The Opioid Emperor Has No Clothes

Michael Keane, BM, BS, FANZCA

Anaesthetic Department
Casey Hospital
Berwick, Victoria
Australia

Therapeutic prescription of opioid analgesics has risen sharply in the United States over the last two decades. Unfortunately, increased supply of prescription opioids has been mirrored by higher abuse rates and more unintentional opioid overdoses. Thus, some experts have called for restraint, citing the need to balance the benefits of opioid therapy with approaches to curb prescription drug abuse. Yet others have expressed concern that tighter restrictions will prevent some pain patients from obtaining this effective analgesic class. Here, Dr. Keane challenges some long-held beliefs related to the potential harms associated with nonmedical use of prescription opioids, including the desirability of this class among potential abusers, the relationship between opioid abuse and wide-ranging functional impairment, and the concept that all nonmedical opioid use inevitably results in poor outcomes.

References

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3) Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med. 2010;363(21):1981-5.

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