Opioids have been somewhat overprescribed, with resulting deaths. This has changed, and deaths from prescription opioids has been decreasing the past several years(despite the media reports). There has been an enormous backlash against the use of opioids, with very negative consequences for many people with pain.
Until not long ago, the mantra was “treat pain seriously, it causes huge decreases in quality of life, increased depression, suicide, etc…”…and “Pain is the fifth vital sign”.
That has all changed; since the opioid deaths have made the news and everyone gets into the act(from the NY Times to CNN to Sanjay Gupts to Dr. Drew to…), doctors are very reluctant to prescribe pain meds, and pharmacists give patients and doctors a hard time. There is a shrinking # of doctors willing to prescribe, due to increased scrutiny and oversight(by the DEA, State regulatory agencies, etc. etc.). This leaves the millions of legitimate pain patients out in the cold.
Of course, pain is not treated just with opioids; in fact, they are a last resort. Everything else should be tried: all of the non-medication avenues(PT, psychotherapy, meditation, massage, exercise, injections); and the non-addicting meds(anticolvulsants, antidepressants, muscle relaxants, nsaids etc…).
However, for many, nothing works very well, or they cannot take certain meds(nsaids, for instance). Only 10% of people tend to overuse or abuse any med, but the other 90% are punished due to this.
We used to say “..it is not about the drug, it is the person”, when speaking of addiction. SO, now many people have segued over to heroin, due to it’s low cost…and heroin deaths are skyrocketing(which is a separate problem).
The cost of untreated pain is huge: depression, loss of relationships and jobs, suicide etc.
SO, RATIONAL CONSERVATIVE use of pain meds is reasonable; however, it is difficult for patients to now ask their docs for small or moderate amounts of pain meds.
