Fibromyalgia Pain: New Guidelines for Opiates

In most cases, fibromyalgia pain isn't relieved much by opiates such as Vicodin (hydrocodone acetaminophen) or OxyContin (oxycodone). For some of us, however, opiates do work. Like many, I take Vicodin now and then for breakthrough pain. Unlike many, I don't have to beg my doctor for refills, sign a contract, provide urine samples, or jump through other hoops to prove I'm not abusing them.

With prescription drug addiction having become a serious problem in our country, a lot of negative attention has been focused on those of us who take opiates for chronic pain, even though studies show only a 3% addiction rate in pain patients without a history of drug abuse or addiction. Many doctors refuse to prescribe them at all, and too many of us have been accused of being drug seekers.

Now, in The Journal of Pain, the American Pain Society has published recommendations for how doctors should use opiates for treating non-cancer pain. (If your doctor balks at the mention of opiates, click here for the report and print it out for your next appointment.)

Basically, the report suggests that doctors:

* Determine whether other drugs may work.
* If not, assess the patients risk of abuse, misuse or addiction, based on personal and family history of drug problems.
* Give written rules for those at high risk, requiring them to use one pharmacy only, take random drug tests, and make regular doctor visits.
* Conduct regular monitoring - for low-risk patients, once every 3-6 months. For high-risk patients, weekly. (Can include pill count, urine screening, family interviews and prescription monitoring.)
* Discontinue opioid therapy in patients who abuse the drugs or give/sell them to others.

What I really like about this is that it doesn't lump us all into one boat. Those of us who are low risk don't have to endure being treated like criminals, while measures are put in place to identify and monitor those who are at high risk. I hope doctors will adopt these recommendations so that we can have appropriate pain treatment along with safeguards to prevent abuse and addiction.