What works better for long-term pain: opioids or non-opioids?

VA researchers studied this question. The following summarizes what they found. 

Before the study, health researchers already knew that opioids were more likely than non-opioids to cause serious harms such as injuries, breathing trouble, addiction, and even death. 

But they didn’t know if opioids worked better for long-term pain than non-opioid pain medications.

To study this question, VA doctors and researchers recruited 240 VA patients with long-term back, hip, or knee pain. One group received opioids, such as morphine and oxycodone. The other group received non-opioids, such as lidocaine cream, acetaminophen, and naproxen. They collected information from participating Veterans throughout one year to answer the following two questions.

Question 1: How much does pain interfere with your… general activity, mood, walking ability, normal work, relations with other persons, sleep, and enjoyment of life? 

What researchers found: Most study participants in both groups (opioids and non-opioids) improved over the one-year study. 

Question 2: What medication side effects do patients report?

What researchers found: Medication side effects were twice as common in the opioid group. 

Based on these results, VA doctors and researchers concluded that opioids did not work better than non-opioids for long-term pain. 

Content last updated: March 2023