Randomised trial reveals opioids relieve acute back pain no better than placebo

Caitlin Jones and colleagues present the world's first placebo-controlled trial of opioids in acute low back and neck pain. 1 Jones C O'Day RO Koes BW et al. Opioid analgesia for acute low back pain and neck pain in Australia (the OPAL trial): a randomised placebo-controlled trial. Lancet. 2023; (published online June 28.)https://doi.org/10.1016/S0140-6736(23)00404-X Google Scholar This trial was conducted in 157 Australian primary care and emergency department sites and included multiple safeguards against bias, including random computer allocation and triple masking of participants, prescribers, and assessors. Despite multiple trials and systematic reviews assessing opioid therapy for chronic back and neck pain, there have been few controlled trials of opioids in acute and subacute back and neck pain. The question of effectiveness is important because opioid use often begins with treatment of acute back pain and can then be continued indefinitely. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trialOpioids should not be recommended for acute non-specific low back pain or neck pain given that we found no significant difference in pain severity compared with placebo. This finding calls for a change in the frequent use of opioids for these conditions. Full-Text PDF