Opioids and Pain


Since the opioid crisis was announced in the USA, Oxford Medicine has been creating a series of content pieces to inform the public about the medicinal impact of opioids. Now, with the crisis as widespread as ever and sparking debate internationally, we have collated our resources in order to provide detailed, authoritative, and varied information about opioid use from a medical perspective.

Opioids encompass both those drugs derived from opium, such as morphine and codeine, as well as synthetic drugs made to emulate the sensation created by true opiates, methadone, for example. These drugs are defined as narcotics, and work by depressing the nervous system. This in turn causes pain relief and feelings of euphoria, as well as some less desirable side-effects such as drowsiness, nausea, and the depression of breathing. Opioids have long been used in pain medicine to relieve severe pain, particularly as part of cancer treatment. There are guidelines on the application of opioids, including the WHO Cancer Pain Ladder. Despite this, arguments continue on the question of whether these drugs should be prescribed at all, and if so, under which circumstances. 


How much do you know about opioids? [quiz]

By Amy Cluett


As we know, the current opioid epidemic is widespread, and is growing ever-bigger. How much do you actually know about opioids, though? Test your knowledge and learn fascinating facts about this controversial group of drugs with this quiz.


Five key underlying drivers of the opioid crisis

By Larry Cohen 


Larry Cohen, author of Prevention Diaries, discusses how the face of addiction has changed since President Nixon's 1971 War on Drugs, and identifies that five main drivers for the United States' current opioid crisis.


The evolution of pain medicine adherence [extract]

By Martin Cheatle and Perry G. Fine 


Hippocrates once commented 'Keep a watch also on the faults of the patients, which often make them lie about the taking of things prescribed'. Patients have tested clinicians with the ways in which they choose to take their prescribed medication. Martin Cheatle and Perry G. Fine explore the particular challenges associated with patient non-adherence to pain medicine.


We can predict rain but can’t yet predict chronic pain 

By Steven Z. George 


Chronic pain is one of the primary causes for taking prescription opioids, and is extremely hard to predict. Steven Z. George guides us through possible solutions to this problem, a problem which - if solved - could lead to opioid treatment becoming redundant.





The return of opiophobia

By Robert C. Macauley


Learn about some of the lesser-known effects of the opioid epidemic with this article by Robert C. Macauley. Here, he looks at the recent resurgence of opiophobia, the fear of opioids, examining ways of approaching patients suffering with this condition to ensure that their comfort is not compromised.




The opioid crisis in black and white: the role of race in our nation’s recent drug epidemic

By Anjali Om


This perspective piece by Anjali Om of Virginia Commonwealth University examines the genesis and response to the US opioid epidemic in the context of race. Do racial biases exist within the opioid crisis?




The Demise of Interdisciplinary Chronic Pain Management and Its Relationship to the Scourge of Prescription Opioid Diversion and Abuse

By Michael E. Schatman


Taken from Prescription Drug Diversion and Pain: History, Policy, and Treatment, this free chapter addresses the benefits of interdisciplinary pain management, and the consequences of its recent demise in the US.




Pain medicine and addiction: A reading list

By Rebecca Parker 


We've selected poignant chapters and articles surrounding pain medicine and addiction, which you can read here for free.






Reducing the harm done by substances: key strategies

By Dr Peter Anderson and Fleur Braddick 


Does probation work? The result of a decades-long study, this blog explores some of the options available to policy-makers when it comes to tackling substance abuse. 




An examination of opioid prescription for Medicare Part D patients among family practice prescribers

By Kevin Pan, Alan I Blankley, and Peter J Hughes 


This article outlines a study into the prescription rate of opioids from family practitioners for Medicare Part D patients in light of statistics showing 6 of every 1000 Medicare beneficiaries have been diagnosed with an opioid use disorder.  





Reducing opioid use for chronic pain in older adults

By Joshua K Goga, Annie Michaels, Marc Zissleman, Antonio DePaolo, Sunil Khushalani, J Ken Walters, Anita Poloway, Robert Roca, Matthew Kopp


A multidisciplinary team at Sheppard Pratt Health System collaborated to create SAFE PAIN, a treatment algorithm based on the Center for Disease Control and Prevention's recommendations on nonpharmacologic interventions as first line therapy for chronic pain, leading to a reduction in the prescribing rate of new opioids. Learn more here.  




Newly Emerging Drugs of Abuse and Their Detection Methods: An ACLPS Critical Review

By Li Liu, Sarah E Wheeler, Raman Venkataramanan, Jacqueline A Rymer, Anthony F Pizon, Michael J Lynch, Kenichi Tamama


With illicit drug use reaching an epidemic level in the US, drug overdose has become the leading cause of injury related deaths since 2008. The American Journal of Clinical Pathology illustrates how increase in use and ultimately overdose by opiates has led to an emergence in synthetic drugs to cater to demand, causing identification issues for clinical toxicology laboratories.