We are experiencing a crisis of opioid use in America and its use is also rapidly increasing in foreign countries. The problem began to gain steam in the 1990’s, in part, due to the pressure upon medical providers to alleviate pain in patients who were in the hospital and Emergency Rooms. It was also fueled by pharmaceutical companies who profited from developing and marketing new opioid products, initially touting some of them as having lower risk for causing addiction. These statements turned out not to be true, and the problem has gradually worsened.
Opioids depress cerebral and respiratory function and, when taken in large quantity, cause death. There were over 70,000 overdose deaths the US due to opioids in 2018. Women are more likely to use opioids, as they have been shown to be more likely to become dependent, and also, are more likely to be prescribed opioids for their pain. In addition its use by youth has more than doubled since the late 90’s.
There is a substantial risk of patients starting long term use whenever they are treated for acute pain with opioids for as short a period as a week. Therefore, physicians are being encouraged to try to choose alternatives to use of opioids for patients who present to the office or emergency room with acute or chronic pain.
For those patients who are already using opioids, perhaps some of my patients who are on “pain contracts”, we will continue to urge the reduction of opioid use and coming up with alternative treatment for your pain. In addition, you will note that I am very reluctant to prescribe it as a first time choice for treatment of pain from any cause.
Please do your part to help reduce this epidemic by discouraging friends and family from using them. Educate yourself about alternatives to treatment of pain and use them, rather than requesting an opioid prescription from your doctor. And, if you are currently using opioids on a regular basis, talk to your doctor about a plan for tapering and discontinuing them, if at all possible.