Opioids No Better Than Placebos for Back and Neck Pain, New Study Says

 A new study just published in The Lancet, a highly respected mainstream journal, reported that patients with low back pain and neck pain who were prescribed opioids did no better than patients given a placebo. The randomized, controlled study of 347 patients found that there was no significant difference in pain scores between the two groups at six weeks. A year later, the placebo group had slightly lower pain scores,1.81 compared to 2.37 for the opioid group. The average age of participants in the study was 44.7 years and they all had lower back pain, neck pain or both for 12 weeks or less.

According to the National Institute for Drug Abuse (NIDA), 10-12% of those prescribed opioids develop an addiction. Despite the fact that over a million Americans have died of opioid overdoses to date, opioids continue to be widely prescribed as noted by the CDC. After peaking in 2012 at 81.3 prescriptions per 100 persons nationwide, the prescription opioid rate was 43.3 per 100 persons in 2020. However, some counties had rates that were nine times higher than that. This study indicates that many pain patients are being unnecessarily exposed to devastating and potentially fatal risks for absolutely no benefit.

I believe that the reason that opioids continue to be so widely prescribed despite the risks is that healthcare providers and patients have heard so often that “opioids are the best treatment we have for pain”. This statement has been repeated so often by pharmaceutical interests and their enablers despite the lack of evidence that most people believe it. Will this study be enough to change these beliefs? I doubt it.

Besides patients’ and healthcare providers’ frequently reinforced beliefs that “opioids are the best treatment we have for pain”, there are several other barriers that get in the way of change. These include:

 

Healthcare providers are not educated about safer and more effective alternatives.

One survey of medical school curriculum in the U.S. found that physicians were receiving less than two hours of education about pain during their four years of medical school. Post-graduate education is largely sponsored by the drug companies, who fund the medical journals through advertising, sponsor most of the continuing education courses and conferences that physicians attend and send sales reps to physicians’ offices to peddle their wares on an almost daily basis. There are no comparable platforms for educating physicians about alternatives to pharmaceuticals for the treatment of pain.

 

Insurance companies won’t pay for alternative treatments or severely underfund them.

They do not pay for acupuncture, biofeedback, massage, nutritional counseling or supplements, exercise programs, herbal treatments, light therapy or other proven pain treatments. They have not raised fees for chiropractors, mental health providers or physical therapists in over 40 years.

 

Government policy often blocks access to alternative treatments.

Marijuana is still federally illegal, making it inaccessible for many. The FDA has gone to great lengths to try to ban kratom, a very effective southeast Asian pain-relieving herb, and failing that, has done their best to demonize it. Several states have banned kratom. 

The FDA has also recently declared homeopathy illegal, classifying all remedies as unapproved drugs, despite significant evidence that homeopathy is safe and effective and a long tradition of its use being legal.

No federal or state laws require insurance coverage for most alternatives or adequate fees for the treatments, like physical therapy, psychotherapy and chiropractic, that are covered.

 

Sign My Petition to Require Insurance Companies to Pay for Alternative Treatments

 

The supply of alternative service providers cannot currently meet increased demand.

 For instance, while the demand for chiropractic services has been increasing, the U.S. Small Business Administration reports that the five-year survival rate of chiropractic practices is only 48.9%. This is most likely due to low fees and excessive paperwork demands by insurance companies.

The physical therapy profession is currently hemorrhaging providers despite increasing demand, with over 22.000 physical therapists leaving the workforce in the last quarter of 2021 alone. Over 15,000 licensed clinical social workers left the workforce during the same time period in professions where there were already significant shortages.

There are already shortages of massage therapists and demand for acupuncturists is already increasing compared to supply. These shortages will be even more severe if insurance coverage is made available.