OPIOID THERAPY

The experience of pain specialists over decades has convinced us that
long-term opioid therapy is beneficial for a minority of patients with
common causes of chronic pain and for a large majority of those with
pain due to serious illness. Undertreated pain is a serious public
health problem, and access to opioid medicines must be preserved even
as society deals with the serious public-health problem of rising
prescription drug abuse.

To do so, we must understand that opioid addiction, overdose and abuse
are separate but related problems. The compulsive use that
characterizes addiction may or may not be involved in the overdose
deaths of recreational drug users or the misuse of a drug prescribed
by a poorly trained physician. When two public health problems of such
complexity coexist, aggressive action for one problem must acknowledge
the complexity and avoid actions that unintentionally worsen the other.

Russell K. Portenoy, M.D.

New York