Opioids for Chronic Pain & Questioning Pain Doctor vs. Drug Pusher

Pain specialist Ronald McIver is serving a 30 year sentence for drug trafficking. The drugs? Opioids prescribed for pain relief. NY Times Magazine looks into McIver’s case and the mess surrounding opioids for pain management.

The in-depth piece definitely supports the use of opioids for pain management. I’ve created a PDF of the article so I could highlight what jumped out at me. I didn’t highlight any details of McIver’s case.

I, too, believe that opioids should be available for people with chronic pain. However, the devil’s advocate in me jumped on a bunch of thoughts that I hope to explore this week:

  • Not feeling the body’s pain signals isn’t necessarily good.
  • The effects of long-term opioid use aren’t well known. Most research has been with cancer patients, who do not use the drugs for extended periods.
  • Building tolerance is not only your body getting use to the drug (called desensitization), but becoming more sensitive to pain overall, not just the pain that you are specifically treating.
  • When most patients (and some doctors) feel like they’ve tried
    everything, they haven’t. Often other treatments should be considered
    before turning to opioids.

Just reading this list may raise your ire. Please give me a chance to write about the topics before jumping down my throat. We’ll be able to have a more thorough discussion that way.