We already know the downside of having prescription opioid painkillers available and prescribed for an increasingly wide range of applications. These powerful drugs have escaped the constraints of legal use and become widely misused, leading to high rates of addiction, overdose fatailies, a Canadian ban on Oxycontin, and now, tragically, escalating rates of infants being born addicted from the mother’s opioid use.

But, it has always been argued, these drugs are needed. And most people are only on them for a short time. The medications do their job, and then are discontinued, having benefitted the sufferer.

Except that, maybe, they don’t.

This study, based on a careful review of literature and publications related to studies on opioid painkillers, concludes that, in fact, there isn’t much evidence that opioid painkillers are effective for chronic non-cancer pain.

An excerpt from the article that summarizes the debate:

It is argued that physicians should be encouraged to prescribe opioids because they are indispensable for the treatment of pain and suffering, because uncontrolled pain could have deleterious physical effects, and because persistent pain destroys people’s autonomy, dignity, and decision making capacity (2). It is also recognized that opioid therapy, specifically on a long-term basis for chronic pain, is associated with multiple side effects, drug abuse, and addiction. In fact, in Denmark, a country that has a free flow of opioids, the results showed worse pain, higher health care utilization, and lower activity levels in opioid-treated patients, compared with a matched cohort of chronic pain patients not using opioids (3). This provides prima facie evidence that when opioids are prescribed liberally, even if a small number of patients benefit, the overall population does not.” (emphasis ours)