Polyneuropathy is a painful condition, severe enough that, it often leads physicians to make the decision to initiate opioid therapy for pain relief. Gaining insight into the effects of long-term opioid use in patients with polyneuropathy may provide physicians with valuable information that could drive positive change in the management of the condition.
Polyneuropathy is a condition characterized by symptoms of numbness, burning sensations and weakness due to the nerve damage resulting from disease or injury. This common condition, often seen in the elderly, has a profound effect on the functional aspects of a patient’s life.
Opioid use for the treatment of pain has been long established within the medical community and has proven its worth for use in the short-term. However, long-term use, which is considered as 90 days or more, can lead to problems rather than solutions. Long-term use of opioids is associated with depression, addiction, dependence and overdose.
A retrospective study conducted in Minnesota, USA assessed the number of opioid prescriptions given, length of opioid treatment and subsequent outcomes for a group of patients diagnosed with polyneuropathy.
The study found that patients receiving long-term opioid therapy reported pain more frequently than patients receiving short-term therapy. In addition, long-term opioid therapy was associated with increased reports of issues with daily activities such as using the stairs and attending work. Some patients receiving long-term opioid therapy did not report a worsening or improvement of their condition, indicating that their condition simply remained the same.
A key finding of the study was that long-term opioid therapy led to an increased risk of adverse outcomes including depression, overdose and dependence. In addition, doctors who have specialized training in the treatment of conditions like polyneuropathy were not responsible for the majority of prescriptions written for long-term opioid therapy. This indicates a need for the cases of patients on short or long-term opioid therapy to be reviewed by neurologists or pain specialists at regular intervals.
The primary aim of opioid therapy is to help polyneuropathy patients manage their pain and improve their quality of life. This study, however, suggests that the long-term use of opioids does not necessarily improve function in these individuals, but has potential to worsen functional aspects and lead to negative outcomes such as unemployment and depression.
Since polyneuropathy is a long-term condition, it is important that it is treated effectively and safely in order to reduce the burden of pain and improve the quality of life. Therefore, causing further complications for patients by inappropriate use or overuse of medications such as opioids is unacceptable and must be minimised. Obtaining data, such as that presented in this study, is valuable as it provides physicians and patients with the information needed to make informed decisions when considering opioid therapy.
The authors state that their results demonstrate that polyneuropathy increases the risk of long-term opioid use, which does not necessarily improve patients’ comfort or quality of life and may lead to additional problems for patients. They highlight the importance of counselling patients with polyneuropathy who are considering or have already commenced opioid therapy on the associated risks. Finally, these findings could potentially prompt a change in current health guidelines used to treat polyneuropathy.
Written By: Jade Marie Evans, MPharm, Medical Writer