Monday , December 6 2021

Opioids are no more effective in treating pain than over-the-counter options: study



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Opioids are not better in the treatment of chronic pain than appeal painkillers like ibuprofen and naproxen, according to a study that raises questions about how often the drugs are prescribed, given the risks they make.

The study, published Tuesday in the Journal of the American Medical Association, was an analysis of nearly 100 studies on the efficacy of opioids in the treatment of chronic non-cancer pain. The studies compared opioids with placebo as well as other analgesics. The researchers concluded that opioids are slightly better than a placebo in the treatment of pain and give similar benefits to non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen. The results also indicate that opioids are no better than antidepressants to treat pain, but that they can provide better pain relief than anticonvulsant drugs such as gabapentin and pregabalin.

"It was this dramatic increase in opioid deprivation in the 1990s and early 2000s and only now 20 years later it is clear that these drugs may not work at all or if they have an advantage it's very small," said Nav Persaud, a family doctor at Toronto St Michael's Hospital and a researcher at the hospital's Li Ka Shing Knowledge Institute. He was not involved in the study.

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According to the study, research also showed that the modest benefits that the opioids gave rise to were weakened over time, for reasons that are not entirely clear. Despite this, many patients stayed on drugs for long periods, indicating that they may have experienced severe and painful withdrawal symptoms if they attempted to stop taking them, "said Jason Busse, senior author of the study and associate professor at anesthesia at McMaster University, Hamilton, Evil.

"[Opioids] will not work for most patients. For those who do, these benefits will often diminish over time, he says. "So why is it that so many patients, when initiated for long-term opioid treatment, will continue?"

Many of the focus on Canada's opioid crisis are currently determined by the increasing number of deaths and hospitalizations caused by overdoses of fentanyl. But prescription opioids are still an important part of the problem that should not be ignored, says Dr. Busse, especially since some evidence suggests that many who overdose the opioids had at death or during a previous point of their lives received recipe for an opioid analgesic.

Dr Busse said that the results show underlining the need for better access to other treatments for managing pain, such as mindfulness treatment. He said he is also concerned that many people market cannabis as an effective treatment for chronic pain, although there are small clinical data to back up it. He said patients and clinics should wait until there is sufficient evidence before using cannabis for pain to prevent problems similar to the opioid crisis.

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