Pharmacy Daily | Opioids not effective for acute pain

OPIOID pain relievers prescribed for acute pain provide only small, short-term relief for some acute conditions and are ineffective for some others, according to the world's largest review of the medicines.

The study team, led by researchers from the University of Sydney, set out to investigate the efficacy and harms of opioid pain relievers - such as codeine, morphine, oxycodone and tramadol - compared with placebo for acute pain.

They looked at 59 systematic reviews covering more than 50 acute pain conditions in children and adults.

"Opioids are among the most commonly prescribed treatments for acute pain, however, our review found that they did not provide large or lasting pain relief compared with placebo for the vast majority of acute pain conditions, with pain relief typically lasting only a few hours," said lead author Associate Professor Christina Abdel Shaheed, from the School of Public Health at the University of Sydney.

The team found that overall, oral opioids were only slightly better than placebo for acute musculoskeletal pain, in the six to 48 hours after starting treatment, but were linked with increased risk of side effects when used for acute musculoskeletal pain, some types of post-surgical pain or traumatic limb pain.

"By showing that the benefits are generally small, short-lived, absent for many common conditions, and sometimes harmful, our research challenges the widely held belief that opioids are the most effective 'go-to' option for acute pain," Associate Professor Shaheed said.

The findings also raised concerns about side effects, especially dependence and tolerance with regular use.

"Persistent use of opioid medicines can develop quickly following first time use - sometimes within days - and may arise from regular use for acute pain," said co-first author Dr Stephanie Mathieson from School of Pharmacy.

Read the paper HERE. KB