However, "if psychiatrists do decide to get involved in the pharmacological management of pain and to focus heavily on opioid
use, then they are going to have to be prepared for a lot of the issues that come with that," Sunil Panchal, M.D., an anesthesiologist
and president of the Coalition for Pain Education Foundation in Lutz, Fla., said. "Over the past 15 years, there has been
a significant liberalization in the use of opioids for chronic pain patients. And with that you have seen an increased spike
in abuse and diversion. This is a societywide problem now. Studies have demonstrated that high doses of opioids make the nervous
system more sensitive to painâ¦. We now know that testosterone levels drop even with short-term exposure to low doses of opioids.
And with that drop in testosterone for both men and women, you have an increased risk of osteoporosis and bone fracturesâ¦.
Immune system effects are also emerging, suggesting that cancer spreads more aggressively with the use of opioids. So if psychiatrists
incorporate opioids into their treatment of pain patients, they should be aware of these long-term health risks."