Back pain can be difficult and complex to treat. Sometimes treatments are used before there's any real evidence that they work. The use of opioids may fall into this category. Opioids are painkillers that act like morphine in the body.
The use of opioids started to rise in the last 20 years thanks to advice from pain specialists. Drug companies added to the problem. They launched ad campaigns that helped support the belief that these drugs were the answer to chronic pain.
But the evidence to support routine or long-term use of opioids (more than four months) just isn't there. They may be effective for short-term control of back pain but the evidence is shaky. In addition, studies show major problems from opioid use.
Addiction is more common than previously thought by pain specialists. And more than half the patients don't really get the pain relief they need. Quality of life isn't better and may decline with ongoing pain and addiction. According to a large study in Denmark, opioid use is linked with higher levels of unemployment, less physical activity and fun, and poorer overall health.
If the goal of opioids is to get pain relief, increase function, and improve quality of life, then they are not doing what they are supposed to do. Until there is better evidence to support their use, researchers suggest caution when using long-term opioids for the treatment of chronic pain.
Opioid Backlash: Are Opioids Just a Passing Fad in the Treatment of Chronic Back Pain? In The BACK Letter. March 2007. Vol. 22. No. 3. Pp. 1, 32.'