A new study by physicians at the Geisinger Health System in Danville, Pennsylvania, has found that the use of opioid therapy to treat chronic pain is not only ineffective, it can increase the likelihood of more harmful consequences, including death.
Palliative care physicians Mellar P. Davis, MD, and Zankhana Mehta, MD, authored the study, which reviews the current research on chronic opioid therapy. Their findings were published in the December 2016 edition of Current Oncology Reports.
“When patients are given opioid therapy for chronic pain, there is evidence that it interferes with the body’s natural resolution of the pain,” Davis said. “Opioid therapy may put someone at an increased risk for multiple adverse effects, and it actually has the potential of extending the history of their pain.”
The authors wrote that the risks of addiction, depression, central hypogonadism, sleep-disordered breathing, impaired wound healing, infections, cognitive impairment, falls, fractures, and death increase in patients receiving chronic opioid therapy.
Drs. Davis and Zankhana acknowledge that the use of opioids has been helpful in reducing the intensity of acute pain and in managing pain associated with terminal cancer, but they found that the use of opioid therapy to treat chronic pain—defined as lasting more than three months—has been a common practice without significant research to judge its safety in that setting.
In addition, Dr. Davis believes that opioids have been overprescribed by physicians because of limited treatment options.
“There are not a lot of pain management centers providing a variety of effective, nonopioid and nonpharmacologic therapies,” he said. “In addressing the opioid epidemic in our society, 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 authors conclude that the management of chronic pain needs to be vastly different than the treatment of acute pain. They urge physicians to take into consideration the significant delayed adverse effects and adverse health consequences of opioids.
“Opioids are not the answer,” Dr. Davis stressed. “Chronic pain rehabilitation, exercise, cognitive behavioral therapies, acupuncture, yoga, or tai chi are all better options than opioids.”
Dr. Davis will present the study findings in February 2017 at the annual assembly of the American Academy of Hospice and Palliative Medicine in Phoenix, Arizona.
Source: Geisinger Health System; December 7, 2016.