Geisinger study finds opioids not helpful in treating chronic pain

"When patients are given opioid therapy for chronic pain, there is evidence that it interferes with the body's natural resolution of the pain," said Dr. Davis, who co-chaired the 2015 International Conference on Opioids at Harvard Medical School. "Opioid therapy may put someone at an increased risk for multiple adverse effects. And it actually has the potential of extending the history of their pain."

The authors wrote that the risk of addiction, depression, central hypogonadism – where the hypothalamus and pituitary glands don't function properly – sleep-disordered breathing, impaired wound healing, infections, cognitive impairment, falls, fractures and death increase in patients on chronic opioid therapy.

The Geisinger physicians acknowledge that the use of opioids has been helpful in reducing the intensity of acute pain – sudden pain due to injury that doesn't last long – and in managing pain associated with terminal cancer. But they found that the promotion of opioid therapy to treat chronic pain – defined as lasting more than three months – has been common practice without significant research to judge the safety of the practice.

In addition, Dr. Davis believes opioids have been over-prescribed by physicians because of limited treatment options.

"There are not a lot of pain management centers providing a variety of effective, non-opioid and non-pharmacologic therapies," he said. "In addressing the opioid epidemic in our society, we should be putting our efforts into developing more chronic pain rehabilitation programs versus making opioid packaging tamper-resistant to prevent the crushing, snorting and injecting of prescribed narcotics."

The authors conclude that the management of chronic pain needs to be vastly different than the treatment of acute pain. They urge physicians to take into consideration the significant delayed side effects and adverse health consequences of opioids.

"Opioids are not the answer," Dr. Davis stressed. "Chronic pain rehabilitation, exercise, cognitive behavioral therapies, acupuncture, yoga or tai chi are all better options than opioids."

Dr. Davis will present the findings from his research at the Annual Assembly of the American Academy of Hospice and Palliative Medicine on Wednesday, Feb. 22, in Phoenix, Arizona.

About Geisinger
Geisinger Health System is an integrated health services organization widely recognized for its innovative use of the electronic health record and the development of innovative care delivery models such as ProvenHealth Navigator® and ProvenCare®. As one of the nation's largest health service organizations, Geisinger serves more than 3 million residents throughout 45 counties in central, south-central and northeast Pennsylvania, and also in southern New Jersey with the addition of AtlantiCare, a National Malcolm Baldrige Award recipient. The physician-led system is comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 12 hospital campuses, two research centers and a 551,000-member health plan, all of which leverage an estimated $10.5 billion positive impact on the Pennsylvania and New Jersey economy. Geisinger has repeatedly garnered national accolades for integration, quality and service. In addition to fulfilling its patient care mission, Geisinger has a long-standing commitment to medical education, research and community service. For more information, visit www.geisinger.org, or follow the latest Geisinger news and more on Twitter and Facebook

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