In Sickness & In Health: Opiates, Effective or Unsafe?

In Sickness and In Health

On today’s show Doctor Mike Jaffe of Adventist Health Castle discusses Opiates.  

Here are his thoughts on whether they are effective of unsafe:

“Opioids are pain pills that act on areas of our brains to produce morphine-like effects. Side effects of this class of drugs are sedation, respiratory depression, constipation, and euphoria. Opiates can be effective for pain control in some situations, however they also get people addicted and can lead to death if used improperly.”

CDC statistics for 2016 claim 42,000 people died in the USA from opiate use.  

This number may be closer to 50,000 for 2017 (statistics still out for 2017) That is 174 deaths / day.

This makes opiate associated death the leading cause of death for people under the age of 50 years.

Jaffe went on to say, “Starting in the mid 1990s, The Joint Commission on the Accreditation of Healthcare Organizations or (JCAHO) started a national campaign to get physician’s to consider pain as a “5th vital sign”  in order for physicians to treat pain conditions more aggressively. However, there were no guidelines nor good studies on the use of opiate medication for chronic pain conditions.  This led to leniency in opiate prescribing practices across the nation.  It turns out, up to 25 % of patients who start opiate for pain management develop a substance use disorder (or addiction)”  

Guidelines have suggested that the risk of opioids is likely greater than their benefits when used for most non-cancer chronic conditions including headaches, back pain.

In Fact, a recent JAMA study showing opiates are no more helpful for pain management than Tylenol or NSAIDs for chronic low back pain, hip and knee arthritis. 

Jaffe says, “As physician’s we need to do a better job of offering our patients more non-opiate alternatives for pain management such as physical therapy, acupuncture, cognitive behavioral therapy, and non-opiate medications. “

The bottom line is doctors need more time and resources to educate the public and their patients about “Pain, especially chronic pain”.  

Western Medicine has its limitations in controlling chronic pain and just dialing up the opiates can not only be ineffective but create secondary problems such as substance abuse and dependence. 

Sometimes it is realistic to live with some level of pain and focus more on function and how patients can work around their chronic pain conditions.


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