Topic Spotlight

Pain Care and Opioids

PCORI Answers Critical Questions

Evidence gaps can make it difficult to know which pain treatments work best while reducing the risk associated with long-term opioid use, given a patient's needs. PCORI funds studies that seek to help patients, clinicians and others answer questions they might have about treatment options, such as:

Patient: After hearing so many stories of people who struggled with opioid addiction, I’m afraid to use these drugs for my low back pain. Would mindfulness meditation work as well as pain drugs for me?

Patient: I don’t feel comfortable speaking up when I don’t understand what my doctor is telling me about managing my chronic pain. What would help me get more involved in making choices about my pain care?

Clinician: I see many patients with chronic pain who have trouble going about their day-to-day business. Other than prescribing them opioids, what are other strategies I could present that have proven effective in reducing chronic pain?

Study Results that Support Better-Informed Decisions

A photo of the back view of a male adult in exercise attire, as he grabs his lower back in pain. A red spot highlights his pain. Comparing Ways to Treat Back Pain Using a Stratified Risk Approach

A PCORI-funded study aimed to test whether a risk-stratified approach to treatment in primary care settings would result in lower rates of patients with acute back pain developing chronic back pain. To assess chronic pain risk, researchers at the University of Pittsburgh asked patients questions about how they were coping with back pain and assigned them to either low-, medium-, or high-risk groups. Patients who scored high risk were placed into two groups: usual care or usual care plus psychologically informed physical therapy, which also teaches patients coping skills to manage back pain. As reported in EClinical Medicine, among patients at high risk, 50 percent developed chronic back pain regardless of type of care, while 20 percent of low-risk and 33 percent of medium-risk patients developed chronic low back pain.

Pain Care and Opioids Study Spotlights

Tackling Chronic Pain While Reducing Opioid Use

This study found that a clinical plan to encourage safe opioid prescribing for pain succeeded in lowering patients’ doses.

People Involved in Chronic Pain Research

Hear about several comparative clinical effectiveness research studies that aim to help patients and those who care for them make better-informed decisions about their options for managing chronic pain.

Non-Opioid Therapies for Chronic Low Back Pain

This study compares how well cognitive behavioral therapy and mindfulness meditation work in mitigating pain and enabling people to reduce or discontinue opioid use.

Pain Care and Opioids Portfolio Snapshots

The most studied populations of interest among PCORI-funded pain care and opiods projects, for noncancer pain-related studies and opioid-related studies.
Funded projects by stage of opioid prevention/treatment: Prevention/Non-opioid alternatives (15), Treatment for opioid use disorder (11), Long-term therapy (9), Prevention/Unsafe prescribing (5), As of April 2019