Pubdate: Mon, 20 Jun 2011 Source: New York Times (NY) Copyright: 2011 The New York Times Company Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html Website: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Russell K. Portenoy, M.D. Referenced: http://www.nytimes.com/2011/06/14/science/14volkow.html OPIOID THERAPY The experience of pain specialists over decades has convinced us that long-term opioid therapy is beneficial for a minority of patients with common causes of chronic pain and for a large majority of those with pain due to serious illness. Undertreated pain is a serious public health problem, and access to opioid medicines must be preserved even as society deals with the serious public-health problem of rising prescription drug abuse. To do so, we must understand that opioid addiction, overdose and abuse are separate but related problems. The compulsive use that characterizes addiction may or may not be involved in the overdose deaths of recreational drug users or the misuse of a drug prescribed by a poorly trained physician. When two public health problems of such complexity coexist, aggressive action for one problem must acknowledge the complexity and avoid actions that unintentionally worsen the other. Russell K. Portenoy, M.D. New York - --- MAP posted-by: Richard R Smith Jr.