Sample 2: 2000
Papers published in
200026–32generally acknowledged concerns about opioid prescribing, but viewed
them as a secondary concern after treating pain. For example,
Quang-Cantagrel writes that the controversy about opioids “results from
confusion about pathologies which could benefit from opioids and
misconceptions about addiction and tolerance that may result from
long-term opioid
administration.”30Similarly, Watson acknowledges that “the use of opioids for neuropathic
pain, generally when all else has failed, remains contentious,” but
immediately goes on to write that “opioids may be the only avenue of
relief for many patients with severe neuropathic
pain.”32
Anesthesiology articles published in 2000 were more supportive of
opioids for pain treatment (57.1%) than they were in 1991. There was
common agreement that opioids can be safe and effective for short-term
treatment of non-cancer pain. Yet, there continued to be uncertainty and
disagreement about long-term effectiveness and risks of opioid treatment
for chronic pain. Covington writes that “[w]hat we do not yet know
is what the effects will be of years, in fact decades, of opioid
treatment of intractable
pain.”27Only Mindach took a strong stance against the index study and opioid
prescribing in his commentary, claiming that “[n]ot a single
convincing clinical study could be found to prove the claimed absence of
addiction in pain
patients.”29Of note, this article was published in a German, rather than an American
or Canadian, journal.