The CDC’s training module for medical staff is frank about the limited usefulness and substantial risk of using opioids for long-term pain management. Slide 5, for example, offers this list:
Research findings inform how and what we communicate to our patients who are experiencing chronic pain. These findings include:
- While every patient is different, most people using opioids long-term continue to say they have moderate to severe pain.
- Patients using opioids long-term actually may report worse pain than those using other approaches to pain management.
- Opioids, especially at high doses, can cause patients to stop breathing and die. Taking alcohol, sleeping pills or anxiety medications increases these risks.
- Some pain patients develop a serious, lifelong addiction to opioids. It is difficult to predict who will develop an addiction to prescription opioids.
- Opioids can cause constipation, dry mouth, nausea, vomiting, withdrawal, drowsiness, and might make driving unsafe.
- Providers must meet often with patients to make sure opioids are not causing more harm than benefit.
And this insight from the following slide:
- We used to think it was safe to increase dosage to reduce pain. Now we know this increases risks of overdose and physical dependence, and it may not reduce pain over the long run.
Many more informative slides follow, and other web pages, too, including the very substantial 2016 CDC Guideline for Prescribing Opioids for Chronic Pain intended to guide the choices made by primary care clinicians. [One or two dead links as well.]
As in other important and reputable web resources on the opioid crisis, it can be easier to find crucial documents aimed at an audience of medical professionals than to find documents intended to meet the needs of legislators, teachers, students, voters, social service workers, and other generalists who are involved in our communities in addressing the opioid crisis. It appears, then, that a portion of the crisis is a problem of translating and publishing information in forms suitable for that wider audience. As Indiana begins its 2018 state legislative session, for example, what information do legislators and their staffs need? Do they have this information in a form they can use in crafting legislation and in building understanding and support among citizens?