Chronic pain patients, in order to manage their pain, use a combination of therapies and medications. Opioids are a class of drugs often utilized by chronic pain patients.

Opioids are synthetic narcotics that bind to opioid receptors in the body, causing a reduction in the sending of pain messages and subsequently reducing pain. Opioids are often prescribed when other pain medications do not adequately control moderate or severe pain.

Different types of opioid medications include forms of codeine, hydrocodone, morphine, fentanyl, hydromorphone, miperidine, methadone, oxycodone and naloxone.

The majority of pain patients take prescribed opioids appropriately and do not become addicted or misuse the drugs. But many chronic pain patients also struggle with opioid addiction (and subsequent withdrawal) as well as improper usage of opioid medication.

The April issue of the journal Pain, which is published by the International Association for the Study of Pain, determined two significant and disturbing statistics:

• 20-30% of opioids prescribed for chronic pain are being misused.
• 10% of chronic pain sufferers are addicted to opioid medication.

The study defined “misuse” as utilization of the medication in a way that was contrary to the prescribed use, including to cause a euphoria or high sensation, altering one’s consciousness in order to sleep or zone out, as well as abusive usage like taking more than the prescribed amount of medication or crushing and  snorting the drugs.

The study did not address the issue of opioid tolerance, which occurs when a patient needs higher and higher dosages of opioids in order to continue to manage pain effectively.

Opioid abuse and addiction can be fatal. In 2013, there were 16,235 deaths involving prescription opioids in the United States, according to the Centers for Disease Control. This was an increase over the previous year.

Physicians, patients, patients’ families and state and federal government are all concerned about these statistics. Doctors are working to monitor prescriptions and to look out for patterns of abuse and addiction. Michigan requires tracking of prescriptions for controlled substances, which is why many doctors and pharmacists will not use electronic prescriptions for these classes of drugs.

For the majority of pain patients who use opioids responsibly and appropriately, they may feel the pressure of increased surveillance by pharmacists and doctors. This should not be perceived as intrusive, but as protective.

Honest communication between doctors and patients about medication usage, continued monitoring of opioid use and effectiveness and an openness among patients who wish to be pain-free but are aware of the dangers of opioid addiction and abuse are helpful in managing pain relief without the unwanted consequences of opioid abuse.