Opioid drugs make pain tolerable, most long-term users say

Opioid drugs make pain tolerable, most long-term users say

https://www.washingtonpost.com/news/to-your-health/wp/2016/12/20/opioid-drugs-make-pain-tolerable-most-long-term-users-say/

At the center of the nation’s opioid crisis is a simple fact: Large numbers of Americans experience serious pain, and the vast majority of those who have used strong painkillers for a long period say they work.

That’s one key takeaway from a new Washington Post-Kaiser Family Foundation national poll of long-term opioid users, people who have taken the drugs for at least two months during the past two years.

The Centers for Disease Control and Prevention has discouraged doctors from prescribing opioid painkillers for chronic pain treatment after a sharp rise in overdose deaths related to opiates ranging from prescription painkillers to heroin and synthetic drugs such as fentanyl. CDC Director Tom Frieden recently told The Post that “prescription opiates are as addictive as heroin,” and the agency’s guidelines have noted that there is limited evidence that the drugs are effective in treating long-term pain. The Post-Kaiser survey finds that about 1 in 20 Americans have taken the drugs to treat pain for at least two months over the past two years, representing a significant barrier to curbing the country’s reliance on the drugs.

The survey of adults who have used opioids for at least two months in the past two years found more than 4 in 10 saying that their health is “only fair” or “poor” (42 percent), more than double the share of all Americans who rated their health as negatively in a November Kaiser Family Foundation poll (18 percent). And 7 in 10 long-term opioid users say a disability, handicap or chronic disease keeps them from participating fully in work, school, housework or other activities.

Roughly 4 in 10 long-term opioid users say chronic pain was the reason they first started taking the drugs, while about one-quarter each cited pain after surgery or following an accident or injury.

But opioid users say the painkillers make a significant difference — 92 percent say that prescription painkillers reduce their pain at least somewhat well, including over half (53 percent) say they do so “very well.” In a separate question, 57 percent say their quality of life is better than if they had not taken the medications.

When long-term opioid users are asked about the medication’s impact on five broad aspect of their lives, they rate two positively on balance, two as mixed and one negative. Opioid users report the most positive impact on their physical health, with 42 percent saying painkillers have had a positive impact on their health, another 20 percent saying it has been negative and 37 reporting no impact. Regarding their ability to do their job, just under a quarter (23 percent) say painkillers have had a positive impact, while 14 percent say they’ve had a negative impact and another 48 percent said they’ve had no impact.

Opioids’ impact on physical health and work

Percentage of long-term opioid users on how drugs impact their lives

0
10
20
30
40
Physical health
 
Positive
42%
Negative
20
No impact
37
Ability to do your job
 
Positive
23
Negative
14
No impact
48

Long-term opioid users split on how the drugs have affected mental health and personal relationships. About 1 in 5 say painkillers have had a positive impact on their mental health and another 1 in 5 say they have had a negative impact on their mental health, while almost 6 in 10 say they’ve had no impact. Similarly, 68 percent say opioids have had no impact on their personal relationships, while 15 percent report a positive effect and 16 percent say it has been negative.

Mental health and personal relationships

Percentage of long-term opioid users on how drugs impact their lives

0
20
40
60
Mental health
 
Positive
21%
Negative
19
No impact
57
Personal relationships
 
Positive
15
Negative
16
No impact
68

The only measure in which long-term opioid users report more of a negative impact than a positive one was in finances: Just 8 percent say painkillers had a positive impact on their finances compared with a larger 17 percent who said they were negative. A 74-percent majority, though, said painkillers had no impact on their finances.

Finances

Percentage of long-term opioid users on how drugs impact their lives

0
20
40
60
Finances
 
Positive
8%
Negative
17
No impact
74

Two areas where long-term opioid users report significant problems are dependence and adverse side effects. Roughly one-third (34 percent) of long-term opioid users say they became addicted to or physically dependent on the drugs (separately, 31 percent say they are dependent, 23 percent say they are addicted). Physical side effects are common, with 55 percent saying the drugs have caused constipation and another 50 percent reporting indigestion, dry mouth or nausea.

The poll finds that people who live in the same household as a long-term opioid user report a more negative picture across the board — 54 percent say the person they live with is or was addicted to or dependent on painkillers. Household members are also significantly more concerned about side-effects than are opioid users themselves. A 67 percent majority say they’re at least somewhat concerned about side-effects of the painkillers, compared with 49 percent of those who use them. Household members are also more likely than opioid users themselves to say the painkillers have had negative impacts on the user’s physical health (39 percent vs. 20 percent of users) and the user’s mental health (39 percent vs. 19 percent).

[Read full poll results]

But regardless of the adverse effects, the Post-Kaiser survey results show clearly why opioid users feel the medication is necessary, and why they are worried about the impact of a crackdown on abuse of the drugs.

