Surprisingly new study says opioids aren't any better for pain than over the counter meds

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Surprisingly new study says opioids aren't any better for pain than over the counter meds

canadiana
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This post was updated on .
chronic pain than over-the-counter drugs: study
Drugs
Hydrocodone pills, also known as Vicodin, are arranged for a photo at a pharmacy in Montpelier, Vt. on Tuesday, Feb. 19, 2013. (AP Photo/Toby Talbot)
       
Lindsey Tanner, The Associated Press
Published Tuesday, March 6, 2018 2:37PM EST
  CHICAGO -- A yearlong study offers rigorous new evidence against using prescription opioids for chronic pain.
In patients with stubborn back aches or hip or knee arthritis, opioids worked no better than over-the-counter drugs or other nonopioids at reducing problems with walking or sleeping. And they provided slightly less pain relief,
  Opioids tested included generic Vicodin, oxycodone or fentanyl patches although few patients needed the most potent opioids. Non-opioids included generic Tylenol, ibuprofen and prescription pills for nerve or muscle pain. The study randomly assigned patients to take opioids or other painkillers. That's the gold standard design for research.

  If they don't work better than less risky drugs, there's no reason to use opioids given "their really nasty side effects -- death and addiction," said lead author Dr. Erin Krebs, a physician and researcher with the Minneapolis Veterans Affairs Health Care System.
  The results likely will surprise many people "because opioids have this reputation as being really powerful painkillers, and that is not what we found," Krebs said.

  The results echo less rigorous studies and bolster guidelines against routine use of opioids for chronic pain.
  The study was published Tuesday in the Journal of the American Medical Association.
About 42,000 drug overdose deaths in the U.S. in 2016 involved opioids, including prescription painkillers, heroin and fentanyl. Many people get hooked while taking opioids prescribed for injuries or other short-term pain and move on to cheaper, more accessible illicit drugs like heroin.
  Krebs said the strongest evidence from other studies shows that physical therapy, exercise or rehabilitation therapy works best for chronic pain. And she said noted that there are a variety of nonopioid drugs to try if one type doesn't work.
  U.S. government guidelines in 2016 said opioids are not the preferred treatment for chronic pain, and they recommend non-drug treatment or nonopioid painkillers instead. Opioids should only be used if other methods don't work for chronic pain, the guidelines recommend. Prescribing rates have declined slightly in recent years although they are still much higher than two decades ago.
  The study involved 234 patients from Minneapolis-area VA clinics who were assigned to use generic versions of opioids or nonopioids for a year. Follow-up ended in 2016.
  "This is a very important study," said Dr. David Reuben, geriatrics chief at UCLA's medical school. "It will likely change the approach to managing long-term back, hip and knee pain."
  He noted one limitation -- most study participants were men, but Krebs said the results in women studied were similar.
  The study's opioid patients started on relatively low daily doses of morphine, oxycodone or generic Vicodin.    
  They switched to higher doses if needed or to long-acting opioids or fentanyl patches. The nonopioid group started on acetaminophen, ibuprofen or similar anti-inflammatory drugs. They also could switch to higher doses or prescription nonopioid pain pills. Few in either group used the strongest medicines.
  Patients reported changes in function or pain on questionnaires. Function scores improved in each group by about two points on an 11-point scale, where higher scores meant worse function. Both groups started out with average pain and function scores of about 5.5 points.
  Pain intensity dropped about two points in the nonopioid group and slightly less in the opioid patients.
  Other research has shown that over-the-counter medicines can also work as well as opioids at treating short-term pain, including from broken bones, kidney stones or dental work.
       

