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In the 1940s, opioid-based narcotics like opium and heroin were popular drugs of abuse, which lead to strict controls being put into place to curb their use. Regulations existed to control who could prescribe opioids and at what doses; breaches to the regulations could lead to a loss of your medical license or criminal prosecution.

Many physicians feared the repercussions, and thus may have under-prescribed such medications, even in cases where they’re called for, such as in late-stage cancer pain.1

Decades later, in the 1990s, successful lobbying by pharmaceutical makers led to changes in the opioid regulations, such that doctors couldn’t be penalized for prescribing them.

The loosened regulations paved the way for the aggressive treatment of pain, not only in cancer patients and those with terminal diseases, but in virtually anyone with chronic pain. We’re now at the opposite end of the spectrum, where opioids are vastly
overprescribed and doing far more harm than good.

American Academy of Neurology: Opioids Not for Non-Cancer Chronic Pain

The American Academy of Neurology has released a new position statement on opioids, highlighting the problems of overuse. Since policies changed in the late 1990s, over 100,000 people have died, directly or indirectly, from prescribed opioids in the US.

In the highest-risk group (those between the ages of 35 and 54), deaths from opioids exceed deaths from both firearms and motor vehicle accidents.

The report notes that while such drugs may offer short-term relief for non-cancer chronic pain such as back pain, headaches, migraines, and fibromyalgia, they cause more harm than good over time:2

“Whereas there is evidence for significant short-term pain relief, there is no substantial evidence for maintenance of pain relief or improved function over long periods of time without incurring serious risk of overdose, dependence, or addiction.”

Research has shown, for instance, that more than half of people who use opioids for three months will still be using them five years later.3 Meanwhile, a study published in the
New England Journal of Medicine found that long-term use of opioids actually does little to relieve chronic pain.4 In some cases, they may even make chronic pain worse. As
TIME reported:5

” the opioids can backfire in excessive doses; in the same way that neurons become over-sensitized to pain and hyper-reactive, high doses of opioids could prime some nerves to respond more intensely to pain signals, rather than helping them to modulate their reaction.”