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AAN on chronic opiod (over)use


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MONDAY, Sept. 29, 2014 (HealthDay News) -- The risks of powerful narcotic painkillers outweigh their benefits for treating chronic headaches, low back pain and fibromyalgia, a new statement from the American Academy of Neurology says.

 

Full article http://www.empr.com/opioid-guidelines-for-chronic-noncancer-pain-issued-by-the-american-academy-of-neurology/article/374398/

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I've read the article and they should have been more specific. I would agree that narcotics are far overused in headache and much of my time is spent in getting patients off daily or near daily narcotics. Beyond addiction there is the unique problem in headaches of Medication Overuse Headache Syndrome.

 

With that said, every headache specialists in the world would agree that there is a place for narcotics in headache treatment and that place is well-defined. It is as rescue (not first line) in patients who have failed preventative and abortive measures and are not used more than 2 days per week.  I'm concerned that the wording of this article will be interpreted as headache pain is not narcotic worthy . . . ever.

 

My severe headache patients report that their headache pain (and associated symptoms) are worse than their major surgery pain, worse than their cancer pain, worse than fractures or renal calculi.  Because headaches cannot be visualized by a machine or in real life, they have traditionally been relegated into the insignificant, imaginary or hysterical category.

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