Opioids in Pain Medicine – Boon or Burden

March 12th, 2018 - By Deeya Ranjan

Chronic pain as defined by the International Association for the Study of Pain – “pain that persists beyond normal tissue healing time, which is assumed to be three months.”

The outcome of chronic pain is debilitating – poor quality of life, negative impact on personal, professional and social life. Pain management thus becomes a focal point in restoring quality health. With the right support, guidance, and treatment, the constant drudgery of living with pain can be substantially marginalized.

Opioids and prescription medications have been widely used in chronic and acute pain management. They are effective in alleviating pain but the constant danger of a possible drug abuse always exist. There have been instances of drug abuse/overuse in various instances. So the question – do the benefits outweigh the harm?


Pain Medicine Management

The number of people dealing with chronic pain in US is expected to be around 11.2%. Pain medicine management becomes extremely crucial along with the role played by health care providers. The focus lies on the type of treatment and choices of drugs being administered. In a well-structured treatment plan, the provider considers risks and benefits associated with the prescribed drug. Factors taken into consideration are – medical history, physical exam, blood tests, and other underlying medical conditions and side affects. The prescribed drug is then ensured to comply with the requirements of the patient’s body and the severity of the health condition.


Opioids and their role in pain management

 Opioid are widely used for the treatment of acute pain and chronic pain related to cancer or severe health ailment. They are also prescribed for surgery and other types of chronic pain but their dosage, length of time to administer and side effects are still being evaluated by the healthcare industry.

When looking for opioids as a solution, physicians strive hard to maintain a balance between providing relief from pain and limiting overdose. Chronic pain commonly divided into nociceptive (caused by tissue damage) and neuropathic (damage of nervous system) when not monitored correctly results in increasing health care costs, and loss of health and productivity.

Until recently, opioids were used in acute pain and cancer treatment. The use of opioids for non-malignant chronic pain was associated with too many risks. Regulatory concerns, dosage abuse and development of tolerance created a reluctance to prescribe opioids. But recent studies of physicians and those specializing in pain medicine, has shown that prescription of long-term opioids has become increasingly common.

A 2015 National Survey on Drug Use and Health estimated that 3.8 million Americans use opioids for non-medical reasons every month. When taken continually, opioids tend to create cravings for more than the required dosage leading to an abuse syndrome.


Key recommendations in opioid therapy

  1. Opioid therapy should be considered when its benefits outweigh the risks.
  2. When starting opioid therapy, lowest effective dosage of drug should be administered.
  3. Benefits and risks should be evaluated with patient on an ongoing basis – checking the treatment and results regularly.
  4. Patients PDMP (Prescription Drug Monitoring Program) should be reviewed before prescribing an opioid.



 The best possible solution for this ongoing debate on opioid treatment is to focus on identification and training of best treatment practices and promoting social and family-oriented research initiatives.

With all such complexities in patient treatment and management, a physician can implement quality care by adopting EMR software. It will provide benefits in –

  1. Documenting dosage details
  2. Managing pain levels and treatment plan
  3. Monitoring progress
  4. Controlling dosage to optimal level – creating effective dosage management plan

PrognoCIS EHR combines all these benefits, and additionally provides opportunities for telemedicine too.

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