‘Editorial: Opioids can make the pain worse’


By Max R. Weller

Read the editorial from the Times-Call here. Copied below in its entirety:

A recently released study by researchers at the University of Colorado supports previous discoveries about the harmful nature of narcotic painkillers: Opioids, in the long run, can make the pain worse.

Even the brief use of opioids might be to blame for the onset of chronic pain, according to the researchers, who found that in rats, brief treatment with the powerful pain killers ended up intensifying the long-term release of pain signals.

“Our key finding is that we were able to demonstrate that a brief treatment with a pain killer, like morphine, doubled the duration of chronic pain,” Peter Grace, assistant research professor at CU’s department of psychology and neuroscience, told the Denver Post.

The animals had sutures tied around their sciatic nerves for five days and were left in pain for 10 days, before morphine was applied directly to their spinal cords.

Whether the specific findings in the CU study have implications regarding human opioid use and abuse is unknown, as patients treated for pain aren’t intentionally left in pain for a week and a half. Nor is morphine applied directly to their spinal cords.

Opioids are the most potent of painkillers, reducing the perception of pain by attaching to nerve receptors in the brain and other parts of the body, often producing sleepiness and a sense of euphoria.

Delivered orally, intravenously or through patches, they are an essential part of treatment for patients after a severe injury or in recovery from surgery, as they can help in the healing process.

However, it has been known for years that opioids can make the pain worse. In humans, this worsening of pain is called opioid-induced hyperalgesia. The leading theory is that opioids can “excite” nerve receptors so that they more readily transmit pain impulses. Increasing the dose of the narcotic only exacerbates the problem.

Studies such as the one released last week receive so much attention because the overuse and misuse of opioids in the United States is becoming epidemic.

The use of opioid painkillers by Americans is off the charts, as about 80 percent of the world’s supply of opioids is consumed in the United States, which has 5 percent of the world’s population. The National Institute on Drug Abuse has reported the number of Americans who died from prescription opioid overdoses increased from just under 6,000 in 2001 to nearly 20,000 in 2014.

Just last week, it was announced that the musician Prince died of an opioid overdose.

The numbers support the conclusion that too many Americans are taking too many painkillers, and that access to and the prescribing of opioids must be checked.

“The implications for people taking opioids like morphine, oxycodone and methadone are great, since we show the short-term decision to take such opioids can have devastating consequences of making pain worse and longer lasting,” CU professor Linda Watkins said in a news release regarding the findings.

It’s settled that opioids are as dangerous as they are helpful, and that brief exposure is enough to trigger dependence or addiction.

The take-away from the CU study — and from the numbers released by the NIDA — is not that opioids should not be used at all. It is that these narcotics, which for centuries have been used to ease human suffering, should continue to be used only under the strictest guidance and supervision.

Millions of Americans who suffer from chronic pain, including end-stage cancer patients, need the relief that opioids provide. Hundreds of millions more worldwide would benefit from access to these narcotics.

But clearly, millions who use these drugs don’t need them and are only worsening their condition with their use.

If only a study could reveal how humans could master their own tendency to abuse that which is powerful and good.

My online comment (posting as RealityCheck) follows:

Years ago, I went to the ER at a hospital in Kansas City, MO because of excruciating pain from passing a kidney stone, which a CT scan showed to be 4mm in diameter, just below the threshold that would have necessitated surgery. I received an injection of Fentanyl, an extremely powerful synthetic opioid; it made my pain tolerable, but did NOT turn me into a junkie.

I’ve also had surgery in the past to remove veins in my left leg, which was done by making a 3″ deep and 4″ long incision in my groin. I received Percocet (a combination of acetaminophen and oxycodone) for my post-operative pain, which was significant for almost a week. Again, I did NOT become a junkie, and in fact safely discarded the unused portion of my scrip for this powerful painkiller.

I’m opposed to the practice of medicine being affected to an unnecessary degree by dope fiends who will abuse almost any drug to get a so-called high. In fact, ERs across the country have a “frequent flyers list” for those addicts who repeatedly attempt to scam narcotic painkillers. Some jurisdictions even prosecute the scammers. Among the worst-behaved transients in Boulder County, CO there are many who visit the ER with no good reason, and I’ve even seen them turned away by paramedics who responded to their 9-1-1 calls for fake emergencies.

The majority of patients who need pain medication for legitimate reasons should not be inconvenienced and made to suffer by the dope fiends. I trust health care professionals to use their own good judgment.


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