Disability and quality of life following long-term opioid therapy in patients with chronic low back pain

Purpose: To compare the effects of long-term opioid therapy versus no opioid therapy on self-reported disability and quality of life (QOL) in patients with chronic low back pain (CLBP). Methods: Patients with CLBP enrolled in the PRECISION Pain Research Registry were grouped according to opioid use. Patients reporting opioid use for 12 consecutive months were classified as opioid users; patients reporting no opioid use for 12 consecutive months were classified as opioid non-users. Disability (Roland Morris Disability Questionnaire) and QOL (29-item Patient-Reported Outcomes Measurement Information System) were compared using multiple linear regression. Results: There were 78 opioid users and 134 non-users. Opioid users were significantly older and reported significantly higher measures of depression and pain intensity. Opioid users reported greater disability (17.1 vs 10.84, p< 0.001), sleep disturbance (57.9 vs 54.7, p< 0.001), pain interference with activities (66.1 vs 57.9, P< 0.001), anxiety (54.1 vs 51.0, p=0.04), and fatigue (61.3 vs 55.0, p< 0.001); less participation in social roles (40.9 vs 48.5, p< 0.001); and lower physical function (34.3 vs 40.6, p< 0.001). With the exception of anxiety, these findings did not change after controlling for age, body mass index (BMI), depression, and pain intensity. Conclusions: After controlling for age, BMI, depression, and pain intensity, patients with CLBP receiving long-term opioid therapy reported significantly greater disability and poorer QOL compared to those receiving no opioid therapy. The findings of this study draw into question the utility of long-term opioid therapy for CLBP.