Reduction of opioid use and improvement in chronic pain in opioid-experienced patients after topical analgesic treatment: an exploratory analysis

ABSTRACT

Objective: There is a need to identify safe and effective opioid-sparing multimodal alternative treatment strategies and approaches, including topical analgesics, for opioid-experienced chronic pain patients to mitigate the risk of addiction, misuse, and abuse of opioids.

Methods: This subset analysis from a prospective, observational study evaluated changes in opioid use, other concurrent medication use, and pain severity and interference in opioid-experienced patients (OEP) treated with topical analgesics for chronic pain with measures obtained at baseline and 3- and 6- month follow-up.

Results: The 3-month opioid-experienced patient (3-month OEP) group included 121 patients who completed baseline and 3-month follow-up assessments; 27 opioid-experienced patients completed baseline and 6-month follow-up assessments (6-month OEP). Demographic characteristics, and mean pain severity and interference scores were similar between groups at baseline. After treatment with topical analgesics, 49% of patients in the 3-month and 56% of patients in the 6-month group reported they had completely discontinued use of opioids. In addition, 31% of patients at the 3-month assessment and 30% at the 6-month assessment reported that they were no longer taking any pain medication. Other concurrent medications decreased by 65% after 3 months, and 74% after 6 months. There were statistically significant decreases from baseline in pain severity and interference scores within the 3- (CI:0.7–1.4, 1.4–2.2) and 6-month (CI:0.7–2.4 (severity); CI:1.2–3.5 (interference)) OEP groups.

Conclusions: Opioid use and other concurrent medications decreased among opioid-experienced chronic pain patients after 3- and 6- months of treatment with topical analgesics. Pain severity and interference scores also decreased. The topical analgesics were reported to be effective and safe for the treatment of chronic pain, with randomized controlled trials needed to confirm these findings.

KEYWORDS:

• Chronic pain
• opioids
• opioid epidemic
• opioid-experienced
• topical analgesics
• pain interference
• pain severity

Acknowledgments

Carole Alison Chrvala, PhD, Health Matters Inc. assisted in editing the manuscript.

Declaration of interest

JAG and MJB received funds for their roles as Principal Investigators and additional protocol-required services. EDH and PLH are employees of Clarity Science. DTD received funds for statistical analysis. JDS is the CEO of Safe Harbor compliance and Clinical Services. Peer reviewers on this manuscript have received an honorarium from PGM for their review work, but have no other relevant financial relationships to disclose.

Additional information

Funding

This manuscript was funded by Annie’s Apothecary, Boothwyn Pharmacy, Cypress Compounding Pharmacy and Safe Harbor Compliance and Clinical Services.