Published: Thu, March 08, 2018
Medical | By Marta Holmes

Influential Minnesota study finds that opioids are no better for long-term pain

Influential Minnesota study finds that opioids are no better for long-term pain

The opioid group was prescribed morphine, oxycodone, or hydrocodone, while the non-opioid group was prescribed acetaminophen (i.e., Tylenol) or a nonsteroidal anti-inflammatory drug (i.e., Advil).

In other outcomes, pain intensity was less intense in the nonopioid group and adverse medication-related symptoms were more common in the opioid group. The participants told the researchers how bad their pain was and how it was affecting their lives over the course of a year.

This was a randomized clinical trial (RCT).

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Researchers followed 240 people being treated at a VA hospital in Minneapolis for serious, chronic pain for over a year; most of the study participants were men.

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.

All patients started with lower levels of pain medications and were able to "step up" their treatment as necessary. The mean age was 58.3 years, meaning few young people were included. However, the average pain intensity dropped two points in the non-opioid group and slightly less in the opioid group. After 12 months, 59 percent of those in the opioid group and 61 percent of those in the nonopioid group reported an improvement of at least 30 percent. This was measured with a patient reported checklist. The one exception was anxiety, which improved more for those taking opioids. When she looked for data on the efficacy of opioids, she was troubled to find that there were no longitudinal studies on the effects of taking opioid painkillers long term.

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Opioid medications were not better than nonopioid treatment to improve chronic back, hip or knee pain, according to medical research conducted at Veterans Affairs clinics in Minnesota.

Researchers approached the study with this question: Does opioid medication compared with non-opioid medication result in better pain-related function for patients with moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use? 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.

The study was funded by the Department of Veterans Affairs.

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