Opioids— drugs like OxyContin® and Percocet® — are powerful painkillers. But opioids aren’t usually best for chronic pain. Advertising Policy Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy “Today, pain specialists rarely prescribe opioids for chronic pain unless … Read More
It wasn’t always that way. From late 1980s through early 2000s, physicians tried to improve the way they treated chronic pain by prescribing opioids for more people. They believed that by taking the highly addictive drugs only as prescribed, patients wouldn’t become addicted. This thinking was quickly proved wrong.
“Reality caught up with us,” says Dr. Rosenquist. “Over the years, we learned that dependence on opioids develops quickly.”
The consequences have been making headlines ever since. Just a few examples include:
15,000 to 18,000 U.S. deaths per year due to overdose of prescription opioids
“Pill mills,” or business that dispense opioids inappropriately for profit, quickly springing up (and later cracked down on)
Growing rates of addiction to heroin. Why? This less-expensive opioid is commonly turned to by addicts for cost reasons or when their pill mill gets shut down
These powerful pain killers aren’t only highly addictive. Experts also learned that they:
Don’t provide adequate pain relief long-term. “After a while, patients are lucky to get 20 or 30 percent relief,” says Dr. Rosenquist. “Often, improvement in function and general well-being is even lower.”
Cause unwelcome side effects. Weakened immune system, hormone imbalances, respiratory depression, sedation and constipation are just a few. For some patients, opioids make their pain worse.
When are these drugs appropriate?
Opioids are best for treating short-term pain. For chronic pain, Cleveland Clinic physicians prescribe them only for cancer pain or when other treatments don’t work. Even then, they’re used only in low doses. Plus, they are continued only if the patient’s function (not just their level of pain) improves.
If you’ve taken opioids long-term
If you’ve taken these pain killers for a long time, see a pain management specialist. He or she can re-evaluate the cause of your pain.
“If you were taking antibiotics for a urinary tract infection but your infection wasn’t going away, you’d stop using the antibiotics and try something else,” says Dr. Rosenquist. “The same is true with opioids and chronic pain.”