Geisinger: Opioids not helpful in treating chronic pain

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A new study by a pair of Geisinger Health System physicians reports that the use of opioid therapy to treat chronic pain is not only ineffective, it can actually increase the likelihood of more harmful consequences, including death.

Palliative care physicians Mellar P. Davis, M.D., and Zankhana Mehta, M.D., authored the study which was published in the Dec. 2016 edition of Current Oncology Reports.

“When patients are given opioid therapy for chronic pain, there is evidence it interferes with the body’s natural resolution of the pain,” said Davis, who co-chaired the 2015 International Conference on Opioids at Harvard Medical School. “Opioid therapy may put someone at an increased risk for multiple adverse effects and it has the potential of extending the history of their pain.”

The authors wrote that the risk of addiction, depression, central hypogonadism — where the hypothalamus and pituitary glands don’t function properly — sleep-disordered breathing, impaired wound healing, infections, cognitive impairment, falls, fractures and death increase in patients on chronic opioid therapy.

They acknowledge that the use of opioids has been helpful in reducing the intensity of acute pain — sudden pain due to injury that doesn’t last long — and in managing pain associated with terminal cancer. But found that the promotion of opioid therapy to treat pain lasting more than three months, has been common practice without significant research to judge the safety of the practice.

Davis said opioids have been over-prescribed by physicians because of limited treatment options.

“There are not a lot of pain management centers providing a variety of effective, non-opioid and non-pharmacologic therapies,” he said. “We should be putting our efforts into developing more chronic pain rehabilitation programs versus making opioid packaging tamper-resistant to prevent the crushing, snorting and injecting of prescribed narcotics.”

The management of chronic pain needs to be vastly different than the treatment of acute pain and they urge physicians to take into consideration the significant delayed side effects and adverse health consequences of opioids.

“Opioids are not the answer,” Davis stressed. “Chronic pain rehabilitation, exercise, cognitive behavioral therapies, acupuncture, yoga or tai chi are all better options.”

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