Chronic Opioid Consumption Not the Answer in Chronic Pain and Politics Gets in the Way

Previously, Dennis Turk has contended that only 1/2 of chronic pain sufferers will tolerate of find opioids effective.  See: http://painmuse.org/ref/turk.pdf

Now a Norwegian study suggests even in “planned” opioid users, only 23% will be taking opioids 3 years later.  Meanwhile, doctors in Orthopaedic Medicine, are being targeted by Provincial Colleges…  

LONGITUDINAL STUDY OF NEW NON-CANCER USERS OF PRESCRIBED STRONG OPIOIDSK. Svendsen1,2, A. Moroz1, O. M. Fredheim2,3, S. Skurtveit4,5, P. C. Borchgrevink1,2
IASP Poster DM 045 Montreal 2010

Now look at attrition rates:
Only 1/2 will initially tolerate or find it effective
Only 1/4 of planned opioid users will be taking it 3 years later.

If my math is right, that leaves only 1/8 of sufferers on opioids. If one is really optimistic and assumes 1/2 of people got better, this still leaves only 1/4 chronic pain sufferers on opioids

Well, there are still other meds – right? Authors wrote a sister article on what they are – 

LOW PERSISTENT USE OF PRESCRIPTION OPIOIDS IN NORWAY BUT HIGH DEGREE OF CO-MEDICATION WITH ANXIOLYTICS AND HYPNOTICS
A. Mellbye1, K. Svendsen1,2, O. M. Fredheim2,3, S. Skurtveit4,5, P. C. Borchgrevink2,1
IASP poster DM 044 Montreal 2010

– so they are on tranquilizers and sleeping pills – not exactly pills associated with improved quality of life in chronic pain.

Many of these patients cannot afford much in the way of complementary therapies (massage, manipulation, acupuncture and so) which gives temporary respites and temporarily improves Quality of life.

Though I do not feel mistreated by my medical college,  my practice has been restricted…
Also, I am exposed to stories of how physicians in orthopaedic medicine are systematically persecuted – being audited and flippantly restricted while they are the main physicians out there trying to make a difference. I sense it will take the government to straighten up priorities but they appear impotent by their lack of medical expertice…

Who ends up suffering? the 3/4 of pain patients who may have no where to turn… This is like the undertreatment of cancer pain all over again…

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