Opioid treatment is not superior to non-opioid treatment for some pain


The study, in JAMA, used 11-point pain and function scales to measure the effect of treatment, with higher scores indicating poorer results.

"Overall, opioids did not demonstrate any advantage over nonopioid medications that could potentially outweigh their greater risk of harms", wrote the team led by Dr. Erin Krebs of the Minneapolis Veterans Affairs Health Care System's Center for Chronic Disease Outcomes Research.

At the end of 12 months, the opioid group scored an average 3.4 on the function scale, and the nonopioid group 3.3, an insignificant difference.

A report released Tuesday by the Centers for Disease Control and Prevention found emergency rooms saw a big jump in overdoses from opioids a year ago.

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A new study claims to offer evidence that opioids don't work better than non-opioid pain medication for some types of chronic pain, and patients have a lot to say about it.

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

A total of 240 patients were randomly assigned to either the opioid or nonopioid group.

Let's get this out in the open first for clarity's sake: The study is NOT saying doctor-prescribed opioids aren't effective at treating and improving chronic pain, just that in the specific cases listed in the study prescription opioid options were reported to be no more effective than over-the-counter painkillers like Tylenol and ibuprofen for people suffering from specific types of pain.

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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). Both groups started out with average pain and function scores of about 5.5 points.

But Tuesday's publication of the full results in the Journal of the American Medical Association could have additional impact, Krebs said, because policymakers nationally have had little comparative data on whether opioids work well enough to justify their risks. 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. However, hospitalizations and emergency room visits to deal with pain medications were similar in both groups, as were rates of drug misuse.

The VA trial addressed only long-term use, not opioid prescriptions for acute pain or immediately following medical procedures. "Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain".

The study was funded by the Department of Veterans Affairs.

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