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Opioids (Like, Hydrocodone and Morphine) Are Less Effective Than Less Dangerous and Less Addictive Medications like Advil and Tylenol for Treatment of Chronic Pain


Most patients and physicians have always assumed that prescription opioids like hydrocodone or morphine are more effective in treating chronic musculoskeletal pain (low back, knee, or hip pain) than medications like over-the-counter Advil or Tylenol.  Now an extensive 4-year study comparing the two classes of pain medications indicates that the opposite is in fact true.


The SPACE TRIAL, which was just published in the Journal of the American Medical Association (JAMA) shows that:


“It’s not just that opioids were not better — they were a little bit worse”

concludes Dr. Krebs who is the lead author on the first randomized trial, comparing chronic pain patients on prescription opioids (like morphine, hydrocodone, and oxycodone) to patients on non-opioid painkillers (like acetaminophen or Tylenol, naproxen, or meloxicam), measuring their pain intensity and function over the course of a year.

The study was done by assigning half of the patients to opioids and the other half to opioid alternatives and followed them up for a year. As a first step, the opioid group got morphine, oxycodone, or hydrocodone/acetaminophen first, and the non-opioid group tried acetaminophen (i.e., Tylenol) or a nonsteroidal anti-inflammatory drug (i.e., Advil). If these prescriptions didn’t work, the doctors adjusted the patients’ medications, trying other drugs from a pre-set list.

Before the study and at three-month intervals over the course of a year, the patients scored their pain according to two main outcomes: functionality (or how easily they were able to go about their daily lives) and intensity.

At the start of the study, the opioid and non-opioid groups scored almost exactly the same on both measures. By 12 months, the groups looked indistinguishable once again on their functionality scores — they had both improved a little.

But when it came to pain intensity, the opioid group actually reported being in a little more pain than the non-opioid group at one year. What’s more, the opioid group experienced twice the number of side effects — most commonly, drowsiness, grogginess, nausea, difficulty focusing, constipation, and stomach upset.


Prescription Opioid Abuse is a huge national health problem:

According to the Centers for Disease Control and Prevention (The CDC):

Every day, more than 115 Americans die from overdosing on opioids.  The misuse of and addiction to opioids—including prescription pain relieversheroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare. The Centers for Disease Control and Prevention estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78.5 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.

This problem is progressively getting worse.  In the United States deaths from Opioid Overdose have increased by 7%, 14%, 16%, and 28% over the last four years.


What Can You Do About This Problem:

1) Ask your Doctor to consider less dangerous, less addictive alternative drugs, such as Advil and Tylenol instead of Prescription Opioids.

2) Consider  with your doctor non-drug alternatives to the treatment of chronic pain like physical therapy, Tai Chi, Yoga, Pilates, Massage, Exercise, Mindfulness, acupuncture, or Chiropractic Medicine.

3) If you both do wish to use prescription opioids then attempt to use the lowest effective dose for the shortest duration.

4) Visit the Resolve Montana website to find out what else you can do to end prescription drug abuse.

5) Read the Article: How Do I Know If I am Addicted to Prescription Pain Medications.

6) Educate your Family and Friends about the dangers of Prescription Pain Medications, (Opioids).



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