Will I get high, or lose control?
When opioids are taken on a regular
schedule, tolerance quickly develops,
and the psychological “high” goes away,
leaving the user feeling completely
normal. Long-term opioid users, as a
group, have driving records for accidents
and violations that are the same as
everyone else’s.
Will I hurt myself because I
don’t feel any pain?
No. Opioids improve functioning by
reducing pain levels. They don’t remove
all the pain, or the ability to perceive
new pain.
Will I become dependent?
You may. Dependence means that if
opioids are abruptly discontinued you
will have a physical withdrawal reaction,
similar to having the flu. This reaction
can be prevented by gradually tapering
off the medication. Dependence is a
physical phenomenon, not a sign of
addiction.
What if I had a previous
substance abuse problem?
This should not prevent a trial of
opioids. Studies at Harvard Medical
School and the University of
Washington indicate that a past history
of substance abuse has little or no
predictive value for failure of opioid
treatment. If you have current behavioral
or substance abuse problems, you may
appear to have trouble with opioid
treatment.
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Are there any side effects?
Constipation, nausea, itching, insomnia,
and drowsiness commonly occur. All of
these side effects can be successfully
managed.
Will the medicine damage my
liver?
No. Opioids occur naturally in the body,
and are not harmful to any organ system.
They can be taken safely for a lifetime,
if necessary. Anti-inflammatory nonopioid
medications, on the other hand,
kill 16,500 patients each year through
bleeding from the stomach, and are toxic
to the liver and kidneys.
What is the correct dose?
The amount that allows optimal
functioning is the correct dose. There is
no upper limit to the dose of opioids that
can be safely used, when the medicine is
increased gradually.
Why won’t my doctor prescribe
enough medicine to control my
pain?
He is too scared. As part of the War on
Drugs, law enforcement is conducting a
witch-hunt against pain doctors who
prescribe opioids compassionately.
Most physicians won’t risk being
targeted by law enforcement, because
they have families to support. As a
result, chronic pain sufferers have
become non-combatant casualties in the
war on drugs.
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