[DanBC]

Opioids are not a suitable treatment for long term pain, especially in the elderly.

People need rapid access to pain management clinics, with weight loss and strength building exercise, and access to meds (which in long term pain are often not opioids).

Giving those people opioids increases their risk of accidental death, and suicide. It gives them an addiction. But worse it does not treat their pain - they will still have the pain.

[oxide]

This is ignorant at best and naive at worst. God help anyone you treat, and if you aren't a medical professional its probably for the best. Your comment makes me physically ill.

[DanBC]

Which bit is wrong?

You seem to think pain control is opioids or nothing, and that's not true. There are a range of meds that should be used before opioids are tried. You also seem to think that pain control is only medication, and that's not true either. Exercise is a powerful intervention that can cure some long term pain (especially long term lower back pain). This strength building exercise is really important for older people too.

Opioids really don't work for long term pain. People develop a tolerance, which means they need to take more to get the same effect, but that means they end up taking dangerous quantities, and not getting pain relief.

Here's a Pubic Health England project to support prescribing of opioids: https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-awar...

> 1. Opioids are very good analgesics for acute pain and for pain at the end of life but there is little evidence that they are helpful for long term pain.

> 2. A small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is difficult to identify these people at the point of opioid initiation)

> 3. The risk of harm increases substantially at doses above an oral morphine equivalent of 120mg/day, but there is not increased benefit.

> 4. If a patient is using opioids but is still in pain, the opioids are not effective and should be discontinued, even if no other treatment is available.

Here's a BBC Radio programme about health. They visit a pain management clinic. People who visit that clinic usually have to detox from their opioid addiction before they can start the pain management work. This is because opioids really are not suitable for long term pain, and other meds / interventions should be used. http://www.bbc.co.uk/programmes/b04wv052

Here's a physician on HN talking about why opiates are not suitable for long term pain: https://news.ycombinator.com/item?id=10285321

[aminok]

You sound like a drug abuse apologist.