Experts Say Opioids May Not Be Worth Risk for Some Conditions

Risks of addiction, overdose and death from opioid use may not be worth benefits in treating chronic, noncancer conditions

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) In recent years, opioids have become a safety concern for some health officials. The American Academy of Neurology (AAN) recently released a statement on opioid use to address this problem.

The AAN statement said that the risks tied to opioid use — like serious side effects, addiction, overdose and death — outweigh the benefits when treating chronic, noncancer conditions like lower back pain and headache.

The authors of the statement made suggestions to doctors on how to safely prescribe opioids when they're needed.

"More than 100,000 people have died from prescription opioid use since policies changed in the late 1990s to allow much more liberal long-term use," said Gary M. Franklin, MD, MPH, a fellow with the AAN, in a press release. "There have been more deaths from prescription opioids in the most vulnerable young to middle-aged groups than from firearms and car accidents. Doctors, states, institutions and patients need to work together to stop this epidemic."

Opioids are a class of medicines used to treat pain. They include morphine, oxycodone (brand name Oxycontin), hydrocodone (brand name Vicodin) and methadone (brand name Methadose).

Opioids can also be addictive. The authors of the statement wrote that, in past studies, around 50 percent of patients who took opioids for three months were still taking them after five years.

While they can ease pain in the short term, opioids are not proven to help in the long term — at least not without posing serious risks like overdose and death, the authors noted.

To address these problems, the authors of the AAN statement suggested some guidelines for doctors who prescribe opioids. These guidelines included the following:

  • Consult a pain management doctor if the needed opioid dose is higher than 80 to 120 milligrams per day.
  • Screen patients for drug abuse.
  • Look for depression.
  • Monitor other medications the patient is taking.

The authors also wrote that treatment with opioids should only be part of a larger treatment plan — not the only treatment.

The AAN statement was published online Sept. 29 in Neurology.

The authors disclosed no funding sources or conflicts of interest.

Review Date: 
September 29, 2014
Last Updated:
October 8, 2014