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Treatment with opioids not superior to treatment with non-opioid medications – Study

A study published by the Journal of the American Medical Association finds that treatment with opioids was not superior to treatment with non-opioid medications in patients with chronic back pain, hip or knee osteoarthritis pain.

You can find the full study here: http://ow.ly/veOf30iO8ms

Comments

So how, exactly, would a small sampling of 5,000 people”s waste water provide any meaningful data when the information collected would be so abstruse and ambiguous? A better approach might be to probe the causes and sources of opioid addiction. How about studying alternative means of pain alleviation, and making opioids harder to obtain by imposing rules or limits on doctor prescriptions and pharmaceutical companies” advertising to doctors and patients? Not to mention providing psychological counseling for addicts? By the time the waste water testing evaluation is done, there will be many more addicts and overdoses added to the list before any remedial action can be established. There are other methods for dealing with opioid addiction that would be faster more effective.

It needs to be noted that this trial only involved 240 patients treated for chronic pain in US Department of Veteran Affairs. It has been widely and falsely misrepresented as proof that opioids are no more effective than non-opioid treatments for chronic pain, which is an entirely false statement. Millions of chronic pain patients have been effectively taking opioids, even extremely high-dose opioids for long-term pain control for hundreds of years simply because no other pain-relieving modality even compares with their efficacy. To suggest so is simply ludicrous.

Additionally, the supplementary material from this study reveals that the mean dose of opioid was 21 MMED, and only 12.6% of patients randomized to the opioid group were taking over 50
MMED (which are both relatively minimal doses). Consequently, in lieu of falsely claiming that opioids are no more effective than non-opioid treatments for chronic pain, the results of this small trial should be more accurately construed as: 1) patients whose pain is insufficient to actually warrant opioid treatment do not particularly benefit from opioids., and/or 2) opioids are of no benefit to patients with moderate to severe chronic pain when opioid dosage is insufficient.

More succinctly, the “study” was obviously specifically structured in a manner that would best demonstrate the study’s preconceived blatantly false statement. Non-opioid pain medications are NOT anywhere near as effective as opioid pain medications when administered properly and in sufficient dosages. Additionally, many non-opioid pain medications are significantly more dangerous than opioid pain medications. Approximately the same number of people die every year from liver damage caused by non-opioid pain medications as do from legally prescribed opioid medications taken specifically as prescribed.

It needs to be noted that this trial only involved 240 patients treated for chronic pain in US Department of Veteran Affairs. It has been widely and falsely misrepresented as proof that opioids are no more effective than non-opioid treatments for chronic pain, which is an entirely false statement. Millions of chronic pain patients have been effectively taking opioids, even extremely high-dose opioids for long-term pain control for hundreds of years simply because no other pain-relieving modality even compares with their efficacy. To even suggest that non-opioid treatments are comparable opioid treatment is ludicrous.

Additionally, the supplementary material from this study reveals that the mean dose of opioid was 21 MMED, and only 12.6% of patients randomized to the opioid group were taking over 50
MMED (which are both relatively minimal doses). Consequently, in lieu of falsely claiming that opioids are no more effective than non-opioid treatments for chronic pain, the results of this small trial should be more accurately construed as: 1) patients whose pain is insufficient to actually warrant opioid treatment do not particularly benefit from opioids., and/or 2) opioids are of no benefit to patients with moderate to severe chronic pain when opioid dosage is insufficient.

More succinctly, the “study” was obviously specifically structured in a manner that would best demonstrate the study’s preconceived blatantly false statement. Non-opioid pain medications are NOT anywhere near as effective as opioid pain medications when administered properly and in sufficient dosages. Additionally, many non-opioid pain medications are significantly more dangerous than opioid pain medications. Approximately the same number of people die every year from liver damage caused by non-opioid pain medications as do from legally prescribed opioid medications taken specifically as prescribed.

Michael McAulay

Take a look at the limitations section of the study. It specifically states the results do not apply to long term opioid treatment patients.

There is an essential reason for this. Studies like this find it “challenging” to get long term opioid patients to stay in the studies because when given a placebo, they are in intense pain. So they drop out. This is a serious issue in clinical trials regarding chronic pain and opioid therapy.

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