Pain Control and Drug Policy: A Time for Change

Pain Control and Drug Policy: A Time for Change

Pain Control and Drug Policy: A Time for Change

Pain Control and Drug Policy: A Time for Change

Synopsis

Over 70 million adult Americans suffer from chronic pain, which costs the US economy $61 billion a year in lost productivity, not counting medical bills. Left untreated, chronic pain gradually kills its victims while ruining their lives. The only effective way to manage many cases of chronic pain is with opioids, yet fewer than half of all chronic pain sufferers in America get adequate pain relief from their doctors. Why? Physicians fear that if they prescribe Schedule II opioids in accordance with AMA-approved standards of titrated pain management, they will be hounded and criminalized by the DEA.

Excerpt

During my long career as a hematologist-oncologist, I witnessed the growing divergence between the enormous contribution of narcotics to pain management in the clinical setting and the entrenched perception of their lurking dangers. At issue is the belief that narcotics are extremely dangerous drugs that can easily and quickly turn an innocent and unsuspected victim into a drug abuser, at best, and into a crime-prone, self-destroying addict, at worst, whereas reality indicates otherwise. Indeed, the risk of addiction in populations taking narcotics as analgesics is extremely low in the absence of a prior history of drug abuse. As emphasized by the National Cancer Institute (NCI), “Extensive worldwide experience in the long-term management of cancer pain with opioid drugs has demonstrated that opioid administration in cancer patients with no history of substance abuse is only rarely associated with the development of significant abuse or addiction.” This strong endorsement of narcotics as nonaddictive painkillers concludes, “although the lay public and inexperienced clinicians still fear the development of addiction when opioids are used to treat cancer pain, specialists in cancer pain and palliative care widely believe that the major problem … is the persistent under treatment of pain driven by inappropriate fear of addiction.” My own professional experience over more than 30 years of clinical practice confirms this. Similarly, patients taking opioids for noncancer pain have an extremely low risk of addiction. in three large studies involving 11,882, 10,000, and 2,369 hospitalized patients with no prior history of drug abuse who were administered opioids for chronic noncancer pain, only 7 patients, or 0.03%, showed signs of abuse or addiction.2–4 On the other hand, the vast majority of addicts are not criminals to be incarcerated or victims of . . .

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