Readers React: Opioids are a gift for chronic-pain patients. Use them wisely

To the editor: The Times has weighed in on opioid drug use for chronic pain, but it should be cautious. (“Doctors are on the front lines of opioid addiction. They aren’t doing enough to prevent it,” editorial, May 7)

People with chronic pain have many non-narcotic options, but the bottom line for severe pain is opioids. From the tone of the editorial, I surmise that no one on the editorial board suffers from chronic pain.

We don’t need lawmakers getting between doctors and patients when it comes to pain any more than we need them when it comes to abortion. If OxyContin doesn’t last the full 12 hours for some patients, then a different prescription is in order; perhaps Norco, Vicodin, Tramadol or in the severest cases morphine.

Making sure that drug seekers don’t fill multiple prescriptions is a legal matter, but patients legitimately needing pain relief have a hard enough time of it without making them jump through hoops and wait for the medicine that they need to function.

Opium is a gift to be used wisely.

Paul Moser III, Palm Desert

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To the editor: Purdue Pharma has much to answer for when it comes to OxyContin. However, in the later part of the 20th century, several factors set the stage for the present situation.

In 1994, researcher Charles Cleeland and others working with him reported inadequate treatment of severe pain in 42% of a sample of cancer patients. This and similar studies resulted in highly publicized criticism of the medical profession. Cleeland’s system for objectively evaluating severity of pain came into wide use.

Simultaneously, the hospice movement became an active and highly influential advocate for improved palliative care of dying patients, stressing effective use of potent analgesics and promoting the concept that severity of pain is always exactly what the patient says it is. By 2013, the American Academy of Pain Medicine had a membership 5,000 physicians.

These legitimate, well intended efforts created powerful incentives for expanding the use of opiate prescriptions for patients with chronic, non-cancer-related pain. It is not surprising that physicians responded to these incentives or that Purdue adopted marketing practices aimed at enhancing corporate profits.

Richard Ugoretz, MD, San Diego

The writer is a retired medical oncologist.

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