Opioids such as codeine not a good choice for chronic pain


If you’ve had chronic back pain or other long term pain in the past 30 years of so, chances are you were prescribed or taken over the counter opioid medication such as codeine to treat the pain. Now a study has found that you were not only putting yourself at risk of addiction and possibly overdose, it’s likely you could have been using other, more effective and safer medications.

According to a US medical publication called The Back Letter, the long-term study compared opioids with non-opioid medications as a reliever for chronic pain. The study found that opioids provided no better pain relief than non-opioid medications, which are much safer to use.

“Opioids are perceived as strong pain relievers, but our data showed no benefits of opioid therapy over non-opioid medication therapy for pain,” said study leader Erin Krebs from the Minneapolis VA Health Care System. In fact, at the 12-month follow-up, patients taking opioids in the study reported more pain than those who were taking non-opioid medication.

According to The Back Letter, the study supports a recent recommendation by the American College of Physicians that opioids should only be used for patients with low back pain as a last resort.

The concern over opioid use isn’t just one of whether or not it’s an effective pain-reliever. Worldwide, more and more people are dying due to opioids, including legal (e.g. oxycodone) and illegal drugs (e.g. heroin). In the US alone, at least 91 people die every day from an opioid overdose. A Time Health report claims that a recent study has highlighted that this number may actually be higher, with opioid-related deaths underreported.

Australia took a small, but important step of reducing opioid medication and its access, by banning codeine, an opioid drug, from being sold over the counter from 1 February 2018.

At the time of the decision, the Therapeutic Goods Administration (TGA) said the decision was made because of concern over people’s health and wellbeing, and the harm caused by overuse and abuse of the drug. It also took into consideration that there is little evidence that low-dose codeine medicines are any more effective for pain relief, coughs, colds and flus than similar medicines without codeine.

A consideration that has now been backed up by the long-term study.

As reported previously by Integrity Sampling, the over the counter ban of codeine from 1 February 2018 is good news for workplaces, because codeine use can be picked up during workplace drug testing. This is particularly the case if a user inadvertently or deliberately overuses the medication.

Once the change comes into affect, people who test positive for an opiate during workplace drug testing due to codeine will be able to more easily explain the result. And, of course, if required they’ll be able to provide evidence that they have been prescribed codeine medication.

See The Back Letter for more details on the long-term study mentioned in this post.

If you’ve got chronic back pain or other pain, don’t reach for opioids such as codeine, there are safer more effective options to use.

By Michael

Michael is the founder of Integrity Sampling and is responsible for overseeing all national operations. He is based at Integrity Sampling's head office in Melbourne and is also responsible for the co-ordination of drug and alcohol testing within Victoria, assisting in the implementation of drug and alcohol (fit for work) policies and the presentation of drug and alcohol education and awareness programs. You can connect with Michael Wheeldon on LinkedIn

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