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Are opioids a good choice to manage chronic pain?

Donna Hill Howes, RN
Family Practitioner

People should avoid taking opioids for chronic pain. They are usually prescribed only for short-term use when safer treatments do not work. They are often used for severe cancer pain, especially for people with a short life expectancy. Opioids are not recommended for treating pain caused by inflammatory conditions, such as rheumatoid arthritis.

Opioids are not considered a good option for pain from nerve damage, also called neuropathic pain. But an opioid (usually tramadol) is sometimes prescribed for a short time when neuropathic pain is not relieved with first-line drugs, such as amitriptyline or pregabalin.

Opioids carry a very high risk of abuse, addiction, and fatal overdose. This risk is higher in people with a history of substance or alcohol abuse and in people with psychiatric problems, such as depression. The risk of overdose is also higher for people who take extended-release or long-acting forms of the drugs. Opioids also carry a high risk of life-threatening breathing problems (respiratory depression), even when taken at recommended doses.

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Opioids are no longer considered to be good medications for managing chronic pain. Studies have found that opioids do not help treat chronic pain. Other treatments such as physical therapy, non-steroidal anti-inflammarory medications (NSAIDs) and trigger point injections are far more beneficial.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.