They are cracking down on the opiates because too many doctors overprescribed them and got people addicted. Oxycodone is a powerful drug related to heroin. Once you're addicted you're in real trouble. And your doctor is your connection. Too many doctors are very careless and uninformed about the dangers of addictive drugs. This is one where the medical schools should do a much better job of educating the doctors.

When people are treated with opiates for chronic pain, their bodies become physically dependent, but the opiates properly used don't have all kinds of side effects like death. If an individual gets to a point where they no longer need opiate pain medication, their doctor is supposed to gradually ween them of the physical dependence so they can go on with life without bleeding to death from some pharmaceutical creation that makes a lot of money for the pharmaceutical companies and kills patients without even actually giving them relief from their chronic pain. You are just buying the B.S. that is being sold to you by the pharmaceutical companies and agencies like the DEA, you don't realize how much money they are making. You are gullible and buying into everything you are told by corporate and government controllled media. You don't know anything.

I don't know everything, but I know a whole hell of a lot about addiction. I have family that has been down this road. I've spent a fair amount of time in support groups finding out about addiction. I can tell you that addiction specialists are the ones that gave me the information. They know what they're talking about. Over half of the people they treat are addicted to painkillers. One of my granddaughter's friends committed suicide because he couldn't get off oxycodone even after two stints in rehab. Don't tell me how easy it is to stop taking that sh*t, because for a lot of people it isn't easy at all. It sad, and it's life threatening. It destroys you.

You may have had family become physically dependent on oppiates and didn't have medical professionals who knew how to ween them off of them. That doesn't mean the problem is with opiates, the problem is with the medical professionals that you give so much credibility to. Opiates are the least harmful pain killers to the human body. The main problem is incompetent medical professionals, DEA and stupid people who believe everything the medical professionals and opressive government officials say. Like you said, you don't know everything. If you knew anything, you would know the difference between physical and psycological dependence and addiction. To many people don't know the difference, and that lack of understanding causes tremendous harm to society. If you want to talk about death by harmful medications, doctors are constantly prescibing death by non-narcotic medications to avoid scrutiny by the DEA. Research the side effects of non-narcotic medications and you will find a story massively prescribed death as treatment for many conditions.

respectable-citizen,

You stated that "Opiates are the least harmful pain killers to the human body" and in an earlier post stated "opiates properly used don't have all kinds of side effects like death" but provided no data to back that statement up. The product insert of the branded medication Oxycontin, a well known opioid, clearly states

"WARNINGS OxyContin must be swallowed whole and must not be cut, broken, chewed, crushed or dissolved. Taking cut, broken, chewed, crushed or dissolved OxyContin Tablets leads to rapid release and absorption of a potentially fatal dose of oxycodone. OxyContin 60 mg, 80 mg, and 160 mg Tablets, a single dose greater than 40 mg, or a total daily dose greater than 80 mg are only for use in opioid-tolerant patients, as they may cause fatal respiratory depression when administered to patients who are not tolerant to the respiratory- depressant effects of opioids". I count the word "fatal" twice. Even used..."properly".

Tell me, in the context of this story, and in the most commonly sought out pain complaint in this country, would opioid pain relievers be an appropriate treatment plan? Which practice guidelines have shown both safety and efficacy in the use of opioids to treat chronic pain?

Yes, opiates would be an appropriate treatment plan. No medication is without risk. I'd rather see people take opiates for pain than get injected with contaminated steroids...

The cure is never without some side effect.

Pat, I agree that people should take opioids rather than get injected with contaminated steroids. However, opioids are not recommended by AAPM or ASIPP for chronic low back pain. When used in the chronic pain setting, extended-release opioids at the lowest possible theraputic dosing should be prescribed along with UDS, and opioid agreement with the patient.

