Health & Lifestyle

The Great Opioid Lie: Addictive painkillers do NOT reduce lower back or neck pain

Opioids are ineffective treatments for back and neck pain, a new study shows.

Prescription painkillers that have hooked millions of Americans over the past two decades have been shown to be no more effective at reducing neck and lower back pain than a placebo. 

Researchers based in Australia indicated that opioid painkillers might actually worsen pain in the long-run while increasing the odds of becoming addicted.  

Senior author on the study, Professor Christine Lin from the University of Sydney said: ‘Despite there being no evidence of their efficacy in reducing pain, opioid pain relievers are still widely prescribed for people with lower back and neck pain in many countries.

‘Our study now suggests that they could be making patients’ pain levels worse in the medium and long term. 

While still widely used to treat cases of chronic pain, prescription opioids such as oxycodone may actually make pain worse, according to research conducted in Australia

While still widely used to treat cases of chronic pain, prescription opioids such as oxycodone may actually make pain worse, according to research conducted in Australia

There was no significant difference in pain severity between groups after six weeks, the study's primary timepoint. In fact, people who were not given an opioid reported lower pain scores

There was no significant difference in pain severity between groups after six weeks, the study’s primary timepoint. In fact, people who were not given an opioid reported lower pain scores

New research published in the Lancet suggests that, while traditionally believed to be the gold standard for treating pain, opioids may have little to no effect on improving a patient’s lower back and neck pain levels compared to a dummy pill. 

Professor Lin added:  ‘We firmly believe doctors should not prescribe opioid pain relievers for new episodes of lower back and neck pain.’

Australian, Dutch, and Danish scientists set out to determine whether patients with neck and lower back pain benefit from a doctor-controlled course of up to 20mg of oxycodone daily for up to six weeks.

The team of researchers included 347 subjects with an average age of about 45 years experiencing neck pain, lower back pain, or both across 157 sites in Australia. 

People were selected to be in the study if they sought medical help from their general practitioner or a doctor in a hospital and had been experiencing lower back or neck pain for 12 weeks at most. 

Everyone in the study received non-medicinal guidance such as advice to stay active, while 174 were given opiates and the other 171 were administered a placebo.

After six weeks, doctors assessed each person’s pain levels to determine whether the pills had any measurable benefit. And the doctors found that, overall, they did not.

They assessed the subjects’ pain using a 0 to 10 scale called the Brief Pain Inventory Pain Severity Subscale, which was initially developed to gauge pain levels reported by cancer patients.   

On pain scores measured out of 10, the opioid recipients reported a pain score of 2.8, while those in the placebo group reported a slightly lower score, 2.3.

At the one-year mark, the opioid recipients reported slightly higher pain scores compared to the placebo group – 2.4 versus 1.8.

The evidence of the long-term effects of taking the drugs to deal with pain is limited, though people who take them continuously have a higher risk of misusing them down the line.

Doctors also found that the people who were initially given oxycodone were also more susceptible to abusing the pills after one year with 20 percent of those who received opioids reporting misusing them compared to 10 percent of those in the placebo group.

In 1999, approximately 5 percent of the 175 deaths from opioids were from fentanyl. By 2021, 1557 (94 percent) of 1657 opioid deaths were attributed to fentanyl

In 1999, approximately 5 percent of the 175 deaths from opioids were from fentanyl. By 2021, 1557 (94 percent) of 1657 opioid deaths were attributed to fentanyl

Professor Lin said: ‘Lower back and neck pain can severely impact patients’ quality of life, so we need to offer them the best options to help manage their pain, but opioid pain relievers do not work and carry serious risks.

‘Instead, doctors should be encouraged to focus on patient-centred approaches that could include advice to stay active, and simple pain relievers.’

With the opioid epidemic top of mind for many doctors, prescription rates have declined in recent years

The nation’s drug overdose crisis, believed to have been sparked by the introduction of prescription opioids such as OxyContin, has struck everyone, with a record 107,622 Americans dying of a drug overdose last year.

More than 70 percent of deaths were caused by fentanyl, a synthetic opioid up to 100 times more potent than oxycodone.

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