Opioids Don't Treat Chronic Pain Any Better Than Ibuprofen

Henrietta Brewer
March 9, 2018

"There was no significant difference in pain-related function between the two groups over 12 months", researchers reported Tuesday in the Journal of the American Medical Association.

About 42,000 drug overdose deaths in the United States in 2016 involved opioids, including prescription painkillers, heroin and fentanyl.

The findings cast doubt on the medical community's "standard approach" of using opioids to manage chronic musculoskeletal pain, the researchers found.

There are alternatives to opioids and drugs for pain management, if employers are willing to consider them. Medications were changed, adjusted and added within the assigned groups according to a patient's response. The participants were then asked to rate their pain every three months, on two scales: intensity and functionality (how easy it is to go about your day-to-day life). The mean patient age was 58.3 years old and 13 percent of participants were women.

All patients started with lower levels of pain medications and were able to "step up" their treatment as necessary.

A report released Tuesday by the Centers for Disease Control and Prevention found emergency rooms saw a big jump in overdoses from opioids past year. First-line medications for the opioid group included morphine and oxycodone; patients in the nonopioid group started out with acetaminophen and NSAIDs, a group that includes aspirin and ibuprofen.

Measures of how pain interfered with things like work, sleep, mood and general enjoyment of life were almost identical in both groups.

Patients reported changes in function or pain on questionnaires. However, the average pain intensity dropped two points in the non-opioid group and slightly less in the opioid group.

While the study may have useful implications for the specific type of chronic pain studied, the study is being touted by many as evidence that in general, opioids aren't more effective than over-the-counter and non-opioid pain medication - which many people with chronic pain say is incorrect. The opioid group reported an average of 1.8 medication-related symptoms, in comparison to the NSAID group, who reported an average of 0.9 symptoms.

You can read the results of the entire study here.

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.

A yearlong study offers rigorous new evidence against using prescription opioids for chronic pain.

The study was funded by the Department of Veterans Affairs.

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