What Are the True Addiction Risks of Pain Medicine?

I believe most journalists believe they are doing the right thing in repeatedly focusing on only negatives of opioid prescribing: overdoses, addiction, pill mills, etc. But there's a tonal thing happening from several prominent journalists that worries me. The fact is, for many mild-mannered patients with serious pain, it's very very hard to get these drugs much of the time these days, and doctors rarely bring them up as a possibility, which forces one to either suffer silently or ask for them and risk their distrust. I was told by one pain specialist at a leading hospital (and no, he wasn't prescribing me opioids) that he had colleagues who will no longer prescribe them at all....he was referring to doctors whose job is to control pain. This is scary, and unless you have an intimate acquaintance with serious pain and the way it comes to dominate your consciousness, you may not realize that your push for further restrictions may come back and bite you some day when you're at your most vulnerable.

For a lot of pain, opioids really are better: the well-being opioids can induce at times is, if an inducement to addiction in a subset of people, for many others a kind of balm that mitigates the fact that no painkillers are 100% effective with many types of pain. When I've been given them for postsurgical pain, I've always laid them aside when the pain subsided enough, even after taking them for a week or two in a row every 4-6 hours. It wasn't even difficult, and I have as addictive a personality as the next person.

But for my steadily worsening rheumatoid arthritis, I've never been given these drugs. Since I am unable to take NSAIDs, this leaves me with nothing at all, and almost every night I lie awake with throbbing and burning joints. And I'm pretty sure my doctor wouldn't give them to me if I asked, given his respect for his patients' points of view.

Any discussion about these drugs should include a frank consideration of their benefits, and an awareness that there are many doctors and nurses who, despite a period of progress in overcoming their prejudices against pain control, remain fearful and judgmental, and have learned to see patients as the enemies. Not everyone who advocated for better pain control had ulterior motives; many had seen great suffering firsthand. Now we are heading down a road that will take us somewhere we may discover we didn't want to go. I'm all for a registry so we can spot doctor shoppers. But maybe we also need a registry for all the rest of us who can be trusted and aren't as prone to addiction as you'd have us believe.