To reduce diversion for nonmedical use, the authors called for better ways to limit the oversupply of opioids prescribed after surgery.
Aside from surgery, opioids are often — probably too often — prescribed for people with chronic pain. Although these potent drugs may offer temporary relief, “they tend to lose their effectiveness over time, and one pill today can become three later,” said Dr. James Campbell, a neurosurgeon who specializes in pain management.
“As with alcohol, opioids are not a problem for most people, but some people can fall into an abuse syndrome, especially when taken for chronic pain,” said Dr. Campbell, a professor emeritus of neurosurgery at Johns Hopkins Medical Institutions.
With 100 million Americans living with chronic pain, according to a 2011 report by the Institute of Medicine, there is a vast market available for people “legitimately” prescribed an opioid to become hooked on ever-larger doses of these drugs.
But while opioids are now prominent in the national cross hairs, they are only one of many drug-related problems associated with pain management. In fact, opioids aside, the vast majority of medical difficulties pain patients encounter result from the use and abuse of pain-reducing medications that are sold over the counter.
“We’ve seen in recent years that each class of drugs used to treat pain has its downsides as well as upsides,” Dr. Campbell said. “Patients – and doctors – need to be mindful of the risks, especially when drugs are taken long term and in large doses.”
Some people assume that if one pill is good, two must be better. And it’s not uncommon for older people, who may have an acute pain problem on top of chronic pain, say, from arthritis, to be taking more than one pain medication at a time.
Many people think pain medications like NSAIDs (nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen) that they can buy without a prescription are safe. As George Gershwin wrote, “It ain’t necessarily so.”
A 2013 analysis of data from the National Ambulatory Medical Care Survey revealed that NSAIDs were used by 95 percent of the nearly seven million patients in the study who took at least one chronic pain medication. Athletes, from recreational to elite, also often take these drugs to counter muscle aches and joint pain.
“These are powerful medications for a whole variety of acute pain problems, and when taken for a few…