Neuropathic Pain: Opioids May Not Be Beneficial for Long-term Therapy

Canada-based researchers examined the effectiveness of opioids for the long-term management of chronic neuropathic pain and found less than encouraging results, according to a study in The Journal of Pain.

Opioids are often prescribed to patients with neuropathy to ease painful symptoms; however, opioid use is associated with a range of potential adverse events, such as patients moving over to unnecessary long-term use. This new analysis could add fuel to the anti-opioid case as the data reveal that the drug was not beneficial for long-term pain relief.

A total of 789 patients with non-cancer-related chronic neuropathic pain — 55% women and average age of 53.5 – received opioid prescriptions according to standard guidelines. Measures of pain, mood, quality of life, and overall satisfaction with the treatment were assessed after three, six, 12, 18, and 24 months. According to the authors, the primary outcome measure was designated as “the composite of 30% reduction in average pain intensity and 1-point decrease in the mean interference Scale Score (0 – 10) of the Brief Pain Inventory at 12 months relative to baseline.”

At baseline, the average pain score was 6.1 ± 1.9. At the 12-month mark, all outcome measures showed significant improvement, however, only 23.7% of the patients showed significant improvement in pain and function as the primary outcome.

“Univariable analyses showed poorer outcomes at 12-month follow-up with longer duration of pain (P = .002), greater cigarette use (P = .01), more disability compensation (P = .001), and higher opioid doses at baseline and at 12 months (P < .02),” the authors wrote.

The findings indicate that while opioids can provide relief to patients with chronic neuropathic pain, the medication may not be beneficial for long-term use. However, novel strategies such as stem cell therapy and targeting neurotransmitters with antidepressants have recently shown success as neuropathy treatments.