Opioid Prescriptions for Non-Cancer Pain Primarily for Musculoskeletal Conditions, Study Finds

Amid growing concerns over opioid prescription rates and related harms in the U.K., a recent study reveals that nearly 75% of new opioid prescriptions for non-cancer pain are for musculoskeletal conditions, particularly osteoarthritis and lower back pain. Conducted by The University of Manchester and affiliated institutions, this large-scale study examined primary care records from over two million patients to understand the common conditions linked to opioid initiation. The findings underscore the potential need for alternative approaches to chronic pain management in musculoskeletal conditions.

Musculoskeletal Conditions Are the Leading Cause of Opioid Prescriptions

The study analyzed primary care data from 2006 to 2021, finding that the vast majority of new non-cancer pain opioid prescriptions were for musculoskeletal conditions. Conditions like osteoarthritis and lower back pain were most prevalent, even though there is limited evidence supporting opioids' effectiveness for these chronic pain types. This is especially concerning given the known risks of dependency, adverse effects, and limited therapeutic benefit in these cases.

Professional bodies like the National Institute for Health and Care Excellence (NICE) and the Royal College of Anesthetists currently advise against strong opioids for conditions such as osteoarthritis, but opioids remain a common prescription option for these patients.

Implications for Opioid Prescribing Practices

The findings add to a growing body of data about opioid-related harms in the U.K. For example, between 2008 and 2018, opioid-related hospitalizations increased by nearly 49%. This rise in opioid prescriptions and related harms signals the need to re-evaluate prescribing practices, especially given the aging population and the rise in chronic conditions like osteoarthritis, which often lack effective pharmacological treatments.

“While our study does not aim to evaluate the appropriateness of opioid prescriptions, it uses nationally representative data to increase awareness of the possible reasons for opioid initiation in U.K. primary care,” said Carlos Ramirez Medina, one of the study’s authors. The research team hopes their findings will support targeted interventions and encourage policies that prioritize non-pharmacological options for managing chronic musculoskeletal pain.

A Call for Non-Pharmacological Alternatives

These results highlight the importance of non-drug alternatives, especially given the risks opioids pose for patients who may be at higher risk of adverse effects due to age or coexisting medical conditions. According to the study’s senior author, Dr. Meghna Jani, shared decision-making between healthcare providers and patients is essential, particularly for groups where opioids could lead to more harm through side effects or interactions with other medications.