Opioids are not more effective than placebos for many short-term pains

A University of Sydney review found oral opioids gave only small or short-lived benefits for many acute pain types and were no better than placebo for some conditions; other studies report measurable placebo-related pain relief.

Researchers at the University of Sydney reviewed the effectiveness and risks of commonly used oral opioids — morphine, codeine, oxycodone and tramadol — compared with placebo for acute pain. The findings were published in the journal Drugs. The review found that opioids provided only limited or short-lived benefits for many common acute pain types and increased the risk of side effects in some situations. For some conditions, including kidney stone pain, opioids were reported as no better than placebo. Key findings: - The review compared morphine, codeine, oxycodone and tramadol against placebo for acute pain conditions. - Oral opioids were only slightly better than placebo for acute musculoskeletal pain in the six to 48 hours after starting treatment. - Opioids increased the risk of side effects when used for acute musculoskeletal pain, some types of post-surgical pain, or traumatic limb pain. - In some conditions, such as kidney stone pain, opioids were reported as not better than placebo. - Separate studies, including work cited by the NIH and published research, have documented measurable placebo-related pain relief, in some cases reporting effects up to about 50 percent. Summary: The review indicates that short-term oral opioids often deliver small or absent benefits for many common acute pains while side effects are more frequent in certain cases. Other research has shown placebo effects can produce measurable reductions in pain. Undetermined at this time.