This is a controversial subject. While opiates were prescribed frequently for chronic non-cancer pain some years ago, recent evidence showing that prolonged use of opiates can actually increase pain and cause other problems cause concern for patients and medical professionals alike.

Firstly it is important to understand that there are harmful effects of opiates.  There is growing evidence of harm from long term opioid use. Harmful side-effects can include:

  • constipation
  • organ problems
  • cognitive impairment
  • increased risk of death
  • sleep apnoea
  • sexual and other hormone problems
  • hypothalamic-pituitary dysfunction
  • Immune system suppression
  • increased pain
  • driving impairmen
  • tolerance

What to do if you have been prescribed opiates over a long period of time. Suggested approach:

  1. Ask yourself if you managing your pain effectively. If yes, make sure you have your pain specialist test for general health. Check the harm list above to make sure you are not experiencing any of these harmful effects.
  2. If you decide you want to come off your opiates you are probably going to need to be under the care of a trusted pain specialist.
  3. Learn as much as you can about other ways to manage your pain.
  4. Here is a good set of resources to guide this process.
  5. This all will take time. Having a great team is going to be really crucial in this process. Talk to others who have gone through the process and come out the other end.

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