“There is increasing evidence that non-opioid pain relievers are just as (if not more) effective than opioids for chronic non-cancer pain,” Seamans said by email. People in the opioid group started therapy with fast-acting morphine, a combination of hydrocodone and acetaminophen, or immediate release oxycodone.  (Reuters Health) - Acetaminophen, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are better than opioids at easing the intensity of chronic pain in the back, knees or hips, a U.S. experiment suggests. Pain intensity was significantly better in the nonopioid group over 12 months (overall P = .03); mean 12-month BPI severity was 4.0 for the opioid group and 3.5 for the nonopioid group (difference, 0.5 [95% CI, 0.0 to 1.0]). Patients also rated pain intensity on a 10-point scale with higher scores indicating more severe symptoms, and non-opioid drugs worked slightly better on this measure. Follow-up rates were 92% at 3 months (106 in the opioid group and 115 in the nonopioid group), 97% at 6 months (116 in each group), 90% at 9 months (108 in the opioid group and 107 in the nonopioid group), and 98% at 12 months (117 in each group). Back pain was their most common complaint, affecting 156 patients, or 65 percent, and the rest had either hip or knee osteoarthritis pain. First, enrolled patients had characteristics similar to those of patients receiving opioids in VA primary care, including patients with depression and posttraumatic stress disorder.6 Second, flexibility of treatment within assigned groups facilitated high study retention. One limitation of the study is that people knew which medications they were prescribed, which might affect how patients reported their own pain severity and daily functioning, the authors note. “We already knew opioids were more dangerous than other treatment options, because they put people at risk for accidental death and addiction,” said lead study author Dr. Erin Krebs of the Minneapolis VA Health Care System and the University of Minnesota.
– Even after overdose and addiction risks became known, opioid prescriptions continued on the belief that the drugs were more effective at relieving pain than other medications. New research suggests that may not be the case. In a study in JAMA, scientists say opioids appear to be no better at treating chronic pain than non-opioids like acetaminophen (Tylenol), ibuprofen (Advil), and lidocaine, which are much less addictive. In a trial of 240 patients—mostly middle-aged white males who'd endured at least six months of pain in their back, hips, or knees—non-opioid users actually experienced more pain relief than patients using morphine, oxycodone, or hydrocodone, though not in a way that was statistically significant, reports the Los Angeles Times. "There was no significant difference in pain-related function between the 2 groups over 12 months," say the researchers. Half of the trial patients at Minneapolis VA Health Care System were given opioids, while the other half were given acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Both groups reported an average pain score of 5.4 out of 10 at the start of the trial. But after a year, opioid users reported an average score of 4, compared to 3.5 for non-opioid users, reports Reuters. Study author Erin Krebs blames opioid tolerance. "Your body gets used to that level of opioid, and you need more and more to get the same level of effect," she tells NBC News, adding this might explain why opioid users suffered more side effects like constipation, fatigue, and nausea. Since the added risks of opioids come with no advantage over other drugs, Krebs says people with chronic pain just "shouldn't start opioids." (That goes for kids, too.)