Changes in Opioid Prescribing for Chronic Pain in Washington
Changes in Opioid Prescribing for Chronic Pain in Washington
Opioids have not turned out to be the effective and "not as addicting as we used to believe" treatment that some pain champions and pharmaceutical companies promised, based on no good scientific evidence, in the late 1990s. We were told that there is no ceiling on dose and that the best way to treat tolerance is to keep increasing dose. We have now learned that dose is highly related to morbidity and mortality; implementation of more clear-cut dosing guidance and other best practice tools are needed at this point.Practitioners are clamoring for more guidance and community resources to deal with the multitude of patients now receiving long-term opioid therapy and the many other patients with chronic pain who are not taking opioids. There is a particularly urgent and critical need for research that will generate the information necessary to prevent the next cohort of patients from getting potentially lethal but ineffective doses of opioids and to shed light on effective ways to improve the suffering and function of those who already are dependent on or addicted to opioids and are still in pain.
Conclusion
Opioids have not turned out to be the effective and "not as addicting as we used to believe" treatment that some pain champions and pharmaceutical companies promised, based on no good scientific evidence, in the late 1990s. We were told that there is no ceiling on dose and that the best way to treat tolerance is to keep increasing dose. We have now learned that dose is highly related to morbidity and mortality; implementation of more clear-cut dosing guidance and other best practice tools are needed at this point.Practitioners are clamoring for more guidance and community resources to deal with the multitude of patients now receiving long-term opioid therapy and the many other patients with chronic pain who are not taking opioids. There is a particularly urgent and critical need for research that will generate the information necessary to prevent the next cohort of patients from getting potentially lethal but ineffective doses of opioids and to shed light on effective ways to improve the suffering and function of those who already are dependent on or addicted to opioids and are still in pain.