It's true that if someone abuses opiates by using them improperly to get high, they can die from that improper use. Those kind of people would be just as willing to use illegal street drugs, so it can't really be said that opiates are bad, it's the people who misuse them that give a bad reputation to the best pain killers. As you said, there are warnings on the bottle about improper use. As for information about proper use and even use that encourages doctors not to be afraid to prescribe opiates, read information on various medical sites, such as the Mayo Clinic site, State Board of Medical Practice sites, WebMD and so on. Then study up on the deadly side effects of pain medication like Nsaids, Acetametaphine and others. The difference is that the other pain medications kill you over a long period of time by causing things like internal bleeding, kidney and liver damage, etc. Now they even say that SSRIs like Cymbalta, if used for one year or longer can cause bleeding in the brain and death. Opiates are the best long term pain medications, even though they do cause physical dependence, I can tell you also from personal experience that they are the most effective of all pain medications. Because of Government interference I also know what it is like to suddenly have to go off of opiate pain medication and then be forced to use those other useless and harmful pain medications and have to withdraw from opiates and then go back to chronic suffering. I believe without the ability to prescribe opiate pain medication, doctors have become valueless in dealing with long term moderate to severe chronic pain. Because of government interference and orders from the three clinic systems in my area no doctors in are allowed to prescribe opiate pain medication to anyone and many people who have chronic moderate to severe pain are left to suffer. Believe me I have done extensive research on this subject. Also steroid injections in your back over a long period of time cause deterioration of bone in your back in otherwords these injections gradually destroy your vertebrae. These are the reasons I say opiates are the best choice for long term moderate to severe chronic pain, and I do agree they should be used responsibly.

Because of government interference and orders from the three clinic systems in my area no doctors in are allowed to prescribe opiate pain medication to anyone and many people who have chronic moderate to severe pain are left to suffer.

Also steroid injections in your back over a long period of time cause deterioration of bone in your back in otherwords these injections gradually destroy your vertebrae.

There is no government regulation (aside from lack of DEA licensure) that says doctors in any area are "not allowed to prescribe opiates" for patients. If the physicians in your area aren't prescribing, it is because they are afraid to, they don't know how to, or there are no medically appropriate candidates for that class of medications. You state that doctors have become valueless in dealing with long term moderate to severe chronic pain yet if you get your opioids I bet they're the most valuable thing in the world to you.

You also state that "steroid injections in your back over a long period of time cause deterioration of bone" which is misleading. While true that long term exposure to glucocorticosteroids in high concentrations can cause generalized osteopenia or osteoporosis, the common dosing schedule for most patients "epidurals" will never reach that level. However, chronic opioid use will lead to decreased testosterone levels and osteoporosis, decreased muscle mass, and even immunosupression.

Your right the government is not supposed to regulate doctors from prescribing opiate medication, but the DEA has done so where I live, by instilling fear in clinics and doctors, they even made a raid on a clinic in a nearby county last year but made no arrests. Up until recent years doctors did prescribe opiates when it was appropriate in this area, now they will not prescribe them for anyone, because they are forbidden by the clinic systems to prescribe opiates for chronic pain patients, so they can't prescribe opiate pain medication or they will be unemployed, because there are three clinic systems here which all area doctors work for and if they prescribe opiates for chronic pain they will not be able to work for any of the three clinic systems. At the end of commercials on tv for pharmaceutical companies, listen to the side effects of the non-narcotic medications. The side effects are often worse than what they treat, in fact one medication for a skin problem that is advertised recently says it has caused cases of cancer which have been reported from using that medication, yet the DEA, clinics and doctors see nothing wrong with prescribing these harmful and even deadly pharmaceuticals. I have had to tell my doctor that I will not take a variety of medications because I did not want to suffer the deadly side effects and also some because they were ineffective, besides having serious and even deadly side effects. They prescribe these other pharmaceuticals because there are enormous profits to be made.

You don't live here with a chronic pain or other chronic condition and have to do without a doctor who will treat your chronic conditions. In this entire area if you call any of the local clinics and tell the recptionists that you need to establish a primary care physician, they tell you right on the phone that if you require treatment for chronic pain or any other chronic condition, they will not accept you as a patient. This is real, I am not just saying some personal ideas, I'm talking about real life experience, they don't even know who it is that is seeking to establish a primary care physician and the first thing they say is that none of their doctors will treat chronic conditions that require any narcotic pain medication or any other chronic condition requiring any kind of narcotic medication. They are not just talking about opiates, they are also talking about benzodiazapines for anxiety or even ambien for chronic insomnia. What your saying is that doctors should never presribe any narcotic pain medication out of fear of losing their medical license. I'm saying that even medical sites like the Mayo Clinic site, The Board of State Medical Practice in my state which decides if a doctor should lose their medical license, and other medical sites say that doctors should not be afraid to prescribe opiate and other narcotic medications, and that patients should not be afraid of taking such medications out of fear either. But the problem is that this problem does exist and people are suffering who do not need to be suffering. What I am saying is all reality, I didn't just imagine what I have said. I believe there are people who abuse presciption medication, but I don't think people who really need treatment with such medications should be punished for it and I'm telling you reputable medical institutions including an intitution responsible for medical licensure say the same thing. I even called the State Board of Medical Practice and they said what I just told you.