Chronic pain, which lasts for three months or longer, is difficult to treat.
Many people rely on opioid pain medications, but these drugs are controversial. While they can help manage pain, they also come with risks like addiction, withdrawal, and overdose.
Doctors face a tough decision: should they continue prescribing opioids to patients with long-term pain, or should they try to reduce or stop these medications?
A recent study, published in Pain Practice, looked at the opinions of 28 medical experts on this issue.
The researchers wanted to understand the risks and benefits of keeping patients on opioids versus gradually reducing or completely stopping them.
Their goal was to provide guidance for doctors treating people with chronic pain.
The study found that there is no clear agreement among experts. About 36% of them believed that long-term opioid use is helpful for some patients. But the same percentage thought that opioids should be stopped. This disagreement highlights how complicated the issue is.
One major concern is the harm caused by stopping opioids too quickly. More than half of the experts agreed that patients could suffer if they are taken off opioids too fast. Withdrawal symptoms, worsening pain, mental health struggles, and even an increased risk of overdose could occur.
Because of this, some experts recommended tapering the medication slowly. Even if a patient had tried tapering before without success, they suggested trying again, possibly with the help of other medications to ease withdrawal symptoms.
Some experts supported switching patients to buprenorphine, a medication that helps reduce opioid dependency. Buprenorphine can relieve withdrawal symptoms and cravings while still providing pain relief. Others suggested using non-opioid pain treatments, even if these treatments had not worked for the patient before.
There was also some discussion about involving patients in decisions about their treatment. A few experts emphasized the importance of shared decision-making, where doctors and patients work together to decide the best approach. However, there was little agreement on the best way to do this in practice.
Another important issue was mental health and substance use disorders. Some experts said doctors should address related problems like alcohol use, anxiety, depression, and the side effects of opioids. However, very few mentioned assessing patients for opioid addiction or the risk of overdose, even though these are serious concerns.
Dr. Kurt Kroenke, one of the study’s authors, explained the difficult balance that doctors must find. “Opioid pain medications have well-known risks,” he said. “But when patients have been on them for a long time, suddenly stopping can make their pain worse, lead to mental health issues, or even result in overdose or death.”
He also pointed out that opioid medications could be misused by others if they are not properly stored or disposed of.
At the same time, opioids can improve patients’ lives by reducing severe pain. Pain can make it hard for people to work, take care of their families, and enjoy daily activities. For some, opioids provide the only relief they have.
The study highlights the need for better guidelines on opioid use. Right now, different factors—such as legal concerns, health policies, and personal beliefs—make it difficult for doctors to make the best decision for each patient.
The researchers believe that, until clearer guidelines exist, doctors should focus on ethical care. This means giving patients full information about the risks and benefits, listening to their concerns, and making decisions together with them.
This study shows that treating chronic pain with opioids is a complex issue with no easy solution. While opioids can provide pain relief, they also come with serious risks.
The fact that experts cannot agree on whether to continue or stop opioid use reflects how challenging this issue is for both doctors and patients.
One major takeaway is that stopping opioids too quickly can be harmful.
Many experts agree that sudden discontinuation can lead to withdrawal, worsening pain, and mental health issues. Tapering slowly, possibly with medication support, may be a better approach for those who need to reduce their opioid use.
Another important finding is that alternative treatments need to be considered. While some patients might do well on opioids, others might benefit from non-opioid pain treatments or medications like buprenorphine. However, it is unclear how well these options work for all patients, especially those who have not responded to them in the past.
Finally, the study suggests that patients should have a say in their treatment. Doctors and patients need to have open, respectful conversations about the risks and benefits of opioid therapy. This shared decision-making process can help ensure that patients receive care that fits their needs while minimizing harm.
In the end, there is no one-size-fits-all answer. Each patient is different, and their treatment should be tailored to their situation. More research and clearer guidelines are needed to help doctors navigate this difficult issue while keeping patient safety at the center of care.
If you care about arthritis, please read studies about extra virgin olive oil for arthritis, and pomegranate: A natural treatment for rheumatoid arthritis.
For more information about arthritis, please see recent studies about how to live pain-free with arthritis, and results showing medical cannabis may help reduce arthritis pain, back pain.
The research findings can be found in Pain Practice.
Copyright © 2025 Knowridge Science Report. All rights reserved.
