Morphine, oxycodone, tramadol, these are well-known painkillers that are used for heavy work. But it turns out: they don’t work very well at all.
The largest evaluation to date has shown that these painkillers provide only limited, short-term relief in some acute conditions and are not effective at all in others.
Researchers from the University of Sydney compared the efficacy and harmful effects of opioid painkillers with a placebo. The review includes 59 reviews that studied more than 50 acute pain conditions in children and adults. The study provides the strongest and most comprehensive evidence to date on when opioids do and do not work for acute pain.
Just as good as placebo
“Opioids are among the most commonly prescribed drugs for acute pain. However, our review showed that in the vast majority of pain conditions they did not provide significant or long-lasting relief compared to a placebo, with pain relief typically lasting only a few hours,” said lead author Christina Abdel Shaheed from the University of Sydney.
“In general, the opioids were only slightly better than a placebo for acute muscle and joint pain, for which they are often prescribed, in the 6 to 48 hours after the start of treatment. Opioids also increased the risk of side effects, such as nausea and vomiting, joint pain, certain types of postoperative pain or traumatic limb pain,” it said.
“By showing that benefits are typically small and short-lived, lacking for common conditions, and can sometimes even be harmful, our study challenges the widely held belief that opioids are the most effective option for acute pain.”
Limited pain relief
In general, opioids provide only limited and short-term pain relief for some conditions, such as abdominal pain, dental procedures, ear treatments, traumatic extremity pain, postpartum pain, post-cesarean section pain, and pain after hallux valgus removal. Opioids were no more effective than a placebo for some limb surgeries, pain from kidney stones, pain after tonsil removal, and pain in neonates on ventilators.
Very short-term use of opioids can reduce pain in some acute conditions. However, regular use comes with risks, including dependence and tolerance and ultimately overdose and death. “Persistent use of opioid medicines can develop quickly after initial use, sometimes within days, and can arise from regular use for acute pain,” said researcher Stephanie Mathieson.
Better information
“It is important that patients are informed about the possible harmful effects of opioids and that doctors carefully prescribe these medicines, i.e. the lowest effective dose for the shortest possible period.”
Researcher Joshua Zadro added: “These findings are important for patients of all ages who experience acute pain, for physicians who treat these conditions and for policy makers who regulate the safe use of these medicines in society.”
We have written about this subject before, for example you can also read: The benefits of the painkiller tramadol probably do not outweigh the disadvantages and Everyone takes ibuprofen, but almost no one knows this about the popular painkiller. Or read this article: Well-known heavy painkillers do not work better than placebo: even a negative effect in the long term.
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