I am a nurse in an outpatient clinic. I notice that more and more patients are being given narcotics for pain control. I thought this was a big no-no because of the potential for abuse and addiction. What's the current thinking on this?

There is still much argument and debate among health care professionals about the use of potentially addictive medications such as opioids. When these drugs are prescribed for chronic pain problems, there is concern that more and more drug will be needed to maintain the same level of pain control.

Becoming dependent on a narcotic makes it more difficult to withdraw from opioid therapy. This is true even when pain control is so poor there seems no point in taking the drug.

But new studies done in the 1990s and early 2000s have shown that opioids can be very helpful for various chronic pain conditions. For example, patients with arthritis, nerve-related pain, and cancer get good relief from pain. Sleep, anxiety, and function are improved. Quality of life measures are also improved.

Long-term use of these drugs still remains in question. Who is at risk for addiction? What exactly defines addiction? Is it the same from one person to the next? Does pain relief always mean improved function, less disability, or better quality of life?

All these questions have been raised about the use of opioid therapy for chronic pain. More studies are needed before we will have answers to guide us. Much more research must be done before opioids are routinely prescribed for every ache and pain that doesn't go away as expected.

But for now, there has been a softening of some of the rigid policies regarding the use of these medications. You are probably seeing the result of this change based on current evidence available. As more information becomes available, we may see this policy change in the coming years.