Opiates are usually not a good option for long term pain relief for many patients. They can work well in the short term but long term use can ruin a person&#x27;s life (I&#x27;ve seen it happen, it&#x27;s awful) and they lose effectiveness long term and end up causing more problems than they solve. Switching opiodes from a short term option to a long term one in the 90s was a huge (and largely failed) experiment.<p>Long term pain control is a complicated and multi facaded beast. We need to invest in it. &quot;Just take a pill&quot; is clearly not the solution that works.<p>I am not sure what &quot;addiction can be managed&quot; is supposed to mean.<p><a href="http:&#x2F;&#x2F;www.news-medical.net&#x2F;news&#x2F;20130415&#x2F;New-research-shows-effects-of-long-term-use-of-opioid-therapy.aspx" rel="nofollow">http:&#x2F;&#x2F;www.news-medical.net&#x2F;news&#x2F;20130415&#x2F;New-research-shows...</a><p>The prevailing medical notion was that there was this bright line involving the opioids — that they were great for patients but the problems happened when they went out on the streets and were abused by kids and others. But today it’s clear that the long-term use of these drugs can not only be ineffective for chronic pain, but they also create bad side effects for patients. Not just addiction but powerful psychological dependency, depression of hormone production, lethargy and listlessness and sleep apnea, among others. These drugs do work well for some patients, but for many other patients, they’re not working well at all.<p>One leading expert said: “We thought the big problem with these drugs is addiction. Now we realize the problem is with patients who take them and basically opt out of life.” There is a general realization that while they do work for some patients, using them on a massive scale to treat chronic pain has had really disastrous consequences.<p>For instance, back pain is probably the leading workplace injury. What insurers and workers’ comp agencies are discovering is that when workers are treated with high doses of opioid drugs fairly soon after these injuries, it’s the leading predictor for them not coming back to work for long periods of time, or ever.<p>When you take a narcotic painkiller it sets off a natural reaction called tolerance, which means your body adjusts to it. You have to take more of the drug to get the same painkilling effect. Patients would come back to doctors and say, “This drug was working really well for me, but now I’m feeling pain again.” The doctor would increase the dose. The prevailing ideology during the war on pain was that these drugs had no ceiling dose. You could keep increasing them. The doctors kept boosting them every six months. People started taking higher and higher doses of these drugs. At a certain point it appears they create a change in the neurological system where people develop hyperalgesia and they become far more sensitive to pain than when they started out on these drug