Opioid Management 

Pain management with opioids

Opioid analgesic medications can be extremely effective and well tolerated treatments of moderate to severe acute and chronic pain. When used correctly, they can improve the patient's quality of life and functionality. Frequently held misconceptions regarding opioid use can interfere with the delivery of optimal patient care.

Myth: Patients using opioids frequently become addicted to them.
Fact: When used to control acute or chronic cancer-related pain, the incidence of addiction is about 1/3,000 (0.3%). The incidence of addiction is also low when opioids are used to treat chronic nonmalignant pain. The therapeutic goal should be to improve functionality. As a rule of thumb, the person taking opioids for pain relief becomes more functional while the addicted personality (seeking drugs for their recreational or euphoric effect) is less functional.

Myth: Opioids should be "saved" for the last weeks or months of life.
Fact: About one-half of patients with chronic pain syndromes not controlled by other means can have a beneficial response to opioids and improve their functionality. Similarly, for patients with terminal diseases, opioids should be used as early as necessary to control moderate to severe pain. Patients can continue to use opioids for pain management for years or decades. When tolerance (the need to use more opioids to control the same painful stimulus) develops, analgesia can usually be maintained by gradually increasing the opioid dose.

Myth: "I can not work or do normal activities when taking opioids."
Fact: Patients with severe pain have difficulty or find it impossible to perform normal activities. This includes maintaining normal relationships. By achieving adequate pain management, they can often resume normal activities within the confines of their underlying disease process as opposed to being limited by their pain. Cognitive and motor skills (including the operation of motor vehicles) have been shown to be similar for patients on steady doses of opioids for more than two weeks when compared to control groups with similar underlying disease processes but who are not taking opioids. Pennsylvania law prohibits driving if the driver is impaired by any drug. Patients should be told not to drive whenever an opioid is started or the dose increased and to refrain from driving for at least a week or longer, until normal cognitive and motor skills are fully recovered.

Contact Us

For more information, call the program office at (570) 271-7383 or e-mail PallMed@geisinger.edu