VA study: Opioids not better at reducing chronic pain


It would be one thing if opioid-based pain pills simply did nothing for people with chronic pain-but opioids have side effects like sleepiness and cramps and carry a serious risk of addiction.

Erin E. Krebs at the Minneapolis Veterans Affairs Health Care System, Minneapolis, was the lead author of the study.

Oxycodone pain pills. A new study following patients being treated for chronic pain found that those taking opioid-based pain pills didn't experience less pain than those taking over-the-counter pain relievers. Patients recorded between 0 to 19 medication-related symptoms.

The study concluded that prescription opioids were "not superior" to treatment with OTC medications like acetaminophen in improving pain-related function over the period of a year, saying the results do not support prescription of opioid medications for moderate to severe back pain, or hip/knee osteoarthritis pain.

The study comes as USA leaders and medical professionals work toward a solution to the growing opioid epidemic as overdose deaths related to both abuse and misuse of prescription opioids and illegal narcotics claim the lives of more than a hundred people in the US each day.

Researchers found that at a year of followup, pain intensity was significantly better in the non-opioid group and that adverse medication-related symptoms were more common in the opioid group.

US government guidelines in 2016 said opioids are not the preferred treatment for chronic pain, and they recommend non-drug treatment or nonopioid painkillers instead. The workers' compensation industry's approach to chronic pain historically has been trying drugs and other medical procedures first.

This isn't the first study to throw shade at long-term opioid use: just previous year, a thorough research found that a cocktail of two over-the-counter drugs (ibuprofen and acetaminophen, commonly known as Advil and Tylenol) are more effective than heavy opioids in dealing with pain than heavy opioids. Follow-up ended in 2016.

He noted one limitation - most study participants were men, but Krebs said the results in women studied were similar. They switched to higher doses if needed or to long-acting opioids or fentanyl patches. However, hospitalizations and emergency room visits to deal with pain medications were similar in both groups, as were rates of drug misuse. Function scores improved in each group by about two points on an 11-point scale, where higher scores meant worse function.

Measures of how pain interfered with things like work, sleep, mood and general enjoyment of life were almost identical in both groups. However, the average pain intensity dropped two points in the non-opioid group and slightly less in the opioid group.

Other research has shown that over-the-counter medicines can also work as well as opioids at treating short-term pain, including from broken bones, kidney stones or dental work.