Opioids May Not Relieve Pain Better than Non-Opioid Medications

Though the opioid epidemic claims about 115 American lives every day, the drugs continue to be prescribed because they supposedly treat chronic pain better than others like acetaminophen and ibuprofen.

But according to a new randomized trial of 240 patients, opioids are no better at killing chronic pain than safer drugs.

The 12-month trial—called Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE)—randomly assigned 240 Minneapolis Veterans Affairs patients into two groups. In one group, the patients took opioid medications like morphine and oxycodone. In the other, patients took non-opioid medications, such as acetaminophen and NSAIDs-like aspirin and ibuprofen. At the start of the trial, these patients had been suffering pain in their back, knees, or hips for at least six months. They were mostly older, white males.

Researchers did not find evidence that opioids were a better option for chronic pain relief than their safer counterparts.

After a year of treatment, Dr. Erin Krebs of the Minneapolis Veterans Affairs Health Care System’s Center for Chronic Disease Outcomes Research and her colleagues saw no evidence that opioids were a better than their safer counterparts. Here’s Karen Kaplan, reporting for the Los Angeles Times:

“Treatment with opioids compared with non-opioid medications did not result in significantly better pain-related function over 12 months,” Krebs and her colleagues concluded. “Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.”

When rating their pain on a scale from 0 to 10, patients in the opioid group reported an average score of 4.0, while patients in the non-opioid group reported an average of 3.5. Furthermore, 59% of those in the opioid group, compared to 61% in the non-opioid group, reported an improvement of at least 30%.

Not only were patients who took non-opioid drugs in less pain, they also suffered fewer drug-related side effects. Both groups, though, suffered from the same rates of misuse.

Since Veterans Affairs patients are not representative of the country as a whole, the authors cautioned that these results may not apply to everyone. But perhaps it may encourage doctors to reconsider prescribing opioids as the first line of treatment for chronic back and joint pain.