Practical Pain Management Community Advice

Opioids and Chronic Pain Management

From: Living well with pain - 40 weeks 4 days ago

I liked this article as it points out many of the pros and cons for using opioids. I am the CEO of People in Pain Network and we establish peer-led (PSMES) Pain Self-management Education and Support groups. We promote good information about all options for managing chronic pain and opioids are one of the options. I have met thousands of people over the 27 years that I have been living with pain and working with others who live with persistent pain.
The following quote is what I want to comment about
"What makes opioids potentially addictive, unlike some of the other medications that we use in pain management (acetaminophen, NSAIDs, antidepressants, anticonvulsants), is that they affect the pleasure centers of the brain and can expose the individual to a sense of well being, euphoria, contentment."
By making these statement, it will be harder for people to have a trial of opioids when appropriate, and more fear around addiction. The latest research states that 1 to 4 % of people taking opioids for pain become addicted to the medication. Way more people are addicted to caffeine and sugar.

I have been taking opioids to help manage my pain for 27 years and talk to many, many members who also have tried opioids or use opioids and NEVER have I experienced, or has anyone I know reported that they experienced a sensation related to pleasure, contentment or euphoria that would contribute to a possible addiction. All that happens is that the pain decreases. Often the unpleasant sensations like heartburn, constipation, and nausea are what people living with pain experience when taking opioids for pain.

With the current opioid concerns, I feel that people living with pain will be further denied a trial of opioid medication to help reduce their pain. Unrelieved pain interferes with a person's ability to think clearly, remember information, concentrate and be able to learn and practice pain self-management skills. Once this happens and people are able to keep their daily pain baseline lower, then the doctor and patient can consider tapering the opioid dose.
For myself, my opioid medication reduced my pain by about 30% and after learning pain self-management skills, I could reduce my pain another 30%. Slowly we tapered my dose and I am taking 60% LESS opioids than before with BETTER pain management and increased activity.
The new guidelines, while protecting both doctor and patient are being used as laws not guidelines.
People have a right to have their pain managed and to an improved quality of life.

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I always appreciate an educated, informed, unemotional article (or reply) relating to this political "knee-jerk" reaction to opoid therapy these days. After 28 years of AA, lowered er dose down 2/3 for 15 yrs, then scolded and denied any medication to keep pain level below an "8", I just keep breathing because I'm too Irish to stop, I suppose. Even with documentation of decades of responsible opioid use, Rx fill/refill printouts, MRI reports/diagnoses...some of us continue to be neatly dismissed and live in tortuous pain 24/7. The is unconscionable! I wonder what % is over 65?

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