Based on the vast number of prescriptions for opioid medications written by US practitioners over the past few decades, we’ve become the clear leaders in opioid prescribing.
We may be stuck relying on the soft stuff– therapy, support, behavior change, even spiritual growth– all those icky-squicky things that neuroscientists struggle to quantify.
As the old chief says in the movie Little Big Man: “Sometimes the magic works, sometimes it doesn’t.”
It may turn out that chronic pain, like addiction, is one of those conditions that responds best to an approach that’s both individualized and ongoing, and requires considerable commitment on the patient’s part.
It takes thirty seconds to write a prescription… that fits very well into a scheduled 15 minute office visit.
Mood and motivation are, of course, a big part of the discomfort associated with having chronic pain.
Diversion to abuse has been significant. Currently methadone represents only some two percent of all opioid prescriptions, but it’s been implicated in an astounding one-third of all opioid fatalities.
People have abused opiates for 5,000 years. As much as medicine depends on them, they’ve always created problems for a percentage of users.