Acetaminophen, or brand name paracetamol, was used as the non-opioid medication while the other pain-control regiment included morphine, oxycodone, or a combination of hydrocodone and acetaminophen.
A total of 240 patients from 62 Veterans Affairs clinics in Minneapolis, Minn., with moderate to severe chronic back pain or hip or knee osteoarthritis pain were examined from 2013 to 2015 and follow-up ended in 2016. Only 32 women participated in the study (though lead author Erin Krebs said the findings were similar for both groups).
"Overall, opioids did not demonstrate any advantage over non opioid medications that could potentially outweigh their greater risk of harms", the researchers wrote. If the prescription didn't work, it would be changed, selecting from drugs that had been shortlisted.
Opioids tested included generic Vicodin, oxycodone or fentanyl patches although few patients needed the most potent opioids. 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. Patients were randomly assigned to an opioid or non-opioid group (participants knew which group they were in and what medications they were taking).
A report released Tuesday by the Centers for Disease Control and Prevention found emergency rooms saw a big jump in overdoses from opioids a year ago.
The group that took opioids didn't do particularly well in either category-in fact, the group that wasn't on opioids reported less pain; the group scored, on average, a half-point lower on a "pain intensity" scale ranging from one to 10.
Measures of how pain interfered with things like work, sleep, mood and general enjoyment of life were almost identical in both groups. After 12 months, 59 percent of those in the opioid group and 61 percent of those in the nonopioid group reported an improvement of at least 30 percent.
Patients reported changes in function or pain on questionnaires. When she looked for data on the efficacy of opioids, she was troubled to find that there were no longitudinal studies on the effects of taking opioid painkillers long term.
Researchers approached the study with this question: Does opioid medication compared with non-opioid medication result in better pain-related function for patients with moderate to severe chronic back pain or hip or knee osteoarthritis pain despite analgesic use? Adverse medication-related symptoms were more common in the opioid group.