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Opiates are usually not a good option for long term pain relief for many patients. They can work well in the short term but long term use can ruin a person's li

Opiates are usually not a good option for long term pain relief for many patients. They can work well in the short term but long term use can ruin a person's life (I've seen it happen, it's awful) and they lose effectiveness long term and end up causing more problems than they solve. Switching opiodes from a short term option to a long term one in the 90s was a huge (and largely failed) experiment. Long term pain control is a complicated and multi facaded beast. We need to invest in it. "Just take a pill" is clearly not the solution that works. I am not sure what "addiction can be managed" is supposed to mean. http://www.news-medical.net/news/20130415/New-research-shows-effects-of-long-term-use-of-opioid-therapy.aspx http://www.news-medical.net/news/20130415/New-research-shows... The prevailing medical notion was that there was this bright line involving the opioids — that they were great for patients but the problems happened when they went out on the streets and were abused by kids and others. But today it’s clear that the long-term use of these drugs can not only be ineffective for chronic pain, but they also create bad side effects for patients. Not just addiction but powerful psychological dependency, depression of hormone production, lethargy and listlessness and sleep apnea, among others. These drugs do work well for some patients, but for many other patients, they’re not working well at all. One leading expert said: “We thought the big problem with these drugs is addiction. Now we realize the problem is with patients who take them and basically opt out of life.” There is a general realization that while they do work for some patients, using them on a massive scale to treat chronic pain has had really disastrous consequences. For instance, back pain is probably the leading workplace injury. What insurers and workers’ comp agencies are discovering is that when workers are treated with high doses of opioid drugs fairly soon after these injuries, it’s the leading predictor for them not coming back to work for long periods of time, or ever. When you take a narcotic painkiller it sets off a natural reaction called tolerance, which means your body adjusts to it. You have to take more of the drug to get the same painkilling effect. Patients would come back to doctors and say, “This drug was working really well for me, but now I’m feeling pain again.” The doctor would increase the dose. The prevailing ideology during the war on pain was that these drugs had no ceiling dose. You could keep increasing them. The doctors kept boosting them every six months. People started taking higher and higher doses of these drugs. At a certain point it appears they create a change in the neurological system where people develop hyperalgesia and they become far more sensitive to pain than when they started out on these drug

oxide 11y ago
What he meant was that dependency can be maintained. Forever. I disagree that opiates are not a good choice for short-term pain relief, and I also disagree that they are not a good choice for long-term pain relief. If anything, pain is currently being under treated on a massive scale thanks to the new-wave crusaders against opiates, flying a flag of the same type of study they decry as flashy science only meant to gun for the headlines as proof undeniable. There will always be opiate abuse. A moral backlash against abuse should not deny people in pain the quality-of-life increase they can get in return from opiates. Dependency be damned. >Long term pain control is a complicated and multi facaded beast. We need to invest in it. I do agree with this. >"Just take a pill" is clearly not the solution that works. It's the solution we have right now, though. My grandparents, bless them, couldn't function without narcotic painkillers. without narcotics, there is no quality-of-life to speak of for them, and for a lot of people like them. Dependency be damned. Until something as affordable and available as opiates come around, that can give them equipotent pain relief, traditional poppy derivatives can and should be used to treat pain in those who live each day in pain. Tolerance be damned.
- nommm-nommm 11y ago
  I said opioids are a good option for short term pain. They are also usually (not always) a bad option for long term pain. Please go to a treatment facility (volunteer please) and talk to the patients there. It is beyond eye opening, I volunteered at one myself. I've seen pain medicine literary ruin lives, and it's so sad. These are people who have been through hell with their injuries, some of the worst I've ever seen, and then they go through hell again with the opiodes. They can work on a long term basis for SOME (but not the majority) of patients. Psychological treatments are also an important part of pain management.
  - oxide 11y ago
    Yes, opiates can ruin lives. That is not the trump card you want it to be, sorry. If anything, the pushback against opiate prescribing has resulted in a lot of dependent patients (and addicted abusers) looking at heroin as a more potent, widely available, cheaper alternative. opiates have been around a long time for a good reason. they can give an unrivaled increase in the quality of life of those suffering. there will ALWAYS be opiate abuse. taking prescription painkillers out of the picture doesn't even put a dent into it. do you think it makes more sense to spend time and money demonizing prescription opiates and prosecuting those who prescribe them, or use that time and money to implement programs and services that can help those who have become dependent or addicted?

oxide 11y ago

What he meant was that dependency can be maintained. Forever. I disagree that opiates are not a good choice for short-term pain relief, and I also disagree that they are not a good choice for long-term pain relief. If anything, pain is currently being under treated on a massive scale thanks to the new-wave crusaders against opiates, flying a flag of the same type of study they decry as flashy science only meant to gun for the headlines as proof undeniable. There will always be opiate abuse. A moral backlash against abuse should not deny people in pain the quality-of-life increase they can get in return from opiates. Dependency be damned. >Long term pain control is a complicated and multi facaded beast. We need to invest in it. I do agree with this. >"Just take a pill" is clearly not the solution that works. It's the solution we have right now, though. My grandparents, bless them, couldn't function without narcotic painkillers. without narcotics, there is no quality-of-life to speak of for them, and for a lot of people like them. Dependency be damned. Until something as affordable and available as opiates come around, that can give them equipotent pain relief, traditional poppy derivatives can and should be used to treat pain in those who live each day in pain. Tolerance be damned.

nommm-nommm 11y ago
I said opioids are a good option for short term pain. They are also usually (not always) a bad option for long term pain. Please go to a treatment facility (volunteer please) and talk to the patients there. It is beyond eye opening, I volunteered at one myself. I've seen pain medicine literary ruin lives, and it's so sad. These are people who have been through hell with their injuries, some of the worst I've ever seen, and then they go through hell again with the opiodes. They can work on a long term basis for SOME (but not the majority) of patients. Psychological treatments are also an important part of pain management.
- oxide 11y ago
  Yes, opiates can ruin lives. That is not the trump card you want it to be, sorry. If anything, the pushback against opiate prescribing has resulted in a lot of dependent patients (and addicted abusers) looking at heroin as a more potent, widely available, cheaper alternative. opiates have been around a long time for a good reason. they can give an unrivaled increase in the quality of life of those suffering. there will ALWAYS be opiate abuse. taking prescription painkillers out of the picture doesn't even put a dent into it. do you think it makes more sense to spend time and money demonizing prescription opiates and prosecuting those who prescribe them, or use that time and money to implement programs and services that can help those who have become dependent or addicted?