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JAMA Internal Medicine Patient Page
May 26, 2020

What Should I Know About Opioids and Living With Chronic Pain?

JAMA Intern Med. 2020;180(7):1036. doi:10.1001/jamainternmed.2020.1679

At one time, chronic pain (lasting longer than 3 months) was routinely treated with opioid pain medications (oxycodone, morphine, codeine, etc). But we now know that opioids are less effective and more risky than we thought, so many people are choosing other ways to treat chronic pain.

Even when taken as directed, opioids can cause side effects. These include tolerance (requiring more medication to have the same effect), dependence (developing unpleasant withdrawal symptoms if you stop taking opioids), increased sensitivity to pain, depression and fatigue, constipation, low sex hormone levels, itching, sweating, and overdose (slowed breathing, sedation, and possibly death).

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    1 Comment for this article
    Wish would have added
    Steven King, M.D. | Pain Medicine
    Many lay people and, unfortunately, not a few medical professionals still believe the choice is between opioids, NSAIDs, and acetaminophen for pain. I know that the authors couldn't be expected to mention all other treatments but I believe it would have been worth noting other non-opioids such as the SNRIs and gabapentoids and also non-pharmacologic treatments that have been found to be as effective and, for many types of pain, more effective than opioids. I've often heard patients tell me they have to take opioids because they can't take NSAIDs and there have no alternative.