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A new study published in the Journal of the American Medical Association and summarized by Reuters Health, claims that acetaminophen, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are better than opioids at easing the intensity of chronic pain in the back, knees or hips.

And opioids are no better than these other drugs at reducing how much pain interferes with daily activities like walking, working, sleeping or enjoying life, researchers report in JAMA, online March 6.

“We already knew opioids were more dangerous than other treatment options, because they put people at risk for accidental death and addiction,” said lead study author Dr. Erin Krebs of the Minneapolis VA Health Care System and the University of Minnesota. “This study shows that extra risk doesn’t come with any extra benefit,” Krebs said by email.

NSAIDs carry their own risks, especially at high doses, including the potential for internal bleeding, kidney damage and heart attacks. But they aren’t addictive.

For the current study, researchers randomly assigned 240 patients seeking pain treatment at VA primary care clinics to receive either opioids or alternative medicines like acetaminophen or ibuprofen for one year.

Participants were 58 years old on average and most were men. Back pain was their most common complaint, affecting 156 patients, or 65 percent, and the rest had either hip or knee osteoarthritis pain.

People in the opioid group started therapy with fast-acting morphine, a combination of hydrocodone and acetaminophen, or immediate release oxycodone. If that wasn’t successful, patients next got long-acting morphine or oxycodone, and then doctors tried fentanyl patches.

In the non-opioid group, patients first got acetaminophen and NSAIDs. If those options didn’t help enough, doctors tried options like the nerve pain drug gabapentin (Neurontin) and topical painkillers like lidocaine, followed by the nerve pain drug pregabalin (Lyrica) and tramadol, an opiate painkiller.

Researchers asked participants to rate how much pain interfered with their lives at the start of the study, and again 12 months later. By this measure, both groups improved equally over the course of the year, based on a 10-point scale with higher scores indicating worse impairment.

With opioids, scores declined from an average of 5.4 at the start of the study to 3.4 a year later. With other drugs, scores dropped from 5.5 to 3.3.

Patients also rated pain intensity on a 10-point scale with higher scores indicating more severe symptoms, and non-opioid drugs worked slightly better on this measure.

In both groups, patients initially rated their pain intensity at 5.4, but scores dropped to just 4.0 with opioids and fell to 3.5 on the other drugs.

One limitation of the study is that people knew which medications they were prescribed, which might affect how patients reported their own pain severity and daily functioning, the authors note.

Even so, the results offer fresh evidence that opioids may not be worth the addiction risk when treating chronic pain, said Marissa Seamans, a researcher at Johns Hopkins Bloomberg School of Public Health in Baltimore who wasn’t involved in the study. ‘There is increasing evidence that non-opioid pain relievers are just as (if not more) effective than opioids for chronic non-cancer pain,’ Seamans said by email.