more people than vehicle crashes and firearms in this age group. Addiction to painkillers has killed over 100,000 people in the past 10 years.
In the published study, other research is cited that indicates people who take opioids for a minimum of three months (as a temporary prescription) continue to do so for at least five years. During this time, most of the prescription increase in strength and yet the results remain the same in the patient.
Moves to Make
Along with better screening, it’s recommended that doctors draft “opioid treatment agreements” with their patients which outlines the roles of the patient and doctor. Whenever a dosage increase is on the table, the patient’s function level should also be noted. If the opioids aren’t working, perhaps a pain specialist is a better answer than higher doses.
The ultimate goal is pain management without such narcotics for long-term care—especially considering the findings from this most recent study.