Workers' Compensation

Steven D. Feinberg, MD, on Medications and Chronic Pain

The use of analgesics (pain relievers) and other medications is the most common method of chronic pain treatment. Pain medications can be helpful for some patients in chronic pain, but they are not universally effective and may actually create harm.
 In this Emerging Issues Analysis commentary, Steven D. Feinberg, MD, discusses the use of analgesics and other medications to treat chronic pain in patients.
“Medication-related problems would rank fifth among the leading causes of death in the United States if they were considered a disease. Although opioid pain medications can be a useful tool in the treatment of pain, the misuse of opioid pain medications has become a national issue,” writes Feinberg. “The abuse of prescription opioid pain medications now ranks second -- only behind marijuana -- as the nation's most prevalent illegal drug problem.”
Feinberg points out that “Short-term use of medications for pain is rarely worrisome, although side-effects are most problematic while initiating treatment and tend to reduce with prolonged use. On the other hand, in some cases, prolonged use increases the possibility of adverse reactions including gastrointestinal distress, internal organ problems, balance troubles, endocrine problems, sexual dysfunction, and memory and concentration problems.”
The author explains in detail the four major classes of medications used in the treatment of chronic pain:
  • Non-opioids.
  • Opioids.
  • Adjuvant analgesics, including some antidepressants and anticonvulsants.
  • Other medications with no direct pain-relieving properties, to treat insomnia, anxiety, and depression and muscle spasms.
He examines the opioid dilemma, defines important terms in this medical field, extensively reviews the side effects of the various pain medications, asks what are the appropriate goals of pain management, and explains how different pain medications may help those who suffer chronic pain.
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