Our strongest pain medications are called opioids. It is largely believed that opioids are very effective for chronic pain. However, this is not so. There is a lack of benefit if chronic pain is treated with an opioid. (The only exception: Patients with cancer and chronic pain). Important to remember: In patients with chronic low back pain, pain medications are not effective. There is no long-term benefit.
In addition, overdoses of prescribed opioids are increasing. Opioid overdoses and the lack of benefit led to a new American guideline. The new American guideline is very similar to a German guideline. Both guidelines say that treatments for chronic pain that do not include medicinal drugs must be prescribed first.
If medicinal drugs must be prescribed, others drugs must be prescribed first. And, as last resort, opioids can be prescribed. If opioids must be prescribed, immediate-release opioids must be prescribed. The total daily opioid dose must not exceed 50 MME. Opioids must not be prescribed in patients with obstructive sleep apnoea. And opioids cannot be prescribed together with benzodiazepines (medicinal drugs for sleeplessness and anxiety).
If you have chronic pain, do not ask for pain killers. Instead, learn about treatments that do not include medicinal drugs first. I know that this not what you want to hear if you have chronic pain, but it is the truth.