Elimination of Long-Term Opioid Therapy Found to Stabilize or Reduce Chronic Pain 

The discontinuation of opioid therapy may address the rising death toll caused by drug overdoses while maintaining or potentially improving chronic, non-cancer pain in patients, according to a recent study.

Opioid therapy has been used in the United States by medical practitioners since the early 1990s to manage backaches, headaches, and other chronic, non-cancer related pains in patients. However, opioid-related overdoses have increased within the last few years, causing physicians and policymakers to reconsider using opioids as long-term treatments.

The discontinuation of opioid therapy may address the rising death toll caused by drug overdoses while maintaining or potentially improving chronic, non-cancer pain in patients, according to a recent study.

The study, published in Pain, evaluated pain intensity following discontinuation of long-term opioid therapy.

Sterling McPherson, PhD, associate professor and director for biostatistics and clinical trial design at the WSU Elson F. Floyd College of Medicine, and colleagues collected data from patients at the Veteran Affairs (VA) Portland Health Care System and the Oregon Health and Science University. The study surveyed 551 VA patients who had been on long-term opioid therapy for chronic, non-cancer related pain for at least 12 months before suspending their treatment. Participants were identified by a diagnosis of either musculoskeletal pain (87%), neuropathic pain (6%), or headache pain, including migraines (11%).

Over a 2-year period, patients rated their pain on a scale from 0 to 10, with 0 representing no pain and 10 representing the worst possible pain. Researchers tracked changes in pain intensity 12 months before and after patients terminated opioid therapy using biostatistical analysis and computer modeling. Patients were placed in 1 of 4 groups based on the level of pain they reported while receiving long-term opioid therapy and post therapy.

According to the findings, patients experienced a vast spectrum of pain intensity from the time they were treated with opioids to the months after stopping the medication. The survey results showed that chronic, non-cancer pain remained the same or slightly reduced. The researchers noted that it is still unclear why some patients experience greater pain reductions than others and future research will hopefully provide an explanation.

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“Our hope is that this will lead to being able to target specific sub-populations with different types of treatments for their chronic pain,” Dr McPherson said in a press release. “In addition, we hope to continue to characterize potential adverse effects from being discontinued from long-term opioid therapy.”

Results suggest using opioids to manage pain in patients with chronic, non-cancer ailments is no more effective than not using opioids, the researchers concluded. Medical practitioners can utilize the information from this study to make patients aware of the alternatives that exist. Opioid-related drug overdoses are a national issue that won’t improve if health care practices are not modified to deter addictive and dangerous behaviors, according to the study authors.

Reference

Chronic pain remains the same or gets better after stopping opioid treatment: WSU study questions value of long-term opioid therapy for chronic, non-cancer pain [news release]. WSU’s website. https://news.wsu.edu/2018/07/02/chronic-pain-remains-gets-better-stopping-opioid-treatment/. Accessed July 3, 2018.