Years of opioid use fail to ease chronic back pain, Northwestern study finds
Key takeaways
- Taking opioids for years did not reduce pain or improve daily functioning in chronic back pain patients, a Northwestern University study found.
- The 140-patient study, published October 1 in the journal Brain, is the first to examine long-term opioid use alongside brain properties.
- Researchers identified serotonin-related molecular markers that could point toward new pain treatments and tapering strategies.
Taking opioids for years does not reduce pain or improve functioning in people with chronic back pain. That is per a Northwestern University study comparing 70 long-term opioid users with 70 similar patients not taking opioids.
The study, published October 1 in the journal Brain, also found large differences in brain activity between the two groups. It identified new molecular markers, including some involving serotonin receptors, that could lead to new treatments for pain and for tapering off opioids.
A prescription pill bottle. Photograph: IagoQnsi/Wikimedia Commons
Image Credits: Wikimedia Commons (CC BY-SA 3.0)
What the researchers found and didn't
The reassuring news came first. Despite years of opioid use, the patients' brains were essentially intact.
"The psychological and brain properties of the participants on long-term prescription opiates were essentially intact," said senior study author A. Vania Apkarian, director of the Center for Translational Pain Research at Northwestern University Feinberg School of Medicine.
"That's good news because there's this fear nowadays that as soon as you start ingesting opiates, your brain is going to go crazy, and it doesn't," Apkarian said. "But the bad news is that we saw no sign that their pain had gotten any better by using this drug for so many years."
Roughly 5 million U.S. adults use prescription opioids regularly to manage chronic pain.
Apkarian noted the study participants were taking low or moderate doses under medical supervision. He said this was the first study to look at long-term opioid consumption together with brain properties.
Capsules spilled from a pill bottle. Photograph: Mpelletier1/Wikimedia Commons
Image Credits: Wikimedia Commons (CC BY-SA 3.0)
What's next
Based on the serotonin-pathway markers identified in the study, the Northwestern team plans to test whether an antidepressant targeting the same molecular pathway can help treat chronic pain and opioid dependence.
The findings land with an important nuance: while the opioid group fared no better on pain, they were not dramatically worse off either. The open question now is whether the newly identified markers can be turned into therapies that succeed where long-term opioids did not.
Reporting by Rive News research desk.
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