Nonmedical use of prescription opioids: What is the real problem?

The evidence from high-quality nationwide Canadian surveys indicates that NMPOU is decreasing, and the use of POAs to get high is in the range of 0.4% and decreasing. Shield et al (1) found no association between the misuse of POAs and the general use of POAs. It has also been determined that most of the individuals who are using opioids 'nonmedically' are actually using them for the treatment of pain and have obtained the medication from a friend or family member. There have been similar trends in the United States. There has also been a significant decline in the use of illicit substances in general, as well as a decline in the rates of substance dependence and abuse. It is important to remember these facts as we interpret the continuous stream of data-mining studies on the topic of NMPOU (11-13). Now that we have a greater understanding that most NMPOU is an attempt to treat pain, it is important to develop policies to address the issue of the undertreatment of pain in Canada. For this, we need a national pain strategy (14).