PS:I have had 2 friends who used to be on morphine that say pot actually works better for their back pain!On the other hand I had a sister that died 11 years ago from chronic use of  Tylenol for back pain over 20 years that destroyed her liver!(acetemeniphren is the active ingredient is only supposed to be used no more than 10 days straight and a deadly mix with alcohol for destroying your liver)....."canadiana
       
https://www.ctvnews.ca/health/opioids-no-better-for-chronic-pain-than-over-the-counter-drugs-study-1.3831289
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Re: Surprisingly new study says opioids aren't any better for pain than over the counter meds

Chivis
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This is such bullshit I don't know where to begin.  I have studied opioids for the last six months and am writing a post.  Opioids is a life saver for chronic pain illnesses.  People with chronic pain need to be under the care of a pain specialist.  They assure medication is not abused, and use other pain relief methods to assist with pain.  such as epidurals, acupuncture, nerve medications such as Lyrica and many more.  They require urine analysis once or twice a month, and register the patient with RX data from all pharmacies, a patient signs a contract not to get RX from anyone but the pain specialist, and the urine tests measures amount of drg and determines if patient is using other types of drugs incl street drugs.

numbers are manipulated for RX OD's.  they say 60k per year, but that incld street drugs like heroin.  fact is that only 2% of all pain med rx patients abuse drugs, including alcohol.

yep...2 percent.

a year long study with a couple of hundred patients is no study.  and the UCLA guy is a geriatric [folks over 65 doctor not a pain specialist.  just another excuse to keep meds after from legit users who are able to function with medication.

this is a VERY dangerous report. but should be pointed out.

tylenol is on percocet and other pain meds.  more caution should be given to patients about its danger as well.  
 
The way I see it.... the more people that don't like me, the less people I have to please
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Re: Surprisingly new study says opioids aren't any better for pain than over the counter meds

leChef
In reply to this post by canadiana
234 patients would give a margin error of about 7% on the study. That is a bit high for a relevant study. I wonder why they didn't make it a larger case. There must be ample pain patients out there.

I am not saying anything against the result, but generally I think there is always a unspoken reason why people go public about something, and when talking healthcare industry, that is the norm. I wonder who paid for the study.

Sorry about your sister, Canadiana!
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Re: Surprisingly new study says opioids aren't any better for pain than over the counter meds

canadiana
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This post was updated on .
In reply to this post by Chivis
I agree,it's not really a relevant study.As a  person who's worked in data collection for 2o years it's an extremely small sample.Most samples are in the thousands or even 10's of thousands.Must have just been an inhouse study.That's what they are prescribing people nowadays instead of morphine (at least here)it's Tylenol 3 with codeine or a pot prescription  without the stomach problems of opioids.The 2 people I know that were cut off opioids and they were in chronic pain was my room mate (and he's in pain about 85% of the time)and my neighbour who both said pot works better than morphine for their pain which I was surprised at then came across this article.They did tell me however that opioids don't get rid of 100% of the pain just take the edge off.I have an acquaintance I know that's terminal with cancer and hydro morphine is not strong enough to kill the pain anymore or even take the edge off  but she is a person that has abused opioids all her life so maybe has no tolerance when she really needs it but maybe it's time for the drip in the arm or hospice time where she can be monitored by a pro.I have heard through the grapevine (although I don't know how true it is)that terminal people in hospitals get so much opioids that in the end it's the opioids they die from shutting their organs down rather than the disease because it's so hard to kill the pain and at that point it doesn't really matter they are better off nodding out so they are not conscious and feeling pain.
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Re: Surprisingly new study says opioids aren't any better for pain than over the counter meds

ElGrandeRojo
As a person with chronic back, knee and shoulder pain, I call bs. Nothing eases pain like opiates. Tylenol, Ibuprofen, aspirin, all are far worse on your body than opiates in prolonged use. Tylenol will destroy your liver very quickly, especially if you drink alcohol, Ibuprofen will burn holes in your stomach if used at prescription dosage over long periods, and even aspirin is fucking up people's organs who use it daily for heart issues. If you don't abuse your pain meds, no issues. But the same people that get aadicted to opiates are/we're addicted to other stuff too. Addicts are born, not made.