Opiates have become an increasingly common treatment for back pain as well as for other chronic pain conditions. However, the potentially harmful effects of these drugs, primarily the risks of addiction and overdose, make them a risky treatment option for many patients. Even the American Academy of Neurology (AAN) has publicly stated that opiates do very little to improve the day-to-day life of chronic pain sufferers. Now, physicians are being urged to seek alternative pain treatment methods that truly contribute to the overall health of their patients without placing them in undue harm.
A Double-Edged Sword
While the AAN agrees that opiates have some pain relieving properties, it argues that the potentially dangerous compilations of the drugs make it unsuitable for most pain sufferers. Specifically, the organization cites the high risk of addiction and accidental overdose as reasons that physicians should seek out alternative medications and therapies. In addition, while the pain relieving properties of opiates have some benefits, the AAN argues that opiates don’t actually improve a patient’s health. The AAN’s statement is significant because they are the first major American specialty society to state that the risks associated with opiate use may not be worth the benefits that the drugs provide.
One Step Forward, Two Steps Back
In the 1940s, opioid-based opium and heroin were rising in popularity among drug abusers, as well as those seeking relief from pain. In an attempt to stop the improper use of these drugs, the government instituted strict standards on the types of physicians who could prescribe them and the amount that they could prescribe. While these stricter standards did curb the abuse of these opioids, it also meant that many patients, especially those suffering from cancer, were left without adequate pain treatment options. That is why pharmaceutical companies and lobby groups began to fight to remove the rigorous controls over opiates. They argued that they wanted to restore adequate pain management to patients who truly needed, it. Unfortunately, these revised state laws were far too lenient. Thus, they set the stage for today’s rampant over prescription and abuse of opiates and opioids.
These drugs were initially used only to treat patients with cancer, but they were soon expanded to include those who had chronic pain such as lower back pain, headaches and fibromyalgia. The problem is that there are no studies that prove that taking opiates for months or years is effective. In fact, most of the studies that have been done in this area lasted for only a month.
Regulatory Changes Are Needed
Since the 1990s, over 100,000 people have died from opioid overdoses. In addition, prolonged use of opioids has been linked to deteriorating health including changing hormone levels that can contribute to infertility, abnormal function of the immune system, heart problems and in some cases, even worsening of pain.
To stop the rise of overdose deaths and other harmful health effects, stricter regulatory guidelines are once again needed at the state and federal levels. While opiates may be appropriate for patients with cancer and terminal illnesses, other patients should seek alternative treatment options. The Centers for Disease Control (CDC) and several states have started this increased regulatory process by instituting a yellow flag warning system. This system requires physicians to get a second opinion before prescribing additional opiates to patients who are already at a certain dosage level. The ANN urges patients and physicians not to use pills as a first method of treatment but to seek alternative pain treatments that are often just as effective as opiates.