More opioids doesn’t mean less chronic pain: study

Boosting doses of opioid pain medicines doesn’t appear to benefit patients with chronic pain, researchers report.

“What we found was that the pain relief the provider and the patient are going for really isn’t there when they increase their doses,” said study author Corey Hayes, an assistant professor at the University of Arkansas College of Medicine.

“You don’t see the benefit, but you do see the risk. Our overall message is, when you’re thinking about increasing the dose, you need to realize the risk it brings, too,” Hayes said in a Veterans Affairs news release.

The researchers analyzed the medical records of more than 50,000 chronic pain patients in the VA health system who were prescribed opioids between 2008 and 2015. Their conditions included arthritis, back pain, neck pain, nerve pain and headache/migraine.

During the study period, nearly 21,000 patients had their opioid dose upped—defined as a more than 20% increase in average daily dose. These patients were compared with more than 32,000 patients who continued to take the same opioid dose over the study period.

The researchers found that patients who had their opioid dose increased didn’t have meaningful improvements in pain management, compared with those who continued to take the same dose.

The findings show that “clinicians should exercise extreme caution when embarking on a path of increasing opioid doses to manage non-cancer pain,” the authors wrote.

The findings were recently published in the journal Pain.

A study by the same group of researchers that was recently published online in the journal Addiction confirmed that higher doses of opioids raise the risk of certain side effects. These include constipation, dizziness, greater sensitivity to pain, and increased risk of substance use disorder.