There is a huge discussion ongoing in healthcare today on the use of opioids in treating chronic condition, specifically non-cancerous chronic pain. There are several groups who have come out in favor of utilizing opioids less because they come with a high risk and little reward. By little reward I mean they do not treat anything, only mask the pain and create a potential for the patient to become dependent on them to function daily. Clinicians should never treat the pain but what is causing the pain. Sometimes that is difficult to do but do it we must the alternative is to keep a patient dependent on a medication which has serious negative side effects. Case in point, this recent study that found taking long-acting opioids increases your risk for death.
This study was published June 14 in the Journal of the American Medical Association. The authors studied Tennessee medicaid patients between 1999 and 2012 who were either prescribed long-acting opioid drugs or other medications for non-cancerous chronic pain. The other medication group acted as the control to compare the opioid medication group to. The authors found that the group who was prescribed opioids has a higher number of deaths, even when accounted for accidental overdose. These were largely cardiovascular deaths. From their conclusion:
Prescription of long-acting opioids for chronic noncancer pain, compared with anticonvulsants or cyclic antidepressants, was associated with a significantly increased risk of all-cause mortality, including deaths from causes other than overdose, with a modest absolute risk difference.
What does this mean, taking opioids for non-cancerous pain comes with a huge risk and is something that should not be taken lightly. I believe the literature is clear, opioids should be a very last resort option for managing a chronic pain condition. As a chiropractor we have seen many difficult cases come into our office and when the patients commit to care we have great results in helping them manage their chronic spine pain. Sometimes these cases take more time and effort on ours and the patients part but the end result is almost always a success.