Increasing concern about the risks and limited evidence supporting the therapeutic benefit of long-term opioid therapy for chronic noncancer pain are leading prescribers to consider discontinuing the use of opioids. In addition to overt addiction or diversion, the presence of adverse effects, diminishing analgesia, reduced function and quality of life, or the absence of progress toward functional goals can justify an attempt at weaning patients from long-term opioid therapy. However, discontinuing opioid therapy is often hindered by patients’ psychiatric comorbidities and poor coping skills, as well as the lack of formal guidelines for the prescribers…
Gee, are those the only reasons discontinuing opioid therapy is problematic? Could it be that doctors have nothing to replace it with?
Doctors to pain patients: We’re going to taper you off this medication that helps you function every day and reduces your pain, but we’re not going to replace it with anything. In other words, just suffer. After all, suffering is better than the possibility of addiction or diversion, don’t you think? Sure, unmanaged pain will shorten your life span, make you miserable, and may produce suicidal ideation, but so what. We’re doctors and we know what’s best.
And the reason there’s “limited evidence” for long-term opioid therapy is because the research hasn’t been done yet. Hey, I have an idea: Why not do the freaking research?
You know what else hasn’t been proven to work on a long-term basis? Antidepressants. Go ahead, doctors, start tapering those medications too. Pretty soon, we won’t even need doctors any more.