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Researchers from the University of Alberta have found that opioids are best used for acute pain relief for four weeks or less and may cause more harm than good when used for chronic pain for more than 12 weeks.

In a recently published paper in the British Journal of General Practice, the team reported on a systematic review of 27 randomized controlled trials comparing opioids with nonopioid pain management for the treatment of osteoarthritis or chronic low back pain.

The trials examined the ability of opioids such as oxycodone, buprenorphine, oxymorphone, hydromorphone and morphine to produce clinically meaningful pain relief—defined as 30% or more—over time.

Their analysis showed that, although opioids did work in the first four weeks of acute pain, they provided little or no benefit over longer periods and may worsen pain control beyond 12 weeks by potentially increasing the patient's sensitivity to pain.

"If someone breaks a limb, has surgery or a dental problem, where you anticipate the problem is going to resolve in a relatively short time, it's probably OK to give an opioid for that," says principal investigator Scott Garrison, a professor of family medicine, director of the Pragmatic Trials Collaborative and member of the PEER (Patients, Experience, Evidence, Research) team.

"Opioids still have a role in managing acute pain.

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