Have you ever wondered why your doctor is suddenly hesitant to prescribe opioid medications? My initial set of blog posts will go thru the basics of the opioid guidelines and the “why” behind their development, and thus why your doctor may not be prescribing opioids now. I will have more detail and information to help those with chronic pain understand what they need to know about the guidelines and how they impact you as a patient. I’m planning on my future blog posts being more conversational in tone, but I think I need to lay out this foundational information.

As a framework, there are 4 background elements to the guidelines as I see it:

  1. Issues associated with use of chronic opioids for non-cancer pain and how some patients develop an opioid use disorder (the term that is now used to describe addiction, which is a term we no longer use).
  2. The risk of overdose that opioids have that is not just for those that overuse. This was an important factor in the development of the guidelines because it was identified how significantly increased doses could lead to increased unintentional overdoses (and death in some cases) for those that were using the medication as prescribed by their medical provider.
  3. Understanding how chronic use of an opioid does not always lead to the intended impact of relieving pain. There is a reason for this, and I will explain this in the coming days. This is a very important part of the complex equation of whether or not to use opioids.
  4. The unintended consequences of chronic use of opioids that impact the person’s ability to properly sense their body, which has a clear impact on potential for injury or further damage. We need to be able to sense our body and feel pain in order to operate it correctly and not damage it. The analogy I use is as follows: You have a car that is making a big clunking sound. You are going on a cross county trip and have your mechanic take a look at it. He indicates that he does not know what it is but advises you to “just turn the radio up real loud so that you can’t hear it” and then sends you out on your trip. Most of us would agree that is a poor method of dealing with the problem. We do need to understand what is causing our pain and also sense our bodies at some level.

My next series of blog posts will focus on these four elements to help individuals understand the basics behind the CDC opioid guidelines and recommendations for chronic non-cancer pain. This will help individuals understand the proper place for opioids and the “why” behind the clear need to limit them in certain areas. I hope to make this a compelling read, and my patients would say that this information really helps them in understanding how to move forward in a positive way with the opioid question.