Many Australians taking opioids long-term for chronic non-cancer pain (CNCP) also use non-opioid pharmacological and non-pharmacological treatments outside clinical guidelines.
The Pain and Opioids IN Treatment study comprised adults receiving opioids for CNCP for more than 6 weeks from community pharmacies who were then followed up annually for four years.
Data from 1,334 participants in the study showed back pain (79.2%) and arthritis (66.6%) were the most common pain conditions.
Over the study period, almost all patients reported at least 12 months of non-opioid drugs including paracetamol (79.8%) and antidepressants (66.2%).
Similarly, the most common medicines reported in the previous 30 days were paracetamol (68.4%), antidepressants (64.5%), sedative hypnotics (48.3%), gabapentinoids (45.8%), and NSAIDs (34.3%).
“Consistency between 12-month and 30-day use indicates potential regular and sustained medicines use between these time periods. Despite this, most participants continued to report moderate pain severity and interference scores throughout the 4-year period, highlighting the ongoing complexity of CNCP management and that many individuals continue to live with pain despite engaging with treatment,” the study said.
The study, published in Pain, said NSAIDs were commonly used consistently despite guidelines recommending short-term use of these medicines because of the risk of AEs such as gastrointestinal bleeding.
And there were risks in taking many of the other non-opioid medicines including psychotropics, gabapentinoids, pregabalin and sedative-hypnotics.