Medical service provided by
Pain Care Physicians, PLLC
206-538-6300 | Fax: 206-538-6301 | Email: info@anesispain.com

Opioid Therapy

Opioid Therapy

Chronic opioid analgesic therapy for pain has fallen into disfavor due to evidence that has been gathered over the last 20 years. The evidence strongly suggests that long term opioid use results in serious side effects, including dependence, addiction, hormone imbalance, bowel problems secondary to constipation, and impaired thinking. A person’s nervous system will quickly adapt to opioids such that their effectiveness diminishes over time, a phenomenon known as tolerance. Increasing dosages to recapture benefit has diminishing returns with increasing risks. Even when taken as prescribed, opioid use may result in overdose, and even death. Patients that have taken opioid medications may not realize that long term use of opioids, especially at high doses, may have actually maintained their pain or made it worse over time. However, there are certain cases in which opioid therapy may be medically appropriate. In these cases, the goal with chronic opioid therapy is to use low dosages on an as-needed basis, which preserves efficacy and reduces tolerance, risk and opioid-related side-effects. Patients on opioid therapy will require regular clinic visits for monitoring.

Older pain management practices utilized higher, more continuous doses of opioids. As a result, some patients have been maintained on moderate or high doses of opioids for many years. We understand that patients who have been on moderate-high doses for an extended period of time will likely need a multimodal approach to slowly taper opioids while incorporating safer and more effective therapies for pain. If an opioid use disorder has developed, there are medications that effectively prevent craving for traditional opioids with fewer side effects.