In response to the growing problem of prescription painkiller abuse in the U.S., three California doctors are calling on their colleagues to rethink the use of narcotic prescription drugs as medication for patients who experience chronic pain.  In the U.S., opioid painkillers including OxyContin, Percocet and Vicodin are now prescribed more than any other drugs.  According to the doctors, up to 20% of patient visits to physicians result in a prescription for one of these opioid drugs.

opioids should not be prescribed

Dr. Deborah Grady, Dr. Seth Berkowitz and Dr. Mitchell Katz have published their plea as an editorial in the Archives of Internal Medicine.  The doctors state that 20-40% of adults report non-cancer chronic pain and that opioids have become the most common form of treatment even though few studies are available that examine the use of these drugs for the long-term treatment of pain.  In fact, a large body of statistical evidence shows the harm these drugs can do.  According to Dr. Katz, the use of prescription opioid painkillers results in more overdose deaths each year in the U.S. than cocaine and heroin combined.

A Misguided Practice that Ruins Lives

Although doctors who prescribe opioid painkillers are attempting to improve patients’ quality of life by reducing chronic pain, they are putting patients at risk of abuse, addiction and death.  These drugs may serve a purpose when used for short-term pain relief, but the doctors believe they should not be used long term.  Instead, patients should be counseled about non-pharmaceutical alternatives for chronic pain management such as exercise, yoga and physical therapy.
In an interview published on the NPR website, Dr. Robert Chou of the American Pain Society responded to the editorial by stating that American Pain Society physicians believe that for some patients, opioids can still play an important role in managing of chronic non-cancer pain.  Physicians need to determine if a patient is at risk of addiction before prescribing opioids and then monitor each patient who takes these drugs.  Dr. Chou gives the example of an ideal patient for opioids as a low-risk woman in her 70s who is suffering from severe arthritis of the hip and who can walk and garden with decreased pain because she is taking a painkiller.
According to Dr. Chou, statistics on opioid drug abuse and overdose deaths are a matter of concern for society but do not justify a ban on the use of opioids for the treatment of non-cancer chronic pain.