A 1980 Letter on the Risk of Opioid Addiction

Abstract

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Overprescribing is major contributor to opioid crisis

“…Aggressive advertising of opioids, including direct-to-consumer marketing, quickly ensued. 10 Another iatrogenic factor driving opioid overprescribing is the notion that pain is the fifth vital sign of medicine. This concept became dominant in the mid-1990s, and its measurement became an indicator of patient satisfaction and hospital performance in the mid-2000s.…”

Neuromodulation: The “Not-so-Hidden” Cure for the Opioid Crisis

“…Leung et al found that the Porter and Jick letter was cited 608 times in the medical literature and that frequently, these citations were inaccurate, uncritical or overly interpreted and misrepresented the limited results. The authors cite articles in the medical literature that cited Porter and Jick as evidence that “This pain population with no abuse history is literally at no risk for addiction” and that “Medical opioid addiction is very rare” .…”

Adverse effects of opioids for non-cancer pain

“…Despite a lack of evidence that opioids are more effective than other drugs used for chronic non-cancer pain (CNCP) there has been a large increase in the use of opioids for CNCP and concerns expressed over the risks associated with long-term use 1. An overview of Cochrane systematic reviews has assessed the occurrence and nature of adverse events associated with opioids 2.…”

“…The review’s authors suggest that “reliance on earlier studies with less robust methodology may have contributed to the current opioid use epidemic and opioid overdoses and deaths.” A letter published in 1980 has been inappropriately cited as evidence that addiction with long-term opioid therapy is rare. 1 Recently updated guidelines on the management of CNCP have highlighted the risks associated with opioids and encouraged use of non-opioid drugs and nonpharmacologic therapy, rather than a trial of opioids 3,4…”