Study Finds Opioids Are No Better than Placebo for Back Pain

Generally speaking, opioids are known for their effective pain relief. But they are also known for their high risk for misuse. Opioids are very potent pain-relieving medications that can reduce the perception of pain. However, in doing so, they tend to make the person feel euphoric and relieved. This is what causes them to develop an addiction.

Opioids are commonly prescribed for acute pain, such as after surgery or injury, or for severe pain like spinal pain or pain associated with conditions like cancer. They can be highly effective in providing relief from intense pain and improving the quality of life for individuals suffering from chronic pain conditions. But if they are misused, they can also cause a wide range of adverse effects like tolerance, dependence, addiction, withdrawal, side effects, and overdose.

Opioid use can be dangerous as it can depress the respiratory system, and taking too much can lead to fatal respiratory depression. The long-term use of opioids can have adverse effects on cognition, hormonal systems, and immune function.

Due to these risks, healthcare professionals often try to limit the use of opioids to short-term or acute pain management and consider alternative pain relief options for chronic pain, such as physical therapy, non-opioid medications, nerve blocks, and other interventions.

As for back pain, a new study suggests that taking opioids is not worth it.

Researchers in Australia have found that opioids do not mitigate pain any better than a placebo, particularly for people in their mid-40s with low back pain. In fact, those in the placebo group experienced slightly lower pain scores than those who were given opioids to manage their pain.

The study, led by researchers at the University of Sydney, had around 350 participants, 51 percent of which were male while 49 percent were female. 44 was their median age. The researchers’ findings were shared by medical journal The Lancet.

The participants, who were chosen through emergency department sites and primary care clinics, were randomly assigned to treat their low back pain or neck pain with either an opioid or a placebo.

Researchers found that the participants felt no difference in reported pain levels after the six-week treatment period. The placebo group had slightly lower pain scores at 2.25, but scientists noted that the disparity was not significant statistically. The opioid group had a pain intensity of 2.75.

The study also trended in favor of the placebo group in terms of physical functioning and quality of life, which were also considered in the study. Again, the difference was not considered significant.

During the study, both groups were allowed to receive additional non-opioid treatments. However, only 58% of them actually adhered to taking the placebo or opiate. Those who did not provide enough follow-up results were excluded from the analysis.

According to Professor Andrew McLachlan, dean of the Sydney Pharmacy School and one of the study’s co-authors, other treatments should become the focus going forward since opioids are no longer recommended for conditions like back pain.

“Managing low back pain requires careful assessment to check for serious causes and reassurance that most people will recover if they can stay active. Treatments such as the application of heat and also anti-inflammatory medicines may be help[ful] in people who can take these medicines,” he said.

However, McLachlan also advised those who are currently taking opioids for pain management to consult with their doctor before stopping their prescription. In most cases, quitting opioids requires a gradual lowering of the dosage so as to avoid harmful withdrawal effects.

As we previously established, opioids can be dangerous when misused. Unfortunately, even those who are only taking opioids as a prescription are exposed to these same risks. Here we will talk about these risks.

One of the most dangerous potential effects of opioid misuse is opioid addiction. Also known as opioid use disorder (OUD), it is a chronic and compulsive disorder characterized by the persistent use of opioids even when the person is already experiencing its harmful effects. People with opioid addiction may find it challenging to control their use, despite the negative consequences on their health, relationships, and work.

An addicted individual will start focusing more on obtaining and using opioids than fulfilling their daily responsibilities and obligations. Their drug of choice will become their main priority.

Other people who struggle with addiction either change their social circle or begin withdrawing from family and friends, often due to shame or fear of being judged. They may engage in dangerous or risky behaviors to obtain opioids such as doctor shopping or stealing.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines criteria for diagnosing opioid use disorder, including factors such as:

1. Taking opioids in larger amounts or for a longer period than intended.
2. Persistent desire or unsuccessful efforts to cut down or control opioid use.
3. Spending a significant amount of time obtaining, using, or recovering from the effects of opioids.
4. Cravings or a strong desire to use opioids.
5. Continued opioid use despite persistent or recurring social or interpersonal problems caused or exacerbated by the substance.
6. Giving up or reducing important social, occupational, or recreational activities because of opioid use.
7. Recurrent opioid use in situations where it is physically hazardous.
8. Continued opioid use despite knowing that it is causing or worsening a physical or psychological problem.
9. Tolerance, as defined by needing more opioids to achieve the same effects or experiencing reduced effects with the same amount of opioids.
10. Withdrawal symptoms when opioid use is reduced or stopped.

Examples of opioids include prescription pain medications like oxycodone, hydrocodone, and morphine, as well as illicit drugs like heroin.

