The Maine Voices column of March 23, “Pain can be managed at any age,” sets up a false choice, between treating pain or preventing addiction. In fact, it is the obligation of every health professional to treat pain and to prevent addiction.

To claim “rarely do people become addicted when taking medication for pain” is to repeat a discredited theory that led to the widespread overprescribing of opioids 25 years ago, a practice for which we are still paying the price.

I work in an addictions program, and every day I see opioid addicts whose first experience with drugs was from a prescription to treat pain. It is true that most people who are prescribed pain medicine do not become addicted. But many do, and it is the responsibility of the prescriber to be aware of this potential and to work to prevent it.

There is no question that pain at any age must be aggressively addressed, but opioids are only one tool, and not necessarily the best one. They are good for acute conditions, but they have been shown to be ineffective for many common forms of chronic pain, such as low back pain, headache and fibromyalgia.

Furthermore, they often lose effectiveness over time, requiring higher and higher doses to maintain the same effect. There are many other options for pain management, such as physical therapy, acupuncture and cognitive behavioral therapy, to name just a few. It is tempting to think that opioids can do it all, but they can’t.

Managing pain requires managing the risk of addiction. It is a delicate balance, and to focus on one side of this balance while ignoring the other is to do a grave disservice to the individual and to society as a whole.

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