January 01, 2019

Nonopioid pain relievers effective for chronic pain

Opioid drugs such as oxycodone and morphine are known for their addictive properties as well as for their ability to relieve pain. Even though there's little research on the use of opioids for chronic pain, many people continue to use them for this purpose, despite the risk of misuse and dependence.

A study in the March 6, 2018, issue of JAMA further highlights the limited effectiveness of opioids for chronic pain.

Researchers followed 240 veterans with severe back pain or pain related to knee or hip osteoarthritis who had pain that had persisted for at least six months. Participants were assigned to two groups, one that received an opioid, and the other that received a nonopioid pain reliever. Those in the nonopioid group were first given acetaminophen and nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen sodium. Some in this group were later given other nonopioid prescription drugs used for relief of more-severe pain as needed.

Over 12 months, there was no significant difference in pain-related function between the two groups. Those in the nonopioid group reported that the intensity of their pain was significantly better compared with the opioid group. Negative effects — including misuse, hospitalization and falls — caused more than twice the number of participants to drop out in the opioid group than the nonopioid group. The researchers summarized that opioids don't have any advantages over nonopioids to outweigh their risks.

Mayo Clinic experts acknowledge the risks involved with opioid use and recommend, if possible, alternatives to help manage...