Emergency Medical Minute

Contributor: Jared Scott MD Educational Pearls: Should we use opioids to treat low back and neck pain? The OPAL Trial, published in The Lancet, in June 2023, attempted to answer this very question. Objective: Investigate the efficacy and safety of a short course of opioid analgesic (oxycodone-naloxone) for acute low back pain and neck pain. Trial Design: Triple-blinded, placebo-controlled randomized trial, conducted in Emergency and Primary Care in Sydney, Australia, involving adults with 12 weeks or less of low back or neck pain. Participants: 347 recruited adults (174 in the opioid group, 173 in the placebo group) with at least moderate pain severity. Intervention: Participants were assigned to receive either an opioid or a placebo for up to 6 weeks. Primary Outcome: Pain severity at 6 weeks measured with the pain severity subscale of the Brief Pain Inventory (10-point scale). Results: No significant difference in pain severity at 6 weeks between the opioid group (mean score 2.78) and placebo gr