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Opioids

In recent years there has been much misinformation and disinformation on the use of long term opioid therapy in the treatment of chronic non-cancer pain. The “opioid epidemic” in the United States has fueled this problem and their “war on drugs” was waged against chronic pain patients, the vast majority of whom were taking their opioid medications as prescribed, were experiencing no adverse effects and were experiencing good pain relief and improved quality of life.

In 2016 the US CDC released their Opioid Prescribing guidelines which were widely misapplied and misinterpreted with devastating consequences for chronic Non-cancer pain patients. Many were force-tapered off their medications resulting in their pain returning, their becoming disabled, house-bound and isolated. They lost their close relationships, their careers, their social lives. Some attempted or completed suicide. A complete tragedy, made worse because it was entirely unnecessary.

but far, far worse is that the CDC guidelines were based on very flimsy science. All the studies reference were low to very low quality, and some statements made in the guidelines had no evidence at all supporting them.

So what is the truth about opioids? This page will link to the latest science. Where possible we will link recent studies, preferably with a large sample size.

The questions we will answer:

Are opioids safe?

Are opioids effective for chronic non-cancer pain?

Do opioids make pain worse long-term i.e does opioid-induced hyperalgesia (OIH) exist?

Do patients need ever-increasing doses of opioids to manage their pain? (Tolerance)

Do chronic pain patients become addicted to opioids?

Is there a difference between “addiction” and “dependence”

The “accidental addict” trope

The harms of forced tapering / involuntary deprescribing – including increased pain, reduced quality of life, depression, isolation, and suicide.

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