Person pouring out pills from prescription pill bottle into hand

Does Discontinuing Long-Term Opioid Therapy Relieve Pain?

Person pouring out pills from prescription pill bottle into hand

This article was originally published on Confronting Chronic Pain by Dr. Steven Richeimer, Director Pain Medicine Master and Certificate.

Many of the people who take opioids regularly to help with their chronic pain may cringe at the thought of discontinuing their usage. They may fear that the pain intensity would become worse, which keeps them from even wanting to try transitioning away from taking opioids or going to intermittent use. Researchers wanted to put this issue to the test so they could see what happened when those using long-term opioid therapy transitioned to something else, or discontinued therapy all together.

The findings of their research were published in the June 2021 issue of the Journal of Pain [1]. For the cohort study, they had over 30,000 veterans who fit the criteria to participate in the study. Some of the participants were to transition away from using the long-term opioid therapy altogether, while others would replace it with using the opioid therapy intermittently, rather than using it ongoing.

Those who participated in the study were on long-term opioid therapy for their chronic pain. When the study began, the researchers took the participants’ pain assessments, using a numeric rating scale. They then followed up with them every 90 days after they transitioned to repeat the assessment.

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What they found was that pain scores were lower during the follow-up period for both groups that transitioned away from the long-term opioid therapy. Those who switched to intermittent opioid therapy and those who discontinued the opioid therapy altogether both reported that they experienced less pain. Meanwhile, those participants who continued with the long-term opioid therapy did not have any reduction in the amount of pain they reported having.

Those who fear transitioning away from long-term opioid therapy should find hope in the results that this study shares. The researchers found the opposite to be true, that if you transition away from them, either by discontinuing their usage altogether or switching to using them intermittently, there’s a good chance that the chronic pain intensity will reduce as well.

Long-term opioid therapy for chronic pain can be problematic. According to the National Institute on Drug Abuse, up to 29% of those who are prescribed opioids for chronic pain misuse them [2]. In 2019, there were around 50,000 people in the U.S. who died from opioid-involved overdoses. In response to the opioid crisis, U.S. health authorities are focusing on five efforts, which include advancing better practices for pain management.

 

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Sources

  1. Journal of Pain. Association Between Pain Intensity and Discontinuing Opioid Therapy or Transitioning to Intermittent Opioid Therapy.
  2. National Institute on Drug Abuse. Opioid Overdose Crisis.

 

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About Dr. Steven H. Richeimer

Steven Richeimer, M.D. is a renowned specialist on issues related to chronic pain. He is the chief of the Division of Pain Medicine at the University of Southern California. He has written or co-written a large number of scientific articles about pain medicine. He recently published an instructive book and guide for pain patients. Dr. Richeimer has given numerous lectures to medical and lay audiences throughout the U.S.