By Ed Coghlan.
The National Pain Report published a story about an article written by one of the nation’s leading pain physicians about the collateral damage that the opioid controversy is inflicting on pain patients.
Dr. Jay Joshi— writing for Quartz Media—declares the medical and scientific communities are reacting by questioning not only the prescription of opioids for treating pain, but the very treatment of pain itself.
It set off a firestorm of commentary from our readership—which is, or course, the pain community.
We at the National Pain Report have been asking—with dunning repetitiveness—what is supposed to happen if opioids are eliminated or restrictions to them are intensified?
In other words, if opioids are so bad what’s the alternative for millions of chronic pain patients who use opioids responsibly?
We have already received dozens of responses. One, in particular, caught our eye.
It was from chronic pain advocate, Richard “Red” Lawhern who wrote the following:
A really fundamental issue is implied by this article: if opioid therapy for pain is considered to be inadvisable for people who have a history of addiction or drug involvement, then just what IS advisable? Are there realistic alternatives? If so, then I don’t see them mentioned here.
The Agency for Healthcare Research Quality is now circulating a draft report of a “systematic review” of over 4,000 published trials of non-invasive, non-pharmacological therapies for pain. By the time AHRQ analysts boiled down this literature, they generated only 265 trials that could be analyzed for the short-term, intermediate-term, or long-term benefits of such therapies for any of five classes of painful disorders. Among those surviving trials, the term “Strength of Evidence – Weak” appeared over a hundred times.
In my personal view, the weakness of methods and protocols used in published trials of non-opioid therapies is so pronounced, that we literally don’t know whether they work any better than placebo. This entire medical literature needs to be burned to the ground and done over.
In the questions he asks, is a broader question.
“If not opioids, then what?”
It’s a question we keep asking leaders in the pain community.
So, let us ask you.