Continuing Warning Signals About the Hazards of Opioid Tapering

doi:10.1097/01.back.0000924384.95445.3e

The Back Letter

2023

DOI: 10.1097/01.back.0000924384.95445.3e

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Continuing Warning Signals About the Hazards of Opioid Tapering

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Online Chronic Pain Program Led to Reduced Opioid Dosage—Without an Increase in Pain

2023

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Decades of research have failed to produce credible evidence that any drug therapy is effective and safe in the treatment of acute low back pain, if a stunning new review and network meta-analysis is correct. (See definition of network meta-analysis below.) This is a stunning conclusion because it conflicts with the dominant view across medicine. Numerous international evidence-based guidelines based on more traditional head-to-head clinical trials and meta-analyses have concluded that several common medications provide modest relief of acute back pain.The massive new network meta-analysis by Michael Wewege, MSc, of the University of New South Wales and colleagues departed from that view in dramatic fashion. "The comparative effectiveness and safety of analgesic medicines for acute non-specific low back pain are uncertain," they concluded. (See Wewege et al., 2023) If the new review is accurate, research to date doesn't provide any conclusive guidance for healthcare providers, patients, and the general public.Or as senior author James McAuley, PhD commented in an accompanying statement, "Despite more than 60 years of research, we are still uncertain whether any analgesic medicine provides meaningful pain relief for people with low back pain. We recommend that doctors and patients take a cautious approach to managing acute low back pain with analgesic medicines until higher quality trials of head-to-head comparisons are available."Another coauthor lamented the quality of the evidence. "It is quite shocking that the evidence base for the effectiveness and safety of some of the most commonly used drugs for such a common condition is so fragile and incomplete. Our findings clearly indicate the need for larger, rigorous trials that can genuinely inform better clinical decisions," according to

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Online Chronic Pain Program Led to Reduced Opioid Dosage—Without an Increase in Pain

2023

The Back Letter

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Continuing Warning Signals About the Hazards of Opioid Tapering

Cited by 1 publication

References 5 publications

Online Chronic Pain Program Led to Reduced Opioid Dosage—Without an Increase in Pain

Online Chronic Pain Program Led to Reduced Opioid Dosage—Without an Increase in Pain

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