Chronic pain is one of the major medical and socioeconomic problems worldwide. The effectiveness of overall therapy for patients with chronic pain syndrome is insufficient, despite the increase in the number of both opioid drugs and non-opioid interventions. In the treatment of chronic non-malignant pain, the elimination of pain syndrome is only one of the tasks.
The main goals of the treatment are to expand the patient’s mobility, ensure their independence, and improve the quality of life. For this, non-opioid treatment options are crucial as they allow to offer patients pain relief in a long-term perspective. There are many options in regards to non-opioid interventions for chronic non-malignant pain: from drug variations to physiotherapy, cognitive therapy, correction of concomitant disorders, and non-traditional medicine such as acupuncture, for example. It is crucial to determine the effectiveness of non-opioid treatment methods compared to opioid interventions in order to provide patients with effective multimodal pain management strategies.
The article written by Noori et al. (2019) discusses the efficiency of non-opioid medical agents compared to opioid drugs in patients with chronic pain associated with degeneration of certain tissues. The authors (2019) aimed to determine which type of treatment is more effective for managing various chronic pain conditions. According to Noori et al. (2019), the study “explores and compares the efficacy and safety of opioid and non-opioid agents for neuropathic pain, rheumatoid arthritis joint pain, cancer pain, and low back pain” (p. 1). The authors (2019) decided to perform a review of both treatment methods due to the fact that opioid drugs are associated with increased risks and complication rates among patients. Moreover, the spread of opioid analgesic abuse among adults, commonly known as the “opioid crisis,” also calls for more research into the issue.
The authors (2019) used a review design for their qualitative study, aiming to create a narrative of existing meta-analyses and systematic reviews. Noori et al. (2019) researched scientific databases to gather a pool of studies on opioid and non-opioid pain management strategies. The authors (2019) state that the study “compared the magnitude of pain relief provided by the numerous pharmacologic agents studied in meta-analyses and systematic reviews involving adult participants suffering from common chronic pain conditions” (p. 2). Several scientific databases, including Google Scholar, PubMed, and Central, were searched to collect existing evidence on the effectiveness of both methods. Moreover, the authors (2019) used cross-reference searching to include additional relevant studies.
The final sample consisted of 23 reviews that were thoroughly investigated, with a total of 349 individual studies that were mentioned in these reviews. The authors selected papers that were written in English and published between November 2006 and November 2016 (Noori et al., 2019). Noori et al. (2019) add that they “included systematic reviews and meta-analyses that evaluated the effects of pharmacologic treatment interventions administered for the relief of pain and excluded any reviews that did contain studies that had a comparator” (p. 2). Data from each trial were included in the study independently. Thus, the sample pool and data-gathering methods provided a significant amount of relevant information for subsequent analysis and discussion.
The authors (2019) discussed in detail the effectiveness of both opioid and non-opioid treatment options for each separate type of chronic pain. Overall, the presented results show that, despite the recent introduction of more varied non-opioid interventions, opioids still hold a major role in managing chronic pain. However, Noori et al. (2019) also note that “there are many concerns regarding tolerance, addiction and opioid-induced hyperalgesia, thus it is even more crucial to properly educate health care professionals on their benefits and risks” (p. 10). The study has found that the efficiency of opioid agents is still unmatched by non-opioid methods, but despite that, the latter also provides valuable pain relief options that should be taken into consideration.
The major limitation of the research is that it did not involve the collection of primary data as would have been appropriate to address knowledge gaps. Thus, the study might be considered as lacking reliability, despite the fact that the necessary data was gathered from a wide variety of sources, especially peer-reviewed journals and books. Moreover, different pain scales were utilized in the different studies the authors (2019) reviewed, and certain reviewed research had too small sample sizes. Still, the article could serve as an appropriate background for future exploration of this particular issue discussed here. It offers a comprehensive and condensed review of the most relevant findings on the issue of the comparative effectiveness of opioid and non-opioid treatment agents. Moreover, the authors (2019) propose several suggestions for future research in that direction, offering a more narrowed-down approach to improving the study design.
The article provides a valuable information framework for nurses working with patients who experience chronic pain. By separately reviewing studies for each type of chronic pain, Noori et al. (2019) offer insight into various treatment strategies for these conditions. The authors (2019) stress that the objective of any intervention is adequate pain relief to prevent the development of comorbidities and complications of existing conditions. Noori et al. (2019) emphasize that tailored and active pharmacotherapy with optimally selected drugs is crucial for effective pain relief.
Reference
Noori, S. A., Aiyer, R., Yu, J., White, R. S., Mehta, N., & Gulati, A. (2019). Non-opioid versus opioid agents for chronic neuropathic pain, rheumatoid arthritis pain, cancer pain and low back pain. Pain Management, 9(2), 205–216. Web.