Opioid Therapy the Only Treatment Option Left Standing in Chronic Pain Debate

SEPTEMBER 06, 2013
Katie Eder
Although clinical psychiatrist Michael E. Schatman, PhD, CPE, formerly “beat the hell out of the opioid industry,” he spent an hour on the PAINWeek stage supporting his new belief that “maybe it’s time to stop fighting.”
 
“I’m not an opioid or a pharma guy, but I’ve got patients on chronic opioid therapy who are stable,” Schatman said during his “Just Saying No to Chronic Opioids For Noncancer Pain: Not Necessarily Good Medical Practice” presentation at PAINWeek 2013. Reinforcing that point, when Schatman asked if anyone in the audience had “never seen a patient do well on chronic opioid therapy,” not one hand went into the air.
 
But Schatman said that doesn’t mean long-term opioid therapy is the “perfect treatment” for chronic pain, as he noted that “the rates of bone density loss in patients is scary stuff,” in addition to more serious diversion and overdose problems.
 
Still, Schatman explained that the upsides to opioid treatment on a long-term basis become very clear after reviewing other options for chronic non-cancer pain patients.
 
For example, even though interdisciplinary chronic pain management programs have the strongest evidence-basis for most types of chronic non-cancer pain, the availability of those programs in the US has shriveled from more than 1,000 in 1998 to fewer than 100 outside of the US Department of Veterans Affairs today.


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