Opioid risk may outweigh benefits

American Academy of Neurology releases new position statement

The American Academy of Neurology is encouraging anyone battling chronic pain from non-cancer conditions, like back pain or fibromyalgia, to avoid taking opioids, which include morphine, codeine, and oxycodone.  AAN researchers say the risk of death, overdose, addiction, and side-effects far outweigh the benefits of these medications.

"So, these drugs are really meant for the short-term treatment. So, somebody who is post-op, somebody who is in a cast and just starting to recover from that- something that's short-term that we know can heal. They're not meant for the chronic duration of a person's life," said Dr. Amy Burleson-Sullivan, who did not take part in the study but is a pain management expert at Cleveland Clinic.

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The position statement from the AAN says prescription opioids including morphine, codeine, oxycodone, methadone, fentanyl, and hydrocodone should be avoided when treating chronic, non-cancer conditions such as headache, fibromyalgia, and chronic low back pain.

The statement recommends doctors consult with a pain management specialist if a patient's dosage exceeds 80 to 120 milligrams a day.  Doctors are also being encouraged to screen all of their pain management patients for current or past drug abuse, depression, and to assess how well the medication is working.

AAN researchers say studies have shown 50% of people taking prescription pain killers for at least three months are still on them five years later.

Bburleson-Sullivan applauds the AAN for their position statement and says there are many ways to manage pain without pills.

"I think psychological principles are always a great place to start. We teach stress management. We can teach mindfulness, biofeedback and that is a way of teaching people how to interpret their pain signals and how to relax," she said.

Read the complete position statement from the American Academy of Neurology in the journal Neurology.