Chronic Pain Remains Stable or Gets Better After Stopping Opioids
By Heather Callaghan, Editor
“Our results indicate that long term opioid therapy does not effectively manage patient pain intensity any more effectively than not receiving long-term opioid therapy.”
Washington State University researchers have found out that chronic opioid pain relief users can take hope that stopping opioid pain pills should not make their condition worse.
Stopping long-term opioid treatment does not exacerbate chronic, non-cancer-related pain, as demonstrated in a new study on VA patients.
“On average, pain did not become worse among patients in our study a year after discontinuing long-term opioid therapy…”
That’s a quote from lead study author Sterling McPherson, associate professor and director for biostatistics and clinical trial design at the WSU Elson F. Floyd College of Medicine.
The study which appeared in journal Pain, is one of the first to investigate what, if any, are the potential adverse effects of discontinuing long-term opioid therapy for chronic, non-cancer-related pain.
If anything, their pain improved slightly, particularly among patients with mild to moderate pain just after discontinuation. Clinicians might consider these findings when discussing the risks and benefits of long-term opioid therapy as compared to other, non-opioid treatments for chronic pain.
He and his colleagues at the Veteran Affairs Portland Health Care System and the Oregon Health & Science University relied on surveys from 551 VA patients (but not any with cancer) who were long-term opioid users for chronic pain conditions for at least one year before stopping opioids.
Washington State University reports:
Eighty-seven percent of the patients were diagnosed with chronic musculoskeletal pain, 6 percent with neuropathic pain, and 11 percent with headache pain, including migraines.
Survey subjects rated their pain over two years, scoring it on a scale of 0-10 where 0 equals no pain and 10 equals the worst possible pain. The researchers used biostatistical analysis and computer modeling to characterize changes in pain intensity 12 months before the patients ended opioid therapy and the 12 months after.
While patients differed widely in the intensity of pain they experienced before and after stopping opioids, as a whole, their pain did not get worse and remained similar or slightly improved.
“Our results indicate that long term opioid therapy does not effectively manage patient pain intensity any more effectively than not receiving long-term opioid therapy,” McPherson said. “There are a variety of treatments available for the management of chronic pain other than opioids and our hope is that this research will help promote conversations about these alternatives between doctors and their patients.”
Chronic pain…and opioid use a national problem
At least one-third of Americans suffer from backaches, headaches or other chronic forms of pain.
The growing prevalence of obesity, diabetes, arthritis and more means that more pain conditions are expected in the population in the future.
In the last 30 years, opioid painkiller use were increasingly doled out to quell the pain – with tragic results. “According to the Centers for Disease Control and Prevention, more than 63,600 Americans died from drug overdose deaths in 2016, a toll five times higher than in 1999. Two-thirds of these deaths, 42,249, involved opioids.”
The team above had categorized the patients into four different groups based on reported pain levels and want to know what differentiates them in order to discover more customized pain treatments. “In addition, we hope to continue to characterize potential adverse effects from being discontinued from long-term opioid therapy,” McPherson said.
The team wants to thoroughly interview the patients over the next year to determine why some experienced more improvement than others after stopping opioids. Ultimately, they do not put faith in opioids for pain management and believe doctors should explore alternatives with their patients.
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