Segebrecht Ray, Khan Abat, Wu Xiangni
Assistant Professor, Division of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, USA.
Department of Hematology and Medical Oncology, Memorial Healthcare System, Florida, USA.
Mo Med. 2025 Jul-Aug;122(4):334-339.
The opioid epidemic claims tens of thousands of lives annually in the United States (US) where opioids are prescribed more per capita than in any other country. Primary care providers contribute to nearly half of these prescriptions, often for chronic non-cancer pain conditions such as back, hip, and knee pain. Despite widespread use, evidence suggests that opioids do not improve pain control for chronic non-cancer musculoskeletal pain. This study aimed to assess whether an opioid prescription in the three months preceding internal medicine primary care appointments was associated with lower pain levels, as reported on a 1 to 10 scale during medical assistant check-ins, among patients with chronic non-cancer musculoskeletal pain. Using a cross-sectional design, we analyzed pain scores for adult patients who had been prescribed opioids versus those who had not. Our findings revealed no statistically significant difference in pain levels between the two groups, with both opioid and non-opioid users reporting similar median pain scores. These results align with existing evidence, reinforcing the notion that opioids offer no substantial advantage in pain management for chronic musculoskeletal pain.
在美国,阿片类药物泛滥每年导致数万人死亡,美国人均阿片类药物处方量高于其他任何国家。初级保健提供者开出了近一半的此类处方,通常用于治疗慢性非癌性疼痛,如背部、臀部和膝盖疼痛。尽管阿片类药物被广泛使用,但有证据表明,它们并不能改善慢性非癌性肌肉骨骼疼痛的疼痛控制情况。本研究旨在评估在内科初级保健预约前三个月开具的阿片类药物处方,与慢性非癌性肌肉骨骼疼痛患者在医疗助理登记时报告的1至10级疼痛水平降低是否相关。我们采用横断面设计,分析了开具阿片类药物的成年患者与未开具阿片类药物的成年患者的疼痛评分。我们的研究结果显示,两组患者的疼痛水平在统计学上没有显著差异,阿片类药物使用者和非阿片类药物使用者报告的疼痛中位数评分相似。这些结果与现有证据一致,强化了阿片类药物在慢性肌肉骨骼疼痛管理中没有实质性优势的观点。