A clinical study published in The Journal of the American Medical Association claims opioids might not be any more effective than over-the-counter options in treating and managing certain types of pain.
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.
As with any independent study that's released and reported on, causation does not necessarily mean corellation -- individual experiences and cases will obviously vary.
However, this does raise questions about the overall effectiveness and necessity of prescribing opioids as a baseline treatment for certain levels and types of pain.
The study comes as U.S. leaders and medical professionals work toward a solution to the growing opioid epidemic as overdose deaths related to both abuse and misuse of prescription opioids and illegal narcotics claim the lives of more than a hundred people in the U.S. each day.
So let's break down the study (you can read it here).
Chronic pain management Dr. Erin Krebs and two other researchers working at the Veteran's Administration Medical Center in Minneapolis conducted a study on chronic disease outcomes.
The three asked the question: Does opioid medication produce better results in treating pain in patients specifically suffering from moderate to severe chronic back pain or hip/knee osteoathritis pain compared to nonopioid options?
The group conducted a randomized year-long clinical trial with 240 patients suffering from the forms of pain listed above in 2016 and split participants into two medication groups to see how they responded. Medications were changed, adjusted and added within the assigned groups according to a patient's response.
One group was given strictly opioids commonly prescribed in the form of immediate-release morphine, oxycodone or hydrocodone-acetaminophen. The other group was given strictly nonopioids you can buy over-the-counter like acetaminophen (such as the drug Tylenol) or a nonsteroidal anti-inflammatory drug like ibuprofen.
Changes in the level of pain were asked and measured through a "Brief Pain Inventory Interference Scale" or BPI severity scale. The levels of pain were recorded throughout the year-long study and rated from 0-10, with people self-reporting their pain as being higher on the BPI scale meaning they were experiencing higher levels of pain/worse function.
What the research discovered was that, over the year, there was not a significant difference in the final average BPI severity between the two groups. The opioid group had a 12-month mean level of pain of 3.4 BPI, and the nonopioid group ended with 3.3 BPI -- meaning the nonopioid group was reportedly better off overall than the opioid group.
Also, the opioid group reported twice the average level of adverse medication-related symptoms than the nonopioid group -- with a 1.8 on a 19-point symptom scale compared to the nonopioid group's 0.9.
The study concluded that prescription opioids were "not superior" to treatment with OTC medications like acetaminophen in improving pain-related function over the period of a year, saying the results do not support prescription of opioid medications for moderate to severe back pain, or hip/knee osteoarthritis pain.
"Overall, opioids did not demonstrate any advantage over non opioid medications that could potentially outweigh their greater risk of harms," the researchers wrote.