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Long-Term Use of Opioids for Chronic Pain: Does It Work?

Every year over 200 million prescriptions are written for opioids in the United States. An opioid is a chemical substance that acts like morphine in the body. It is used mainly for pain relief. Of the total 19 billion dollars spent annually just on pain meds, one-third of that money is spent on opioids for chronic pain.

There is a lot of controversy around these medications. There are concerns about side effects, especially addiction. Many doctors avoid using these drugs. Or they under medicate patients who actually need higher doses.

Part of the problem is a lack of data to identify long-term benefits and side effects with opioid use. And when studies are done, patients often quit early because they are afraid of becoming a drug addict.

Some patients leave a study without giving a reason. They may be afraid to be honest. Or they are unwilling to let their doctor know how unhappy they are with the treatment. Some just want to see if they can manage the pain on their own without using opioids.

The authors of this report review the results of other studies of patients taking opioids. They briefly mention the small, short-term study they conducted with 36 patients. Only a few patients showed signs of abusive pattern of medication use. Men used higher dosages of the drug, especially during the first month.

Further studies are needed to identify the best dosages of opioids to use. Until this information is available, doctors and patients must work together to determine the best pain reliever to use. Likewise, dose is symptom dependent and may need to be changed (increased or decreased) until the patient is comfortable.

References: Michael C. Rowbotham, MD, and Calandra Diamond Lindsey, DO. How Effective is Long-Term Opioid Therapy for Chronic Noncancer Pain? In The Clinical Journal of Pain. May 2007. Vol. 23. No. 4. Pp. 300-302.

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