9 ms·
Not GP but I can expand. Over long periods of use the body develops tolerance to opioids and to get the same level of relief the dose must be increased. This se
by jazoom 8y ago
Not GP but I can expand. Over long periods of use the body develops tolerance to opioids and to get the same level of relief the dose must be increased. This seems to go on forever. Last year I had a patient on 10x what would probably be lethal for me (about 200 times a basic starting dose) and they didn't affect him much at all. He had been on the opiate train for about 30 years.
- justinjlynn 8y agoIndeed, clearly we need to develop a better understanding of the causes of chronic pain and how to treat them directly rather than managing symptoms. My primary concern is maintaining or improving quality of life without impacting the length too negatively. It's difficult to justify saying "sorry, that thing you were taking to make your life bearable makes my colleagues think I'm no better than drug dealer so, uh, you can't have it any more, here's a pamphlet on mindfulness" - if anything it should be buying time for us to find real solutions instead of symptomatic treatment. And that's all opioids really do for those that take it - buy time. If we're going to reduce opioid use we need to treat it as we're treating antibiotics and make sure we're carefully watching outcomes to make sure we're not dropping opioids but raising suicide rates. We owe it to patients to solve their problems and not just treat their symptoms when it's clear they won't heal on their own. Not a GP either.
- jazoom 8y agoGP = Grandfather Post. It's a reference to the comment you replied to.
- justinjlynn 8y agoOh. Hah. Confusing contexts.
- jazoom 8y agoIt certainly is. I probably should have thought of that and been more clear.