A former champion of opioid use for pain management has changed his tune, and he is sending out a strong warning against misusing the treatment that he once championed. Dr. Russell Portenoy’s public change of heart underscores the urgency of addressing this important health crisis: addiction to opioid derived pain medicines.
Shaky data, but a passionate advocate
In the early 90′s and into the early 2000′s, Dr. Portenoy worked diligently to advocate opioid use for chronic pain management. In the 80′s, he co- authored a paper arguing opioids could be safely and effectively used in chronic pain sufferers for all patients, no matter the source or duration of their pain. Unfortunately, Dr. Portenoy’s highly influential paper and subsequent speeches were based on a tiny, short-term study of only 38 patients. Despite the shaky evidence he started advocating wide use of opioid-derived pharmaceuticals for pain treatment. Drug companies responded, and in 1996 Oxycontin and similar drugs were released into the market.
Righting a wrong
Today drugs containing opioids are the most widely prescribed drugs in America. They are also behind the country’s deadliest epidemic: fatal drug overdose. 16,500 people die from drug overdose of legal drugs annually. Citing the overwhelming potential for addiction and accidental deaths due to opioid pain medicines, Dr. Portenoy is expressing regret in promoting their use for chronic pain.
He acknowledges there are no long-term studies proving that the pain medicines even work for long-term pain sufferers.
Scientists are studying the findings of the Human Genome Project to target specific genes with unique drugs to treat diseases. Dr. Portenoy contends that there may be some patients who are more prone to addiction and overdose of opioid drugs. Perhaps there are a group of patients who may benefit from long-term opioid treatment, but science has yet to shed light on exactly who those patients are.
Dr. Portenoy expresses regret in the role he played to vastly expand the use of opioid-based painkillers, but he is moving forward and urging more studies to be done to help those of us who suffer with chronic pain. What has helped you cope with your chronic pain?
El-Ghobashy, Tamer and Barrett, Devlin, “A Pain-Drug Champion Has Second Thoughts,” The Wall Street Journal, Vol. CCLX, No. 141, December 15-16, 2012
National Institutes of Health: National Human Genome R