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The known risks of opioids have focused attention on whether they are effective for alleviating noncancer pain. In this meta-analysis, researchers identified 96 randomized, controlled trials (26,000 total patients) in which neuropathic, nociceptive, and central pain conditions were evaluated. Median daily morphine-equivalent dose was 45 mg; median follow-up was 60 days. Most of the studies were industry funded.
Compared with placebo, opioids conferred a statistically significant, but modest, pain-relief benefit (mean, 0.79 cm on a 10-cm visual analog scale); an even smaller difference occurred in studies that had 3-month or longer follow-up (0.69 cm). Both results failed to meet the prespecified 1-cm minimally important difference (MID). Sim…