Opioids Don’t Relieve Chronic Pain Any Better Than Non-Opioids

[rangerrebew]

Opioids Don’t Relieve Chronic Pain Any Better Than Non-Opioids

 

It may be time to rethink prescribing opioids for chronic pain.

Opioid pain relievers demonstrated no advantages over non-opioid medications for treating chronic back and arthritis pain over a one-year period, but they did lead to more side effects, concludes a study published today in the Journal of the American Medical Association (JAMA).

“We already knew opioids were more dangerous than other treatment options because they put people at risk for accidental death and addiction. This study shows that extra risk doesn’t come with any extra benefit,” Dr. Erin Krebs, lead study author and women’s health medical director at the Minneapolis VA Health Care System, told Healthline.

https://www.healthline.com/health-news/opioids-dont-relieve-chronic-pain-better-than-non-opioids

[aligncare]

Yeah, but they make you feel soooo good you don’t mind the pain.

[Restored]

The druggies will lose their minds if you threaten their dope. I have an aunt with dementia and she can't figure out where she is half the time but she knows how many pills she has.

[driftdiver]

I can say from personal experience they do work better.

[Frank Cannon]

A VA doctor is telling me this? I'll pass on that.

[Applewood]

I don't know about chronic pain, but for temporary pain from a broken ankle and such -- all it did for me was make me not care about the pain...or anything else for that matter.  People would say something to me and I'd reply, "what?  Huh?"  I was awake but out of it.  Not the effect I was looking for.  Last time I had a scrip for a combination of Oxy and Tylenol.  Took it for 2 days before I quit and just took OTC Tylenol.   Pain relief without feeling any more spacey than I already am.

[the_doc]

The title is misleading.  Back pain and arthritic pain are subsets of chronic pain.  I agree that opioids are overprescribed, but there are a lot of bad pains that respond NOT AT ALL to NSAIDs and Tylenol.

[Cyber Liberty]

The title is misleading.  Back pain and arthritic pain are subsets of chronic pain.  I agree that opioids are overprescribed, but there are a lot of bad pains that respond NOT AT ALL to NSAIDs and Tylenol.

Yeah, whoever wrote this never had a major orthopedic surgery like a hip replacement or a broken leg.  Like Hell is an NSAID better than Hydrocodone, at least for the first several weeks.  Tylenol is the most worthless drug on the market to me, it works as well as chalk for the pain, and it's rough as all get-out on the liver.

There was a point I noticed the NSAIDS were more effective after hip surgery, and that was because the pain wasn't from a broken bone but from inflammation.  I liked Naproxin.

[GtHawk]

Yeah, but they make you feel soooo good you don’t mind the pain.

Really? Is that your personal experience? Because I have decades history of prescribed Opioids for pain relief and other than when I received an injection of a really potent pain med, I never experienced what you stated. And as far as the article, when I experience serious pain OTC doesn't do jack, to put it politely.

[Cyber Liberty]

Really? Is that your personal experience? Because I have decades history of prescribed Opioids for pain relief and other than when I received an injection of a really potent pain med, I never experienced what you stated. And as far as the article, when I experience serious pain OTC doesn't do jack, to put it politely.

Tylenol is the most worthless "drug" I've ever seen.  Why the Hell they use it to buffer Opioids is beyond me, it does more damage to the liver than the Opioids.  That stuff is as effective as chalk for killing pain.

[the_doc]

Tylenol is the most worthless "drug" I've ever seen.  Why the Hell they use it to buffer Opioids is beyond me, it does more damage to the liver than the Opioids.  That stuff is as effective as chalk for killing pain.

Yeah, Tylenol can be pretty hard on the liver.  However, studies have shown that it potentiates the narcotic to a measurable degree. 

As a stand-alone pain med, Tylenol doesn't work as well for inflammatory pain as NSAIDs do (because Tylenol has no anti-inflammatory properties whatsoever).

[sneakypete]

Duhhhhhh! Who ever made the claim they do?  Their purpose is to temporarily reduce the pain down to a bearable level so surgery can be performed,and for that,they definitely do the job.

Ask anybody who has ever had kidney stones if they would take narcotics to ease the level of pain if given the chance. If there is anything that hurts more than kidney stones,I don't even want to know about it.

[Applewood]

Tylenol is the most worthless "drug" I've ever seen.  Why the Hell they use it to buffer Opioids is beyond me, it does more damage to the liver than the Opioids.  That stuff is as effective as chalk for killing pain.

NSAIDS would be better.  However, some of us can't take them.  People with chronic kidney disease like yours truly are warned not to take them. 

Aspirin upsets the tummy.  I take a low dose aspirin for the heart, but that's as much as I can stand.

My doctor told me so long as I don't overuse Tylenol, my liver will be fine.  I think taking more than the recommended dose at intervals shorter than what the package says is where people get into trouble. 

[sneakypete]

Yeah, but they make you feel soooo good you don’t mind the pain.

@aligncare

I know you are joking,but for those who don't know better,opioids work less well the longer you take them. They are nothing more than a temporary solution to managing pain. Because of this you should NEVER take them until and unless you are in pain on a level that is unbearable. Even then you only take the minimum amount for the minimum amount of time. Their pain-relieving qualities is a Golden Goose you really don't want to cook.

