30 Jun 2023 • In a study of more than 340 patients suffering from low back or neck pain, a team of Australian researchers found there was no difference in pain severity after six weeks between those who received opioids versus a placebo sugar pill. Results of the OPAL study were published online June 28 in The Lancet.

• The OPAL trial recruited close to 350 participants from 157 primary care and emergency department sites. Participants with acute-meaning sudden and generally short-term-back or neck pain were randomly allocated to a six-week course of a commonly prescribed opioid or a placebo.
• Both groups also received standard care including advice to avoid bed rest and stay active. Participants were followed for 52 weeks.
• After 6 weeks, there was no significant difference in pain scores of patients who took opioids compared to those who took placebo.
• After 1 year, patients given the placebo had slightly lower pain scores.
• Also, patients using opioids were at greater risk of opioid misuse after 1 year.

The researchers say this is proof that treatment guidelines should be updated to advise against the use of opioids for this purpose. They add that according to current back and neck pain guidelines opioids can be considered as a last resort if all other pharmacological options have failed, however, this study is evidence that opioids should not be recommended at all.

Source: The Lancet | Read full story