Studies Find Non-Opioid Meds as Effective for Pain Relief as Opioids

In 2016, 116 people died every day from opioid-related drug overdoses, according to the U.S. Department of Health and Services. Opioid-involved deaths are continuing to increase in the United States. More than three out of five drug overdose deaths involve an opioid.

In 2016, U.S. government guidelines said opioids are not the preferred treatment for chronic pain. Guidelines recommend non-drug treatment or non-opioid painkillers instead. The guidelines also recommend that opioids should only be used if other drugs or modalities don't relieve chronic pain.

Two studies on fighting pain revealed surprising results about painkillers. The more recent study was published in the Journal of the American Medical Association (JAMA) in March 2018. The other study was also published by JAMA, in November 2017.

The results? Both studies reported that common painkillers relieve pain as well as opioids, but without the risks of abuse or overdose associated with opioids.

In the 2018 study, researchers examined 240 patients with moderate to severe chronic back pain or hip or knee osteoarthritis pain. Chronic pain was defined as nearly-daily pain for six or more months. One group of patients was given opioid pain medications, and the other group was given non-opioid pain medications to relieve pain. The researchers assessed both groups based on how much their pain interfered with daily activities such as walking, work or sleep.

The study found that in patients with chronic back aches or hip or knee arthritis, opioids worked no better than over-the-counter drugs or other non-opioids at reducing problems with walking or sleeping. They also provided slightly less pain relief.

The results likely will surprise many people "because opioids have this reputation as being really powerful painkillers, and that is not what we found," said lead author Dr. Erin Krebs, a physician and researcher with the Minneapolis Veterans Affairs Health Care System’s Center for Chronic Disease Outcome Research.

Dr. Krebs says the strongest evidence from other studies shows that physical therapy, exercise or rehabilitation therapy works best for chronic pain. She also noted a variety of non-opioid drugs are available to try if one type doesn't work.

The second, earlier, study also found that non-opioid pain relievers are just as effective as opioids for chronic pain relief.

“The results did surprise me,” says Dr. Andrew Chang, professor of emergency medicine at Albany Medical Center and author of the study. “Most physicians reflexively give opioids to patients with fractures or broken bones. This study lends evidence that opioids aren’t always necessary even in the presence of fractures.”

In that study, Chang and his team of scientists investigated whether alternative pain killers could be effective in treating pain in emergency departments. The group studied more than 400 people who visited two emergency rooms for arm or leg strains, or fractures, as TIME reported. Patients were randomly assigned to receive either non-opioid pain medications (a combination of ibuprofen and acetaminophen) or one of three variations of opioid-based pain drugs. After two hours, the doctors asked the people to rate their pain on an 11-point scale and compared their responses.

A comparison of the responses revealed hardly any difference in pain ratings between the two groups.

Chang, stressing that the study focused only on “severe acute extremity pain,” said the research findings could be expanded to treat other types of pain and further reduce opioid prescriptions.

BCC Research, in its March 2018 report Non-opioid Pain Treatment: Global Markets to 2022 estimates the global market for non-opioid pain treatment to reach $9.9 billion and $22.6 billion by 2022, indicating a compound annual growth rate (CAGR) of 18.0%.

To learn more about this fast-moving market, download the free report overview.