Besides,up to a point,pain is your friend. It is your bodies way of telling you there is a problem that needs your immediate attention,and to be careful to not do anything that might make it worse. You should listen to this,not ignore it.

[mystery-ak]

Tylenol is the most worthless "drug" I've ever seen.  Why the Hell they use it to buffer Opioids is beyond me, it does more damage to the liver than the Opioids.  That stuff is as effective as chalk for killing pain.

ditto...Tylenol has never worked for me.

[sneakypete]

  Took it for 2 days before I quit and just took OTC Tylenol. 

@Applewood

Which is EXACTLY what you were supposed to do. Oxy and similar drugs are for PAIN MANAGEMENT. They don't "fix" anything. You just take them to keep the pain at a bearable level to give your body a chance to start healing. If you are still in major pain 3 or 4 days after an injury,you need to go see a doctor again.

IN FACT,the sooner you are able to stop taking any pain relief medicine,the better off you will be. Your body uses pain as a tool to tell you that you are injured and to avoid doing anything that would or could make the injury worse. If you continue to keep yourself bombed into oblivion for more than a couple of days after the initial injury,you are likely to forget you are injured,and do something stupid that will make the injury even more serious. Listen to the message your body sends you.

[sneakypete]

Really? Is that your personal experience? Because I have decades history of prescribed Opioids for pain relief and other than when I received an injection of a really potent pain med, I never experienced what you stated. And as far as the article, when I experience serious pain OTC doesn't do jack, to put it politely.

@GtHawk

I know/hope you are aware that long-term use of opioids weakens the heart. Yeah,if the pain is unbearable,you have no choice but to take them,but there is a price to be paid down the road.

I had a friend that probably died 10-15 years too early after getting one of his legs traumatically amputated by a AK round on Hickory Hill near DaNang. He not only had "ghost pains" from his missing leg,but the artificial legs people had to use back then weren't no where near as comfortable or work as well as the high-tech ones of today,and his stub was always sore and hurting. Truth to tell,he had taken narcotics for the pain for so long I seriously doubt they even worked anymore. He probably had to keep taking it just to keep from getting sick.

But in his case it was a trade-off. He had to take them to make live worth living,so he had an additional 25-30 years of life he might not have had without the drugs.

[Applewood]

Duhhhhhh! Who ever made the claim they do?  Their purpose is to temporarily reduce the pain down to a bearable level so surgery can be performed,and for that,they definitely do the job.

Ask anybody who has ever had kidney stones if they would take narcotics to ease the level of pain if given the chance. If there is anything that hurts more than kidney stones,I don't even want to know about it.

I believe childbirth might be as painful or more so.  But I get what you're saying.

[GtHawk]

@GtHawk

I know/hope you are aware that long-term use of opioids weakens the heart. Yeah,if the pain is unbearable,you have no choice but to take them,but there is a price to be paid down the road.

I had a friend that probably died 10-15 years too early after getting one of his legs traumatically amputated by a AK round on Hickory Hill near DaNang. He not only had "ghost pains" from his missing leg,but the artificial legs people had to use back then weren't no where near as comfortable or work as well as the high-tech ones of today,and his stub was always sore and hurting. Truth to tell,he had taken narcotics for the pain for so long I seriously doubt they even worked anymore. He probably had to keep taking it just to keep from getting sick.

But in his case it was a trade-off. He had to take them to make live worth living,so he had an additional 25-30 years of life he might not have had without the drugs.

@sneakypete
Yes, thank you I am and have been quite aware of the risks, fortunately I was not a daily user, only when the pain was intolerable. And even now with the pablum they prescribe me, Tramadol, I put it off as long as possible.

[sneakypete]

I believe childbirth might be as painful or more so.  But I get what you're saying.

@Applewood

I have been told that childbirth and kidney stones are pretty close,but that is a contest with no winner in any sense of the word. I like to think I have a high tolerance for pain,but both times I had kidney stones they had me wanting my mama to make it go away.

[Restored]

Ask anybody who has ever had kidney stones if they would take narcotics to ease the level of pain if given the chance. If there is anything that hurts more than kidney stones,I don't even want to know about it.

Done both. Gout beats it.

[sneakypete]

Done both. Gout beats it.

@Restored

I just don't even know how that would be possible.

[the_doc]

@GtHawk

I know/hope you are aware that long-term use of opioids weakens the heart. Yeah,if the pain is unbearable,you have no choice but to take them,but there is a price to be paid down the road.

The worst thing by far about the opioids is the fact that they lower your pain threshold.  Over time, it requires more and more narcotics to mask any given pain.  This is sometimes called "drug tolerance," but it even more pernicious than most folks realize.  Withdrawal is excruciating.  Practically everything hurts--BAD.

Done both. Gout beats it.

I've had patients tell me that.

[sneakypete]

 

Practically everything hurts--BAD.

@the_doc

I'm not sure I understand what they were talking about,but I have heard people claim "You have to pay extra for the stuff that hurts good".

[the_doc]

@the_doc

I'm not sure I understand what they were talking about,but I have heard people claim "You have to pay extra for the stuff that hurts good".

LOL.