The Problem

More Americans die each year from drug overdoses than from motor vehicle accidents. Most of those overdose deaths are due to misuse of prescription opioids. The United States has less than 5% of the world’s population, yet we consume over 80% of the world’s supply of painkillers. How did this happen?





We have caused this problem. It used to be conventional wisdom that prescribing opioids to treat chronic pain was the right thing to do. We were told we should ask about pain, escalate opioid doses if the pain persists. We were told opioid use in the presence of real pain was unlikely to cause harm.

Much of what we were told about the treatment of chronic pain has not been supported by current research. Complex chronic pain is very different from acute pain, or cancer pain. Opioids are at best 30% effective in reducing long-term pain. High doses are associated with high mortality. Now we know that the use of opioids for the treatment of chronic non-cancer pain provide a small amount of benefit, but carry a large amount of risk.



This website was created to help you, the provider, to make a paradigm shift, from the use of opioids, to the use of safer and often more effective modalities for the treatment of pain. Your patients are more resilient than you imagine. They have real pain, but more narcotics are probably not the solution.

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