Experts Proclaim: Stop Treating Back Pain With Opioids

THAT’S A GOOD IDEA –

June 29, 2023 – Complex problems such as opioid use need smart solutions, and another study we recently conducted provides convincing data opioid prescribing can be successfully reduced.

The study involved four hospital emergency departments, 269 clinicians and 4,625 patients with low back pain. The intervention comprised of:

clinician education about evidence-based management of low back pain

patient education using posters and handouts to highlight the benefits and harms of opioids

providing heat packs and anti-inflammatory pain medicines as alternative pain-management treatments

fast-tracking referrals to outpatient clinics to avoid long waiting lists

audits and feedback to clinicians on information about opioid prescribing rates.

This intervention reduced opioid prescribing from 63 percent to 51 percent of low back pain presentations. The reduction was sustained for 30 months. Key to this successful approach is that we worked with clinicians to develop suitable pain-management treatments without opioids that were feasible in their setting.

More work is needed to evaluate this and other interventions aimed at reducing opioid prescribing in other settings including GP clinics.

A nuanced approach is often necessary to avoid causing unintended consequences in reducing opioid use.