A recent study published in JAMA found that OTC painkillers like acetaminophen and ibuprofen were more effective at treating chronic pain compared to prescription opioids. Considering the serious risks of opioid pain relievers – including abuse, dependence and potentially death – the researchers concluded that opioids should not be used to treat patients suffering from chronic back pain or hip and knee pain associated with osteoarthritis.
Opioid painkillers tested in the study included oxycodone and Vicodin, which were unable to beat the OTC drugs at reducing pain-related walking problems or sleep issues. The trial included 250 patients who were randomly assigned to receive opioids or OTC painkillers for a 12-month period.
According to Dr. Erin Krebs, a physician and researcher with the Minneapolis Veterans Affairs Health Care System, the results of their study might be a surprise to doctors and patients “because opioids have this reputation as being really powerful painkillers, and that is not what we found.”
A recently-released report published by the Centers for Disease Control and Prevention (CDC) found opioid overdoses in US emergency rooms increased by 30 percent in a 3-month period in 2017, compared to the same time in 2016. The Midwest was hit particularly hard, however a spike in overdose deaths was seen across the country.
While prescribing rates for opioids has decreased in recent years as the extent of the epidemic has been realized, they’re still significantly higher than they were decades ago. 2016 guidance from the US government lists opioids as a non-preferred treatment for treating patients with chronic pain.
According to Krebs, non-drug interventions like exercise and physical therapy have been shown to be more effective for managing chronic pain in other studies. While the current study did involve more male patients, Krebs and her colleagues reported seeing similar results in both sexes.
“This is a very important study,” said Dr. David Reuben, geriatrics chief at UCLA’s medical school. “It will likely change the approach to managing long-term back, hip and knee pain.”