Pain Medication Does Not Lead to High Risk of Addiction

Using strong pain medications, including opioids, for long-term, chronic pain puts you at high risk of addiction, RIGHT? Srinivasa Raja, MD, a professor of anesthesiology at Johns Hopkins University Medical School says that is WRONG.

Raja presented the lecture: From Poppies to Pill Popping: Is There a "Middle Way"? at the 27th Annual Scientific Meeting of the American Pain Society (APS) Raja reported that less than 3% of all chronic pain sufferers, with no history of drug abuse of any kind, will show signs of abuse or dependence. He urged clinicians not to allow this small percentage to prevent them from prescribing pain medications to patients who are more likely to benefit from them than be hurt by them. Raja also said:

We also are dealing with unfounded accusations in the media that increased prescribing of opioids for severe chronic pain is responsible in large part for reported upswings in the abuse of pain medications

Raja stressed the importance of communication between doctor and patient, the importance of patient monitoring to identify addictive behavior, and the importance of monitoring patients to see if doses can be lowered as pain control improves. He also suggests alternative treatments such as cognitive behavior and physical therapy to supplement pain medication whenever possible.

His lecture asked federal and state regulatory agencies to aim for state-to-state consistency in regulating controlled substances and called for a crack down on illegal internet pharmacies and prescription thefts and forgeries. He applauded teen drug awareness campaigns as a means of preventing this type of drug abuse. Raja's also had a message to the pharmaceutical industry and said:

the key challenge is to match clinical needs for less addicting pain medication with drug development priorities. “There are novel analgesic formulations in various stages of development that we hope can be prioritized and expedited for clinical use

Raja cited two outdated beliefs about pain that were later disproved by scientific evidence. The first, a commentary published in the Journal of the American Medical Association fifty years ago that said cancer patients shouldn't use opioids due to the possible risk of addiction and secondly, the belief, twenty years ago, that infants shouldn't receive anesthesia because they didn’t feel pain. Both beliefs are now abandoned and Raja feels that the fear of addiction in pain management should be abandoned too.

sources: Chronic Pain Meds Unlikely to Cause Addiction and Risks for painkiller abuse do not outweigh benefits in chronic pain