3 ms·

But that's one of the big lies - or minimally very misleading marketing: long term opiate treatment isn't as remarkably effective for chronic pain as Purdue had

But that's one of the big lies - or minimally very misleading marketing: long term opiate treatment isn't as remarkably effective for chronic pain as Purdue had us believe and carries a LOT of downside: https://www.ncbi.nlm.nih.gov/pubmed/30313000 https://www.ncbi.nlm.nih.gov/pubmed/30313000

refurb 7y ago
Your source doesn’t say they don’t work for chronic pain, it says there isn’t data and there are risks. Unfortunately for a lot of patients, opioids are the only thing that works.
taxidump 7y ago
I have a relative with 2 artificial hip replacements and many issues with his other organs which were injured durring a war from machine gun fire in Vietnam. About 8 months ago his opiate pain meds were reduced by over half. We now often visit and help him with chorrs as he can barely move. Opiates are a very important treatment and there is a stigma currently hurting needing patients.
whiskers1960 7y ago
Very true. It's also true that Medicare and Medicaid, used by the majority of disabled and elderly does not provide coverage for most alternative therapies. Medicare recently approved 'dry needle' treatment, a less-effective cousin of acupuncture. Massage therapy is a proven pain reducer but not covered at all. The list goes on. Some of the issues activists are still working on are quality of life aspects of health care: for instance, Most policies will pay for the amputation of a diabetic patient's foot but NOT for a $50 pair of properly fitting shoes. This is my 2 cents: I was looking for access info on the DEA database referenced here and found your discussion interesting. Thanks for the tips on getting past WAPO's paywall!
stordoff 7y ago
> For a number of Key Questions, we identified no studies meeting inclusion criteria. Where studies were available, the strength of evidence was rated no higher than low, due to imprecision and methodological shortcomings, with the exception of buccal or intranasal fentanyl[...]. No study evaluated effects of long-term opioid therapy versus no opioid therapy. > No study evaluated the effectiveness of risk mitigation strategies on outcomes related to overdose, addiction, abuse, or misuse. Evidence was insufficient to evaluate benefits and harms of long-term opioid therapy in high-risk patients or in other subgroups. > CONCLUSIONS: Evidence on long-term opioid therapy for chronic pain is very limited but suggests an increased risk of serious harms that appears to be dose-dependent. More research is needed to understand long-term benefits, risk of abuse and related outcomes, and effectiveness of different opioid prescribing methods and risk mitigation strategies. This doesn't show they aren't effective.

refurb 7y ago

Your source doesn’t say they don’t work for chronic pain, it says there isn’t data and there are risks. Unfortunately for a lot of patients, opioids are the only thing that works.

taxidump 7y ago

I have a relative with 2 artificial hip replacements and many issues with his other organs which were injured durring a war from machine gun fire in Vietnam. About 8 months ago his opiate pain meds were reduced by over half. We now often visit and help him with chorrs as he can barely move. Opiates are a very important treatment and there is a stigma currently hurting needing patients.

whiskers1960 7y ago

Very true. It's also true that Medicare and Medicaid, used by the majority of disabled and elderly does not provide coverage for most alternative therapies. Medicare recently approved 'dry needle' treatment, a less-effective cousin of acupuncture. Massage therapy is a proven pain reducer but not covered at all. The list goes on. Some of the issues activists are still working on are quality of life aspects of health care: for instance, Most policies will pay for the amputation of a diabetic patient's foot but NOT for a $50 pair of properly fitting shoes. This is my 2 cents: I was looking for access info on the DEA database referenced here and found your discussion interesting. Thanks for the tips on getting past WAPO's paywall!

stordoff 7y ago

> For a number of Key Questions, we identified no studies meeting inclusion criteria. Where studies were available, the strength of evidence was rated no higher than low, due to imprecision and methodological shortcomings, with the exception of buccal or intranasal fentanyl[...]. No study evaluated effects of long-term opioid therapy versus no opioid therapy. > No study evaluated the effectiveness of risk mitigation strategies on outcomes related to overdose, addiction, abuse, or misuse. Evidence was insufficient to evaluate benefits and harms of long-term opioid therapy in high-risk patients or in other subgroups. > CONCLUSIONS: Evidence on long-term opioid therapy for chronic pain is very limited but suggests an increased risk of serious harms that appears to be dose-dependent. More research is needed to understand long-term benefits, risk of abuse and related outcomes, and effectiveness of different opioid prescribing methods and risk mitigation strategies. This doesn't show they aren't effective.