The American College of Physicians strongly advises against the use of opioids to relieve back pain. For one thing, opioids don't necessarily relieve pain much better or help you move more easily than over-the-counter anti-inflammatory drugs such as ibuprofen (Advil) or naproxen (Aleve). And while those Over-the-counter drugs do pose some risks when taken long term, they're still much safer than opioids. Narcotic medications often cause side effects such as constipation, drowsiness, headaches, and nausea. The longer you take them, the greater the risk of addiction and overdose, especially when taking high doses.
A recent review in the Journal of the American Medical Association of 20 trials involving nearly 7,300 patients found that opioids didn't provide significant relief for people with chronic back pain. Further, half the participants dropped out early because the medication didn't work, or the side effects were intolerable.
Opioids pose a risk to all patients. Anyone taking prescription opioids is at risk for unintentional overdose or death and can become addicted. From 1999 to 2017, more than 218,000 people died from overdose related to prescription opioids in the United States.1 Up to 1 out of 4 people receiving long-term opioid therapy in a primary care setting struggles with opioid use disorder.
Always remember it is very dangerous to combine opioids with other drugs, especially those that cause drowsiness. Risk of opioid overdose and death increases at higher dosages, and when taken for longer periods of time or more often than prescribed.
In addition to the serious risks of opioid use disorder and overdose, the use of prescription opioids can have a number of side effects, even when taken as directed. Review these with your doctor, so you know what you may expect: