Despite a dramatic increase in opioid prescriptions in the past two decades, a new federal study says there is no good research to guide doctors on the risks or effectiveness of their long-term use for ailments such as back pain and osteoarthritis.
Dr. Erin Krebs admits that she and fellow experts on a federal task force assigned to evaluate the research were stunned.
"The bottom line is, the research hasn't been done," said Krebs, medical director of the Women Veterans Comprehensive Health Center at the Minneapolis VA.
"I expect when I'm making a major medical decision that someone could give me some numbers," Krebs said. "We still can't do that for opioid therapy. It's sad, and I think it's shameful we don't have more research on this."
About 20 years ago, doctors began expanding their use of opioids such as morphine, oxycodone and hydrocodone for the treatment of chronic, non-cancer pain, reasoning they had a moral obligation to help their patients.
In recent years, however, the widespread use of prescription opioids has sparked alarm: Their use was declared an epidemic in 2007 by the U.S. Centers for Disease Control and Prevention, and the government reported in 2011 that more than half of the nation's 41,340 drug overdose deaths were related to pharmaceuticals.
In Minnesota, 200 people died from overdosing on prescription pain relievers in 2013, according to the Department of Health.
Krebs, an investigator with the VA's Center for Chronic Disease Outcomes Research and an associate professor at the University of Minnesota, was one of the experts who analyzed 39 studies on opioid use since 2008. The study was commissioned by the Agency for Healthcare Research and Quality, a branch of the U.S. Department of Health and Human Services.