Two-thirds of long-term users say they are very or somewhat concerned that efforts to decrease abuse of prescription painkillers could make it more difficult to obtain them. Nearly 6 in 10 say that as it is, prescription painkillers are difficult to obtain for medical purposes.

Allaying those concerns represents a big task for those seeking to combat the worst effects of opioids and one that’s not likely to go away soon.

This Washington Post-Kaiser Family Foundation poll was conducted by telephone Oct. 3-Nov. 9 among a random national sample of 622 adults age 18 and older who say they have taken strong prescription painkillers for a period of two months or more at some time in the past two years other than to treat pain from cancer or terminal illness and 187 household members of someone meeting the previous requirements. The results from the sample of personal users have a margin of sampling error of plus or minus five percentage points and the sample of household members has an error margin of plus or minus nine percentage points.

17 Responses

  1. Perhaps pain meds don’t help you with fibromyalgia but it does help mine when on the right dose of the right medication. One of the things we are hoping to make the public and the government understand is that there’s no one size fits all medication! Please remember that when you say this particular health issue doesn’t respond to medication because it might for some! If we who live with pain cannot understand that how do you expect someone who never had a headache to understand?

    • Exactlly,,,it is a fact,,,and impossibility,,,for ANYONE to physically feel the physical pain of another,,,IT IS LITERALLY IMPOSSIBLE,,, thus no-one has the rite to decide who suffers in physical pain and who does not,,,,,that factual ideology USE TO BE UNDERSTOOD,, as commoner logic,,natures law,,,,but now a days we got arrogant sob’s who think they have that rite,,to decide who suffers in physical pain and who does not,,,,for me,,,its a sign of a psychopathic behavior,,,for if u r soooo arrogant u think u have that rite,,to FORCE another humanbeing to suffer in physical pain,,,u r forcing them to endure physical pain,,which any psychopath will do,,,they enjoy watching someone suffer in physical pain,,,thats why their called psychopaths,,,thee inability for empathy,compassion,,and heres a biggy,,thee delusion of grandeur to think they have that rite or ability,,there mental status is non-realistic,,for any NORMAL humanbeing understand it is impossible to feel the physical pain of another,,thus they have thee empathy to not want them to suffer in physical pain,,,,ie Klondike bar is a true PSYCHOPATH,,,along w/his cronies,,they have created thee years 2000-2017 PENNHURST alll over again,,where the crippled,,the true chronic physical pain HUMAN BEINGS are being FORCIBLE locked up in some psych ward OUT IN THE MIDDLE OF NO-WHERE JUST LIKE THE DAYS OF OLD PENNHURST,,,,MARYW

      • pss LOCKED UP IN THE MIDDLE OF NO-WHERE IN A PSYCH WARD WITH,,,,,,,NO EFFECTIVE PAIN MEDICINE,,,, FOR THEIR CRIPPLING DESEASE,MEDICAL CONDITION,,,LEFT TO SUFFER IN AGONY,,,,,IT IS PENNHURST ALLL OVER AGAIN!!

  2. The wonderful, caring doctor I once had (doctors don’t stay in Fairbanks,Alaska for long) told me that he didn’t see the problem with becoming dependant on pain meds when you know that your condition at best will not get better and is likely to become worse. Sadly I was right when I told him that the only problem I see is not having a doctor to write the prescription!

  3. Yes, I’m “hooked” on my pain medication just as I am “hooked” on my antidepressant. I’ve been taking both for the same length of time – about 10 years. I wish people would start educating themselves as to the different between physical dependence and true addiction.

  4. I have been on opiate drug therapy since the early 90’s by a pain a management doctor as more surgery to my lower back wasn’t possible as it would paralyze me. My first surgery to my lower back was in 1973, & the second was in 1980. I also have many other pain conditions that have come along in the ensuing years. Arthritis, MS, scoliosis, fractures from osteoporosis, & many more problems. I also had an ostomy this past year. I am not addicted to the 30 mg of oxycodone I take 4 to 5 times a day. Many may think that is impossible, but I am able to skip doses at times, & at night I take my last dose at 9 P. M., & don’t take another until I get up in the morning. Being in bed helps my pain the best, but I have also the duties of taking care of my husband who is bed bound most of the time. I am now 70 years old, & figure I will never be off of pain meds. My doctor doesn’t like it, & stated he will never increase my dose, which is fine by me. I don’t believe the government has any business on how or why our scripts are written. If I was to be cut off at some point, I too would have to hope I could buy my opiate on the street! What an awful thought! I have a petition to our Congress on MoveOn.com called Chronic Pain Patients vs. the DEA, You can still sign this petition. There are many face book pages on chronic pain. Just type in Chronic Pain for the name, & you will find support for your condition, & how to fight the DEA. Thanks to Steve, we all have a fighting chance to get this understood more that there are many of us that require pain meds, & may have to have them our entire lifetime. I was put on disability by my doctor in 1990, but since I am past 65, am now on SSA instead of SSD. My bones were crumbling from osteoporosis at that time at the young age of just 40. I totally get where everyone is coming from on this issue, & am doing all I can to help. I am just hoping my pain doctor keeps giving me my pain medicine until my end of life. For those that are taking pain meds for fibromyalgia they don’t help! I also have that, & have found that you need to keep moving, not take pain meds for that particular condition. Thought I should add that as I see many people taking strong pain medications for fibro, & they just don’t work for it. There are also many face book pages on that condition also. You may have to join a private group, but the input is invaluable.

