Back

Benefits and Concerns About Use of Opioids for Chronic Pain

Oxycodone is an opioid (narcotic) drug used to help patients with moderate to severe pain. Patients with chronic back pain, diabetic neuropathy, or arthritis are often helped by opioids. Because opioids can be addictive, there's been some concern about the long-term effects of this drug.

In this study 233 patients with chronic pain taking controlled-release oxycodone were followed for up to three years. Researchers collected information about dose used, pain levels, and adverse side effects from the drug. They also noted any drug-related behavior. These included asking for more drug or repeatedly losing the prescription.

The sponsor ended the study early. And more than half the patients withdrew from the study early for various reasons. Some had enough side effects from the drug to quit taking it. Others did not get the pain relief they needed.

Despite these difficulties, some general patterns were observed from the data. First, it's not uncommon for patients taking pain relievers for chronic pain to stop taking them after about six months of use. The reasons for this aren't always very clear.

Second, the need for increasing doses of drug to get the needed pain relief occurred during the first three months. This is called dose titration. It does take a short period of time to get the right dose for medications that can be addictive.

Third, those patients who still had a pattern of increasing drug use after the first three months were not receiving the right amount of medication.

The authors conclude that there is a group of chronic pain patients who can benefit from long-term opioid therapy. They are able to get pain relief over time without the negative side effects. Anyone who is not helped by opioids after three months should be re-examined.

This study points out the difficulty of doing drug-related research. More studies are needed of the long-term effects and benefits of opioids for control of chronic pain.

References: Russell K. Portenoy, MD, et al. Long-Term Use of Controlled Release Oxycodone for Noncancer Pain: Results of a 3-Year Registry Study. In The Clinical Journal of Pain. May 2007. Vol. 23. No. 4. Pp. 287-299.

Back