What makes opioids so addictive is the sense of euphoria and relaxation that it produces along with its pain relieving effects. This can easily lead to their misuse. Over time, individuals who use opioids can develop a tolerance, requiring higher doses just to achieve the same euphoric or pain-relieving effects.

Tolerance can easily lead to dependence, where the body becomes reliant on opioids to function normally. Drug dependence develops when the body is constantly exposed to a particular substance to the point where it adjusts to its presence. If the person stops taking the drug—in this case opioids—they will experience intense cravings and uncomfortable withdrawal symptoms.

Withdrawal symptoms can vary in intensity and duration depending on the individual’s opioid use history and the specific drug they were using. Some common opioid withdrawal symptoms include: anxiety, insomnia, muscle aches and pains, excessive sweating, runny nose, teary eyes, frequent yawning, dilated pupils, diarrhea, abdominal cramping, fatigue, irritability, depression, rapid heartbeat, high blood pressure, nausea, and vomiting.

These symptoms can start within a few hours to a couple of days after the last opioid dose and may last for several days to a week or longer.

The severity of withdrawal symptoms can be influenced by factors such as the duration and amount of opioid use, the specific opioid drug used, and individual variations in physiology and metabolism. Everyone experiences addiction, dependence, and withdrawal differently. In any case, it can be an extremely uncomfortable experience with the potential to escalate into something dangerous.

Opioid addiction is a significant public health concern as it can lead to serious health issues, including overdose and death.

Seeking treatment for opioid addiction is essential, and treatment approaches may include medication-assisted treatment (MAT), counseling, support groups, and behavioral therapies. It is crucial to recognize the signs of opioid addiction early and encourage individuals struggling with opioid use to seek professional help to begin their journey to recovery.

Another potentially life-threatening effect of opioid misuse and abuse is an opioid overdose, which can occur when a person takes an excessive amount of opioids.

When opioids are taken in higher doses than the body can tolerate, it can lead to serious health complications. An overdose can depress the central nervous system, causing the person’s breathing rate and heart rate to slow down significantly. This can lead to a lack of oxygen in the body, which, if left untreated, can result in brain damage or death.

Therefore, it is important to look out for the signs and symptoms of an opioid overdose. Here’s what you need to look out for:

1. Slow or shallow breathing
2. Extreme drowsiness or difficulty staying awake
3. Unresponsiveness or inability to wake up
4. Bluish or pale skin, particularly around the lips or fingertips
5. Pinpoint pupils (very constricted pupils)
6. Slow or weak pulse
7. In severe cases, seizures or convulsions

If you suspect someone is experiencing an opioid overdose, seek emergency medical attention immediately. Opioid overdoses can be treated with a drug called naloxone (Narcan), which can rapidly reverse the effects of opioids and restore normal breathing.

Naloxone is usually available as an injectable medication or nasal spray and can be administered by trained bystanders or emergency responders.

Preventing opioid overdose involves responsible prescribing practices by healthcare professionals, proper use and disposal of opioid medications, and increasing awareness about the risks of opioid misuse. Additionally, helping those who are struggling with opioid addiction gain access to proper treatment and support can reduce the likelihood of deadly overdose incidents.

Before you try out any new alternative treatments for your back pain or neck pain, make sure you consult with a qualified healthcare provider. This is especially important for those who have a pre-existing condition and those who are unsure about the exact causes of their pain.

There are plenty of alternative treatment options out there, and you may have to explore some of these options before finding one that’s right for you and your condition.

For example, physical therapy is a popular pain treatment. During physical therapy, a trained physical therapist can design a personalized exercise and stretching program that will improve your mobility, strength, and posture, which may alleviate pain and prevent future issues.

Other people go for chiropractic care. Chiropractors use spinal adjustments and manipulations to realign the spine, potentially reducing pain and improving function.

Other treatments for back and neck pain include acupuncture, massage therapy, yoga, Pilates, heat and cold therapy, meditation, progressive muscle relaxation, and even herbal remedies.

Keep in mind that these alternative treatments may not work for everyone, and their effectiveness can vary depending on the individual and their specific condition.

Additionally, if you experience severe or persistent pain, numbness, or weakness, seek immediate medical attention, as it may indicate a more serious underlying condition.

If your pain co-occurs with a substance use disorder, you may require care in a rehab facility where they can provide proper addiction treatment. Look for a rehab near you today and learn more about the addiction treatment process. You don’t need to rely on opioids to manage your pain. Don’t let it become an addiction. Get started on the road to recovery today.

Treatment is an addicted individualʼs best option if they want to recover. Beating an addiction not only requires eliminating the physical dependence, but also addressing the behavioral factors that prevent them from wanting to get better. Simply quitting may not change the psychological aspect of addiction. Some people quit for a while, and then take drugs or alcohol again, only to overdose because they did not detox properly. Recovery involves changing the way the patient feels, thinks, and behaves.