Reflections on the efficacy of opioid pain relief


This is a thoroughly sourced article with dozens of references:

In A World of Hurt, by Barry Meier, he quotes Dr. Jayne Ballantyne as saying that her studies, and those of others, show that after a short term of therapy, there is little to no efficacy (5% of patients) of opiates for pain.

I have seen and heard these figures often; yet pain management physicians also have records of people who have been carefully managed on opiates and other pain relieving measures for at least twenty years, who are functioning without severe pain.

So, who will be believed, the person who has the pain or a person who creates her own interpretation about what the pained person is feeling?  

But the continued widespread references to them has created a situation that is clearly morally and ethically bankrupt:

Patients with persistent, severe pain—including, in many states, terminal cancer patients—are being deliberately, systematically deprived of relief and therefore from the ability to lead potentially productive lives

What would make opiate efficacy studies reliable and verifiable? First, to acknowledge that all pain patients are unique in their tolerance to pain, their response to pain, and their response to treatment.

Then there is the issue of the selection of participants. When I read the studies done in past years, I found they were limited to a single practice, or a hospital, or other small group of patients with no concern for variables like age, risk factors, history of abuse, previous treatment and other illnesses.

Yet, at the same time, there is a push toward personalized medicine that condemns arbitrary “standards” for medical treatments as being ignorant and over simplistic.

The participants were not chosen scientifically in order to be representative, so results are inevitably skewed.

Yet, on the basis of these flawed opiate efficacy studies, people’s lives are being damaged, their families are suffering needlessly, and many patients who are cut off from their medication either take to street drugs with the risk of overdose, or just commit suicide in the first place.

We also need politicians to stop enacting laws and policies based on moral definitions of issues, which we can never come to consensus about, and work on the actual economic and environmental issues that they can actually improve

Addiction is a disease, not a moral issue.

Pain is a disease, not a moral issue.

This is exactly how so many people without pain frame the issue and they, of course, are morally superior for not having pain that requires treatment with opioids.

And the DEA is still, regardless of evidence that they are often destroying the lives of the innocent while failing to halt the spread of illegal drugs, using pain patients and their physicians as cannon fodder in their failed war on drugs.

A significant paradigm shift is required here

From family, to education, to religion, culture, economics and government we need a major overhaul of outdated and inaccurate beliefs, and development of procedures that decriminalize the treatment of chronic pain and addiction, as well as the afflictions themselves.

Medical decisions need to be made by medical experts and their appropriate medical agencies

Instead, we now have politicians and police making medical decisions for us.

Please—let’s make 2017 the year we begin to deal with chronic pain and addiction as the disease processes they are, and begin to structure our corporate life accordingly, so that together we can end the war on drugs, and on patients and their physicians, and restore the rationality of the Enlightenment without killing the compassion of empathy.


2 thoughts on “Reflections on the efficacy of opioid pain relief

  1. Laura P. Schulman, MD, MA

    Oh dear. This business of abandoning pain sufferers and/or shaming and humiliating, is doing such horrendous damage. It’s inhumane, it’s a stick in the eye of the Hippocratic Oath. I’m very worried about Johnna of painkills2. We haven’t heard from her for weeks. She’s been suffering horribly. Have you heard from her?

    Liked by 1 person

    1. Zyp Czyk Post author

      No, I haven’t heard anything from painkills2 – and I guess that’s the problem.

      I’m currently staying with my mom in her apartment, so I haven’t been paying attention. Picking up some of the load on her is keeping me pretty busy with taking the dog out several times each day (a tiny mutt) and running various errands.

      I’m flying home on Sat and if she’s still AWOL by then, I’ll try contacting her to find out what’s happening. She’s one tough lady, but I know that enough pain can fell even the strongest of us.



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