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Adverse Results of Early Opioid Use for Low Back Pain

Morphine and other similar opioid drugs are narcotic painkillers. They are very effective but they do have side effects. Until the 1980s, opioids were only used in extreme cases of chronic pain for cancer patients.

But in the past 20 years, opioids have become more accepted for the treatment of chronic back pain. The use of opioids has also expanded to include acute low back pain (LBP).

In this study, researchers review the records of over 8,000 Workers' Compensation patients. They recorded the number of patients with acute LBP who were prescribed opioids early in their condition. Early opioid-use was defined as within 15 days of the start of the problem.

Then they compared this with the long-term results. Outcome measures included disability duration, costs, and how many of these patients used opioids months to years later. They also looked to see how many patients receiving early opioids later had back surgery.

The results of their analysis showed an adverse effect of early opioid use for acute LBP. Those patients were disabled longer. The risk for surgery was three times more than for patients who did not get opioids. And they were six times more likely to still be taking opioids months later.

In fact, the larger the dose and duration of the opioid-use, the longer the disability, greater the cost, and larger the number of patients having surgery later. The authors suggest that using opioids early in the treatment approach for acute LBP may slow or prevent recovery.

References: Barbara S. Webster, BSPT, PA-C, et al. Relationship Between Early Opioid Prescribing for Acute Occupational Low Back Pain and Disability Duration, Medical Costs, Subsequent Surgery and Late Opioid Use. In Spine. September 1, 2007. Vol. 32. No. 19. Pp. 2127-2132.

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