pain pill study Archives - Minnesota Physical Medicine Blog

It may sound counterintuitive, but new research suggests that reducing long-term opioid intake could actually lead to lower pain levels in patients with chronic pain.

More than 10 million Americans are currently prescribed a long-term opioid to deal with a chronic pain condition. The number of people who get these prescriptions continues to grow, and not surprisingly so too do opioid overdose deaths. Used correctly, opioids can work wonders for individuals who have been struggling to find a way to take control of their chronic pain, but far too often they are overprescribed and knowingly or unknowingly abused.

Long-term opioids should only continue to be used if you’re still seeking active treatment options to address the painful condition. Since opioids are a passive treatment option, they are only masking the pain, and they aren’t actively working to correct the problem. They can work wonders when paired with active solutions like physical therapy or exercise because it can lessen pain during these crucial strengthening times, but if you’re not actively working towards a solution, long-term opioids are just dulling the pain while your body begins to crave larger doses of the drug to be effective, which can lead patients down the path of addiction.

Reducing Long-Term Opioid Intake

Researchers conducted a systematic review of 67 published studies in order to determine the effects of discontinuing long-term opioid therapy for patients with chronic pain conditions. Although they admit that the overall quality of evidence was not superb, they found an association between long-term opioid dose reduction and improvements in pain, function and quality of life.

“It’s counterintuitive that pain and well-being could be improved when you decrease pain medication…but patients felt better when dosages were reduced,” said Dr. Erin Krebs, medical director of the Women Veterans Comprehensive Health Center, part of the Minneapolis Veterans Affairs Health Care System, and an author of the study.

However, study authors echoed what we’ve been saying in this blog, that long-term opioid reduction shouldn’t be done by itself. It should be reduced with the oversight of a licensed physician and paired with other multidisciplinary approaches and behavioral interventions to continue actively pursuing pain reduction and function improvement. Hopefully future studies can take a closer look at this idea and provide some clearer solutions with stronger evidence so we can continue doing everything in our power to help patients fight back against their chronic pain conditions.

A recent study on rats has brought to light another problem with using opioids for pain treatment. In the study, rats had an experimental trauma to the sciatic nerve causing leg and foot pain.

One group was given opioids to control pain while recovering from the injury, while the control group was not given any medicine and allowed to heal on their own. The opioid treatment group took at least 16 weeks to heal, while the other group healed in eight weeks, and the control group actually reported more complete healing. The opioid group showed signs of prolonged inflammation throughout the treatment period. The untreated group did not have signs of ongoing inflammation. Now as a reminder, this study was in rats, not in humans.

The significance of the above study is that the use of opioids in humans does have many negative effects. We know that these medications cause problems from cognition to constipation, depression, and many other medical issues. The current leading concern is addiction. Now if the above research holds true in humans, or has even a partial effect in humans, using opioids for pain may be inhibiting recovery from injury and prolonging pain and inflammation.

Having The Reverse Effect

The goal of most physicians when treating pain is to promote recovery from difficulties that may be causing damage to the body. Pain physicians promote multiple strategies to treat painful conditions. Medications are one strategy. More effective treatments often involve physical therapy in order to promote healing and more natural restoration of function. It takes strength and endurance to function normally. Return to normal function after injury takes a lot of work, there is not a magical pill to reverse pain.

As time goes on, the more we learn about medications, the more we realize that every substance that we put in our bodies has the potential to create more problems. Most medications prescribed by physicians are relatively safe, but they can all cause problems. If we want to do the best thing for our bodies, we need to often go back to the basics. The body needs the right exercise, food, nutrition, and rest. Treat the body right and it will not be angry and painful. Doctors can only help a person so much, the rest is up to the patient to take care of themselves.