Wellness & Education

Why Opioids Can’t Fix Chronic Pain

When thinking about opioid risks, most people think about addiction. While the risk of addiction is extremely important, it isn’t the only reason why opioids can’t fix chronic, or non-cancerous, pain.

When patients first begin taking opioids, these drugs may work so well that they often “fix” almost all of a patient’s pain. In many ways, the short-term effect of opioids can feel almost miraculous. As long as the pain is short-lived, the “miracle” works. Opioids are often used for treating patients who have had a molar removed, a surgery or a baby, for instance. They are very useful for three to seven days, which is plenty of time for most patients to get through the most painful part of their recovery.

It doesn’t take long, however, for opioids to begin working less and less. This is just part of the nature of how opioids affect the body. When this happens, the only way to get the same amount of pain control is to give larger amounts of opioids. In other words, the dose of opioids has to go higher and higher in order to get the same amount of pain relief that was felt in the beginning. The “miracle” is starting to fade. Pain – Patient- Safe and Responsible Use of Opioids for Chronic Pain (IB 10-791) (va.gov)

Another part of the nature of opioids is that they can cause the rate of breathing to decrease. (This is not the only side effect of taking opioids, but it is the most dangerous.) The more opioids patients take, the more their breathing can be affected.  If the breathing rate decreases too much, the patient can stop breathing completely, which, of course, results in death. This is what is called an “overdose”.

Most patients who see a Pain Management Specialist have suffered from pain for months before their first appointment. Their pain has already lasted for three to six months, which means that it is chronic. Some of these patients expect to get an opioid prescription for their pain. They don’t realize that chronic pain is the type of pain that opioids are the least suited to treat. The problem isn’t just that there is the risk of addiction. The problem is that the actual pain relief from opioids may be less than they need and riskier than they can afford.

In light of these considerations, it’s clear why patients should be given the minimum amount of opioids for the least amount of time possible. Fortunately, opioids are just one of many tools in the Pain Management toolbox. Safely and Effectively Managing Pain Without Opioids | Feature Topics | Drug Overdose (cdc.gov)