The L.A. Times reported yesterday that researchers now have hard data that challenges the view that opioids’ pain-relieving benefits justify their risks. According to the Times, in the first randomized clinical trial to make a head-to-head comparison between opioids and other kinds of pain medications, patients who took opioids fared no better over the long term than patients who used safer alternatives. Researchers concluded in the Journal of the American Medical Assn that “there was no significant difference in pain-related function between the 2 groups over 12 months.”
The Times reported that the study’s authors concluded that “by some measures, the people using non-opioid drugs such as Tylenol, ibuprofen and lidocaine experienced more pain relief than people using medications like morphine, Vicodin and oxycodone — though the differences weren’t large enough to be considered statistically significant.”
The trial — Strategies for Prescribing Analgesics Comparative Effectiveness, or SPACE — was funded by the Department of Veterans Affairs and enrolled patients who were treated by the Minneapolis VA. All of the patients had pain in their backs, hips or knees for at least six months, and that pain was bad enough to interfere with their daily activities and enjoyment of life. A total of 240 patients were randomly assigned to either the opioid or nonopioid group. About two-thirds of them had back pain, and the rest had osteoarthritis pain in their knees and hips. According to the Times, the study authors cautioned that these results might not apply to pain patients in general, since VA patients aren’t representative of the country as a whole.
“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.
Of potential and particular significance to the WC industry, the Times noted that Dr. Krebs and her colleagues conclude that “treatment with opioids compared with non-opioid medications did not result in significantly better pain-related function over 12 months,” and that, “Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip or knee osteoarthritis pain.”
Thank you to The L.A. Times and reporter Karen Kaplan (firstname.lastname@example.org) for bringing this important study to our attention.