    • Mary B,,,r in wisco??m

    • To Mary B”;;,,,SINCE IT IS factual,,, THAT IT IS LITERALLY IMPOSSIBLE FOR ANYONE TO PHYSICALLY FEEL THE PHYSICAL PAIN OF ANOTHER HUMANBEING,,,,THATS A FACT,,,NO-ONE HAS THE RITE TO DECIDE WHO SUFFERS IN PHYSICAL PAIN AND WHO DOES NOT,,,,”IE STRONG MEDS DON’T WORK FOR FIBROMYALGIA,”’,,,,WHY DO U THINK THAT IS YOUR RITE TO DECIDE THAT??,,,,,,IS IT YOUR BODY THAT IS ENDUREING FIBRO??NO,,,THUS SINCE IT IS LITERALLY IMPOSSIBLE FOR U TO FEEL THE PHYSICAL PAIN OF ANOTHER,,,,ITS NO-ONES PLACE TO DECIDE WHAT HURT,THE SEVERITY OF THAT HURT,,THUS WHO IS SUFFERING IN PHYSICAL PAIN AND WHO IS NOT,,,,,maryw

  5. I am not certain that I agree with strict guidelines, urine tests, blood tests and only certain doctors being allowed to prescribe beccause that in itself leads the uneducated public to believe that opiates are bad. There are no such guidelines for doctors prescribing drugs for diabetes or psych drugs that are being used to treat off label. There are no restrictions for invasive and potentially dangerous procedures that any quack can come up with to treat pain. Before the war on drugs most opiates were otc. People used them as needed, held down jobs, went to church,were active in the community and drug cartels were unheard of. Crimes involviing pain medication were unheard of. They’re finally beginning to admit that legally prescribed drugs are not the problem. Other than job security and big money there’s no valid reason for all the laws and regulations surrounding pain medication.

  6. I am 64,now disabled with chronic pain conditions.The docs have had me on the same dose of hydrocodone for the past several years.A relatively low dose at 4 per day 10-325,or total 40 milligrams daily.For me this has been and continues to be helpful,without any adverse effects.I also drink kratom tea.The Kratom tea has helped to the point that I’ve had no need,or desire to,increase the dosage of the hydro.This combo has been helpful in that I am more functional than I would be without this medicine.

    When I first wake up,I cannot even walk nor function until I take a pain pill.After all these years it still remains efficient.After I am up for about an hour,I will sip on a little kratom tea.The combo makes it possible for me get outside and with my walker take little walks,sit up for a couple hours and talk with others.I am probably medically dependent on the hydro.But that is a small price to pay for being functional and controlling continual pain.If used responsibly there is no doubt that the medicine is useful and safe.There is to much hysteria and focus on the negatives,and not enough focus on the positives.It has given me some quality of life where otherwise there would be none.

  7. I think because of social pressure most people don’t know the difference between addiction and dependence and those who don’t live with severe chronic pain don’t know or understand anything to do with pain or medication! It’s always amazing to me that when they do these surveys they always manage to learn towards the negative side of taking pain meds. I have taken large doses of opiates for many years an feel that if they could cure the pain issues I have I could wean off the meds and never look back. While I still have a fairly high pain level b with the meds at least I am not writhing on the bed crying 24 hours a day!

    • I 1000% agree with you, as well as the statistics, that there is a big difference between addiction and dependence. I also very much believe that the CDC shouldn’t take away opiods from patients who are very well monitored by a good doctor who’s able to prescribe them under the strict guidelines.

    • Ditto Connie,,,,I also believe though,,,many people can’t afford ,”pain management,” or its not a cover’d expense vias insurance sooo let their primary do the job,,for the patients sake,,,maryw

      • I totally agree. I see no need for pain treatment to be a separate specialty! This centimeter specialties are just crap! I have excellent insurance but live in an area where specialist(that are actually needed such as gastroenterologist) don’t exist! I can’t afford to fly out of state every month for treatment especially when it’s something any decent doctor can deal with. Once pain issue has been diagnosed even a np can write prescriptions!

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