Popular opioid painkiller doesn’t ease chronic pain: new study

Talk about a dose of disappointment.

A new analysis suggests that millions of Americans with chronic pain are being prescribed an opioid that likely does little to ease their suffering.

To make matters worse, the research indicates the drug significantly increases the risk of serious side effects — including heart disease, the nation’s leading killer.

Across the US, 51.6 million adults — roughly 1 in 5 — live with chronic pain, according to the Centers for Disease Control and Prevention. For 17.1 million of them, the agony disrupts work, daily activities or both.

Tramadol has been widely used to relieve that pain, with doctors writing 16 million prescriptions for the short-acting opioid in 2023 alone.

Long considered a “safer alternative” to stronger opioids, tramadol isn’t as heavily regulated as other drugs in its class and has a reputation for causing fewer side effects and carrying a lower risk of addiction.

Conflicting findings from the limited research that has been published prompted a group of Danish scientists to ask: Is tramadol really effective and safe for treating chronic pain?

To find out, they reviewed 19 clinical trials involving 6,506 people taking tramadol to manage chronic pain stemming from ailments such as fibromyalgia, osteoarthritis and nerve damage or dysfunction.

The average age of participants was 58. Tablets were the main form of medication, with treatment lasting between two and 16 weeks.

The pooled analysis showed that while tramadol eased some pain, the effect was small and fell below the threshold considered clinically effective.

Eight of the trials also found that tramadol users faced a higher rate of serious side effects. Statistical analysis showed they had twice the odds of suffering harms linked to the drug compared to those on a placebo during follow-up periods of seven to 16 weeks.

This increased risk was largely driven by a higher number of “cardiac events,” including chest pain, coronary artery disease and congestive heart failure.

Tramadol also appeared to raise the risk of milder side effects such as nausea, dizziness, constipation and sleepiness.

The drug may be linked to a higher risk of certain cancers, though researchers called this finding “questionable” due to the short follow-up period.

The research team acknowledged a high risk of bias in the study outcomes but suggested that the positive effects of tramadol were likely overstated, while the negative effects were probably downplayed.

“The potential harms associated with tramadol use for pain management likely outweigh its limited benefits,” they concluded. 

These findings — published Tuesday in BMJ Evidence Based Medicine — come as the US continues to struggle with an opioid crisis, which has claimed hundreds of thousands of lives since it began in the late ’90s.

Studies show that up to 12% of people treated with opioids for chronic pain end up addicted to the drugs or misuse them, increasing their risk for adverse outcomes like overdose.

President Trump declared the epidemic a national public health emergency in 2017, and in the years since, the death toll has continued to rise.

“In the United States, the number of opioid-related overdose deaths increased from 49,860 in 2019 to 81,806 in 2022,” the study authors noted.

“Given these trends and the present findings, the use of tramadol and other opioids should be minimized to the greatest extent possible.”