Views & Reviews From the Frontline

Pain revisited: evidence for opioids

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2659 (Published 19 May 2010) Cite this as: BMJ 2010;340:c2659
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}yahoo.co.uk

    I upset many by asserting that the widespread use of strong opioids for pain in diseases other than cancer was a disaster in the making, after a doubling in the number of prescriptions in a decade (BMJ 2010;340:b5683, doi:10.1136/bmj.b5683). Since then I have immersed myself in the evidence, and I have come to only one certain conclusion: the pain community is well intentioned. But the process again makes me question the role of evidence based medicine. It was once touted to be our saviour, but its flaws are little understood, and “evidence” is given a …

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