Millions of Americans live with pain and have been prescribed powerful opioids. Evidence showing the serious risks of opioid therapy for pain management continues to grow. A recent study reveals that opioids may not be any more effective than nonsteroidal anti-inflammatory drugs (NSAIDS) for treating chronic back pain, and hip or knee osteoarthritis pain.
These findings were released in the March 2018 issue of JAMA (Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients with Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial). The 12-month randomized trial included 240 patients from Veteran’s Affairs' primary care clinics with moderate to severe chronic back pain or hip or knee osteoarthritis pain. They were divided into 2 groups: one group was treated with opioid therapy, and the other received nonopioid drugs, such as acetaminophen and NSAIDS.
A range of tests were used throughout the study, with a primary focus on how pain interfered with function and pain intensity. Both were measured using the brief pain inventory, or BPI, and the BPI severity scale, which measures pain on a 10-point scale (10 being the highest pain level). At the 12-month mark, researchers found no significant differences in how pain affected the ability to function between the two groups. The opioid group scored an average of 3.4 in BPI function and the nonopioid group scored an average of 3.3. The nonopioid group reported a greater reduction in pain intensity, with an average of 3.5 vs 4.0 from the opioid group.
The authors concluded, "Overall, opioids did not demonstrate any advantage over nonopioid medications that could potentially outweigh their great risk of harm."
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