Topical Analgesics Aid Opioid Discontinuation, Pain Management

A woman applying a topical analgesic for chronic pain
A woman applying a topical analgesic for chronic pain
In a recent study, about half of the study patients taking opioids who were prescribed topical analgesics for pain management discontinued their opioids after 3 to 6 months of treatment.

Study data published in the Journal of Postgraduate Medicine showed that about half of study patients taking opioids and who were prescribed topical analgesics for pain management discontinued their opioids after 3 or 6 months of treatment. 

Opioid-experienced patients with chronic pain are at risk for misuse and abuse of, and addiction to opioids. Study authors described the lack of safe and effective “opioid-sparing multimodal alternative treatment strategies and approaches” for these patients.

To better understand the role of topical analgesics, they reported on a subset analysis (n=121) from the Optimizing Patient Experience and Response to Topical Analgesics (OPERA) Study that evaluated changes in opioid use, other concurrrent medication use, and pain severity and interference in opioid-experienced patients who received topical analgesics for chronic pain.

One of 4 classes of topical prescription ingredients—diclofenac, ketoprofen, flurbiprofen, or other non-NSAID formulation— were prescribed and patients were followed up at 3 and 6 months. Of the chronic pain patients taking opioids at study initiation, 49% in the 3-month and 56% in the 6-month groups reported complete discontinuation of opioids. Moreover, 31% of patients in the 3-month and 30% at the 6-month follow-up reported no use of any pain medications. 

Use of concurrent medications were lowered by 65% after 3 months and by 74% at 6 months. Study authors also reported statistically significant reductions in pain severity and interference scores from baseline in the 3-month and 6-month groups. 

Based on the analysis, the authors were able to conclude that 3- and 6-months treatment with topical analgesics effectively cut opioid and other concurrent medications use among opioid-experienced patients with chronic pain, and reduced pain severity and interference.

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“In addition to previous results showing that topical analgesics were associated with reductions of up to 60% in the use of concurrent pain medications, including oral opioid analgesics, we now have data reflecting discontinuation of opioids after being treated with this therapy for 3- and 6-months. Especially in today’s environment, identifying treatments other than opioids for clinicians to prescribe to their pain patients has become a priority,” concluded lead author Jeffrey A. Gudin, Englewood Hospital and Medical Center, Englewood, NJ. 

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Gudin JA, Brennan MJ, Harris DE, Hurwitz PL, Dietze DT, Strader JD. Reduction of opioid use and improvement in chronic pain in opioid-experienced patients after topical analgesic treatment: an exploratory analysis [published online December 22, 2017]. Postgrad Med. doi: 10.1080/00325481.2018.1414551

This article originally appeared on MPR