Why U.S. Doctors Love Opioids and Hate Marijuana for Chronic Pain
The opioid epidemic is well documented, yet physicians still are wary about whether cannabinoids are better options for chronic pain. Neither is a perfect solution.
By: Daniel Clauw, M.D. June 23, 2016 Chronic pain is a tremendous public health problem. The Institute of Medicine estimates chronic pain affects 100 million Americans at an annual cost of $600 billion. Its report notes that evidence based-medicine does not support many of the diagnostic studies (like imaging) and interventions (like injections and surgery) commonly used for chronic pain. But the rampant use of opioids to treat chronic pain stands out as the least defensible and most harmful of our maltreatments. Many U.S. physicians remain resistant to this, though, I would argue other options should be considered.
Here's why.
Opioids: Minimal Evidence of Efficacy
Many meta-analyses have found little evidence that this class of drugs is effective for the treatment of chronic pain. Of course, we all know of individual patients who experience significant relief of their pain and improvements in function with chronic opioid therapy. But for every one of these patients we know there are many more who are not helped or are harmed by opioids. More than 14,000 Americans died in 2014 from unintentional overdose of prescription opioids, making this the leading cause of death among younger individuals in many states, according to the Centers for Disease Control and Prevention. Countless others continue to take opioids not because they have meaningful pain and functional improvement, but because they enjoy feeling numbed, or simply have not been presented with more appropriate and helpful therapeutic options. Unfortunately, it is far faster and easier to give a patient an opioid than to work through the complex issues often present in chronic pain patients.
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