Opioid painkillers carry higher risk of death, overdose, addiction or serious side effects than benefits in chronic, non-cancer conditions like headache, fibromyalgia and chronic low back pain.
Opioids, or narcotics, are pain medications including morphine, codeine, oxycodone, methadone, fentanyl, hydrocodone or a combination of the drugs with acetaminophen.
Gary M. Franklin from the American Academy of Neurology (AAN) said that there have been more deaths from prescription opioids in the most vulnerable young to middle-aged groups than from firearms and car accidents and so doctors, states, institutions and patients need to work together to stop this epidemic.
Studies have shown that 50 percent of patients taking opioids for at least three months are still on opioids five years later and while opioids may provide significant short-term pain relief, there is no substantial evidence for maintaining pain relief or improved function over long periods of time without serious risk of overdose, dependence or addiction.
The AAN recommends that doctors consult with a pain management specialist if dosage exceeds 80 to 120 (morphine-equivalent dose) milligrams per day, especially if pain and function have not substantially improved in their patients.
The statement also suggests doctors to create an opioid treatment agreement, screen for current or past drug abuse, screen for depression, use random urine drug screenings, not prescribe medications such as sedative-hypnotics or benzodiazepines with opioids, sssess pain and function for tolerance and effectiveness, track daily morphine equivalent dose using an online dosing calculator, seek help if the morphine-equivalent dose reaches 80 to 120 milligrams and pain and function have not substantially improved and use the state Prescription Drug Monitoring Program to monitor all prescription drugs the patient may be taking.
The study is published in the medical journal of the American Academy of Neurology.