Pain Management: Is it the Time to Reconsider Using Opioids?

Abstract

Pain is an unwanted sensation for anyone. The management of pain becomes an important issue in medicine. The pain management is usually important consideration in medical procedure practice and surgery. Several drugs and techniques have been introduced for using in anesthesiology and pain medicine. Opium is a classical plant that human beings knew for years. Modification of opium to produce the pain management product has been done for many decades [1]. However, the big issue is the fact that opium and its derivation, opioids, is considered narcotic and become illegal things if used in nonmedical purpose. It is no doubt that opioids can be effective pain killer for the patient but the important issue is on its side effects. It is the present question whether it is appropriate that opioids are widely used in medical society. Setting a guideline to control the use of opioids becomes important issue in present pain medicine [2,3]. Del Portal et al. noted that “an opioid prescribing guideline significantly decreased the rates at which opioids were prescribed for minor and chronic complaints in an acute care setting [2].” According to the recent guideline by American Society of Interventional Pain Physicians, “opioid therapy may be initiated with low doses and short-acting drugs with appropriate monitoring to provide effective relief and avoid side effects [4].” Nevertheless, as noted by Katz et al. “prescription opioid abuse and addiction are serious problems with growing societal and medical costs [5].” A more strict control by law has also been used in some countries [6,7]. This can be useful for control of some non-ethic practitioner who illegal prescribe or sell opioids [7]. For example, the Washington State Legislature has just established “new legal standards of practice regarding chronic non-cancer pain management” for control using of opioids [6]. A challenge is whether we can stop using opioids and use other new non-opioids pain killer that are effective to manage the case.