The argument for chronic use of narcotics is function. Ooh, this guy is on a 50 gallon drum of morphine every day, but he’s still functioning. He’s going to work. He interacts well with his family. He’s sleeping nights. That might be an instance where chronic narcotic use may be reasonable for either particularly chronic low back pain that doesn’t have any leg pain associated with it, which means that probably the studies look pretty normal. The problem has been twofold. Number one is, is that the patients who have been started on the chronic narcotics and are taking more and more don’t function any better. In other words, if you ask many of them, what are you doing now? Well, I’m staying at home and I’m watching TV all day. Why do you watch TV all day? Because they don’t feel good enough to do anything else. So now what you’ve done is you’ve had a patient who isn’t doing very well to begin with. You’ve given them a second problem and you haven’t made their original one any better, but now they’re hooked on the narcotics.
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