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I find myself at a cross roads. I have had back pain for three years now with no relief. I'm finally ready to try the pain killers my doctor has recommended. With all the possible side effects and worries about addiction, I'm still wondering if I shouldn't just tough it out?

This is a good question and one that is highly debated by many people on both sides. The use of opioids for control of chronic non-cancer pain has increased by as much as 600 per cent in some countries. The availability of new drugs and advertising efforts of drug companies are two main factors in this change.

Denmark is one country with very high rates of regular opioid usage. The National Institute of Public Health in Denmark has started a study of the long-term effects of opioid use. Their first report shows that chronic pain patients taking opioids may not have any better pain control or function than nonusers.

With the potential for addiction and other negative effects, these researchers are calling into question the long-term use of such drugs. Their study showed no difference in quality of life between opioid and nonopioid users. And opioid users were more likely to be inactive, out of work, and on disability.

Short-term use to control pain or try to break the pain cycle may still have some merit. Anyone taking these drugs must be aware of the possible dangers and risks linked with long-term use. Besides addiction, there is evidence to suggest a negative impact on the immune system and the reproductive system.

If you decide to try this treatment, stay in close contact with your doctor. Report any unusual symptoms and the need for higher doses to obtain the same pain control. These are red flags of tolerance and dependence possibly leading to addiction.

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