Narcotic Pain Medications

An individual with chronic disabling pain will naturally request pain killers, so why are some physicians reluctant to prescribe narcotics?

  • For thousands of years, narcotic pain killers have been used for pain. When we break a bone, have a heart attack or after a surgery, it is comforting to know that these medications will relieve our pain and suffering. Similarly, for those dying from cancer narcotics can give excellent pain relief.
  • Everyone seems to have an opinion on the use of narcotics for chronic pain. With the scale of prescription drug abuse in Missouri, most families are aware of someone who has been affected by this epidemic.
  • There is no doubt that narcotics are effective in patients with acute pain or cancer related pain.
  • There are no good quality studies to show that narcotic pain medications work in the long-term for musculoskeletal pain alone, but may be beneficial in combination with behavioral therapy, interventional techniques, and physical therapy.
  • There are studies to indicate that narcotic pain medications can be effective in the short to mid-term for bone and joint pain. Such an indication might be for three months of pain control while awaiting a knee replacement.
  • Research studies show that patients on chronic opiate therapy have increased depression, reduced function and decreased activity.

Opiates can cause multiple problems. We have highlighted some of the complications associated with opiate therapy in the sections that follow on addiction, tolerance, hyperaesthesia and hyperalgesia, immune and hormonal changes, withdrawal and detoxification.

Addiction

Detoxification

Hyperesthesia and Hyperalgesia

Immune and Hormonal Changes

Pseudoaddiction

Withdrawal

Tolerance