Balance, Pain

“Opium, Sinner or Saint?” Life Before Death Film No 22


It is interesting to see Cynthia Goh opening this film. On flights into Singapore, passengers are given warnings over the speakers that the import of “narcotics” is punishable by the death penalty. Clearly opium is perceived more as a sinner than a saint.

But what is a saint? Without getting into a theological discussion, lets look at the definitions from Dictionary.com:

  • Saint: a person of great holiness, virtue, or benevolence.
  • Sinner: a person who sins; transgressor.

Opium, and its products, are in themselves medications with the potential of great benevolence. No need to talk about holiness (or getting into Church teachings). They are drugs that when used appropriately give great benefit in terms of the treatment of pain.

As Dr Mosoiu indicates, with any drug there is a risk of side effects and misuse. Dr Foley gives examples, (anti-arrhythmics, insulin) that can cause death but most would not be defined as bad drugs. From cancer, another example.  Tamoxifen is a drug that has great benefits in the treatment of breast cancer, but one that can cause cancer of the uterus.  A bag drug, no. But one with risks.  We have to balance these risks with the benefits.

Just this week, Geripal has a blog on Inappropriate Prescribing.  Dr Kao wrote about seeing geriatric patients who were having regular benzodiazepine prescriptions filled by an oral surgeon and ophthalmologist.  And this is significant as many of the deaths attributed to opioids in the USA also involve benzodiazepines.

It is essential that physicians ensure they are well educated on the use of the drugs they prescribe. This includes opioids.  Prescribers need to become familiar with the benefits, and the risks and side effects and how to manage these when they do occur. Where to do this?  Medical School, residency and ongoing CME.

So the answer to the question.

Opioids: Saintly, of great virtue and benevolence.  

It is not always the drug that is at fault when things don’t work out.

Your thoughts?

@jfclearywisc

About Pain policy & palliative care

Improving global pain relief by achieving balanced access to opioids worldwide

Discussion

One thought on ““Opium, Sinner or Saint?” Life Before Death Film No 22

  1. The write up is really good. It gives a clear information about the myths about Oral Morphine. Infact lot of practicing oncologists have myths and our duty to remove this myths from them. Common peple having this myths can be eradicated by first removing the myths our own professional colleagues.

    Posted by Dr.Lingegowda.K.B | November 12, 2011, 11:21 PM

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