By Neen Monty The headline in Physician’s Weekly screams alarm: “Rising Use of Potent Opioids in Chronic Pain Management” And then th
The headline in Physician’s Weekly screams alarm:
“Rising Use of Potent Opioids in
Chronic Pain Management”
And then the sub heading:
“Long-term opioid use for chronic pain doubled, with potent opioids rising, underscoring the need for stronger guideline adoption”
Terrifying, right? We must do something!
But now, read the article. It’s based on a study recently published in the European Journal of Pain on the prevalence of long-term opioid therapy (LTOT) when treating patients with chronic non-cancer pain…
…And what did they find?
“The prevalence of LTOT increased twofold from 0.54% (95% CI: 0.51–0.58) per 100 patient years in 2013 to 1.04% (95% CI: 1.00–1.07) in 2022. The proportion of LTOT episodes solely involving potent opioids slightly increased between 2013 and 2022”
In plain English, the prevalence of long-term opioid use by patients at the end of the study was just over 1%.
Yes, that’s right: 1%.
And the prevalence increased by just half a percentage point over a decade.
Hardly a crisis. Hardly anything to scream about…
…This tactic is often used in presenting medical research – using relative percentages rather than the actual numbers. That is because relative percentages -- Opioid Use Doubled! -- sounds worse than “Opioid Use Increased by Half a Percent.”
It’s a trick that researchers and the media use all the time…
…It was nice to see some accurate reporting in Scimex, an Australian online news portal that tries to help journalists cover science.
Instead of the usual deceptive, sensationalist headlines, this one tells the truth:
“Pain Reprocessing Therapy (PRT) could help those with mild chronic back pain”
This was so refreshing to see! Because it’s so very, very rare.
Most reporting on PRT glosses over a critical point: It has only been studied in people with mild, non-specific back pain. An average of 4/10 on the pain scale.
That nuance is often lost in the hype about alternative treatments like PRT, cognitive behavioral therapy, mindfulness and TENS units.
You do not treat 8/10 back pain the same way you treat 4/10 back pain.
So what happens when people are misled? PRT is recommended to people with severe, pathological pain - often with clearly identifiable causes - and everyone acts surprised when it doesn’t work.
Let’s be clear:
* PRT is not for severe back pain
* PRT is not for pain caused by pathology
* PRT is not a cure-all
But you wouldn’t know that from the headlines about PRT, such as “New therapy aims to cure back pain without drugs, surgery” and “A New Way to Treat Back Pain.”
We’ve all seen the bold claims: People cured after 10 years of chronic pain! Life-changing results! Breakthrough treatment!
Then you read the small print: All the participants had non-specific back pain from an unknown cause. And they had mild pain.
This kind of spin harms people with severe chronic secondary pain. It feeds the narrative that if you're still in pain, then it’s your fault. You didn’t try hard enough. You’re catastrophizing. You need to retrain your brain.
It feeds the stigma that all chronic pain is mild and easily curable. And that anyone who says their pain is severe, has psychological problems.
No. Maybe their pain is caused by pathology, like tissue damage or herniated discs. Maybe their pain is nociceptive or neuropathic.
This is why chronic pain patients must be included on every research team. Someone with real-world, high-impact chronic pain would never let this kind of misrepresentation slide. And the rest of the team wouldn’t be able to claim ignorance.
We need more honesty and integrity in research and the media. We need headlines that reflect the actual findings. We need conclusions that match the data, not some predetermined narrative. Right now, most media coverage doesn’t even try. (Read more at link)
I usually don’t paste as much from an article (so authors can get paid for traffic) but I thought it was very important to have the examples here instead of behind a link. And as long as it is it’s still not the full article, which I avoid doing.
In any case, the big takeaway is that headlines are not the story, read the article and decide for yourself if the data is convincing or being manipulated. The opioidphobes are determined to take the medication us chronic pain patients desperately need away because of how they hate addicts. Don’t let them fool you.
