Opioid Prescribing: Can the Art Become More Science?

Excerpt

There is controversy regarding the effectiveness and safety of long-term opioid therapy for the treatment of chronic pain. Since the 1980s, a four-fold increase in opioid prescribing has been correlated with a four-fold increase in unintentional opioid overdose deaths and a six-fold increase in substance abuse treatment admissions for prescription opioid addiction.1 Unrealistic expectations by patients, patients’ families and providers regarding the benefits of opioids, and lack of understanding of the potential risks and harms complicate opioid prescribing. While not all patients with chronic pain improve on chronic opioid therapy,2 some do. For those patients who do not respond, uncontrolled dose escalation often ensues, all in a desperate yet futile attempt to obtain pain relief. …