Rebuttal: Will the new opioid guidelines harm more people than they help?

Having practiced in the Arabian Gulf for 9 years (1995-2004), in charge of emergency medicine and family medicine programs, I was struck by the lack of opioid use by local physicians with no obvious deleterious effects and equally shocked upon my return to practice in Canada at the massive escalation in the use of opioids and resultant addictions since I had left.

To determine personally if opioids were as necessary as everyone seemed to be indicating, starting in 2008, I have engaged myself in a "one person clinical trial". I have had back surgery three times and a hip replacement since then. On each occasion I was pressed by nurses, surgeons and anaesthetists to use Oxycontin, Percocet, Tylenol #3 and Hydromorphone (oral and parenteral) for pain management. In all cases I elected to use p.r.n. Acetaminophen, Ibuprofen, ice and ambulation instead with no problems and excellent results. I found that a mild degree of pain was useful. It told me when I had been lying in one position too long and when I had been overdoing exercise. This was useful in managing my pain and in preventing further injury to the surgical site. I also ambulated quickly and was discharged on time. I had no opioid side-effects and no drug dependency or withdrawal issues with which to deal. I also had no "analgesic prescriptions" to fill on discharge.

I would encourage all physicians to find out for themselves which side of this argument to take. Try non-opioid pain management at your next opportunity and run your own "clinical trial". You may be surprised.