Researchers studying 551 Veteran Affairs (VA) patients on long-term opioid therapy for chronic, non-cancer-related pain found that halting such treatment does not make this type of pain worse—in some cases, things actually got better.
Their work, “Changes Ii [sic] Pain Intensity Following Discontinuation of Long-Term Opioid Therapy for Chronic Non-Cancer Pain,” appears in the June 13, 2018 edition of the journal Pain.
Washington State University (WSU) researchers worked with colleagues at the Veteran Affairs Portland Health Care System and the Oregon Health & Science University in an effort to help medical practitioners find alternative treatments to opioids.
Of all the participants, 87% were diagnosed with chronic musculoskeletal pain, 6% with neuropathic pain, and 11% with headache pain, including migraines.
The authors wrote, “Follow-up growth mixture models identified four pain trajectory classes characterized by the following post-discontinuation pain levels: no pain, mild clinically-significant pain, moderate clinically-significant pain, and severe clinically-significant pain.”
“Similar to the overall sample, pain trajectories in each of the four classes were characterized by slight reductions in pain over time, with patients in the mild and moderate pain trajectory categories experiencing the greatest pain reductions post-discontinuation.”
Co-author Sterling McPherson, Ph.D., associate professor and director for biostatistics and clinical trial design at the WSU Elson F. Floyd College of Medicine, told OTW, “Pain intensity following discontinuation of long-term opioid therapy does not, on average, worsen for patients and many slightly improve, particular for patients with mild-to-moderate pain at the time of discontinuation.”
“Clinicians might consider these findings when discussing the risks and benefits of long-term opioid therapy as compared to other, non-opioid treatments for chronic pain. Clinicians should consider these findings when discussing risks of opioid therapy and potential benefits of opioid taper with patients.”
“Going forward we will be collecting additional data and qualitative interviews with patients over the next year to try and determine why some patients experience greater reductions in pain than others after discontinuing long-term opioid therapy.”
Opioid discontinuation does not increase pain