Background & Aims
Chronic non-cancer pain (CNCP) is a global health problem with a significant increase in opioid prescriptions over the past two decades. However, opioid therapy is linked to a range of adverse events as well as a risk for abuse, overdose, and opioid-related death. Despite these risks, reducing or stopping opioid consumption can be challenging, and existing adjunctive therapies are typically time-consuming, difficult to access, embedded outside the patient-physician encounter, and costly. In this context, the administration of an open-label placebo (OLP) treatment, i.e., the placebo treatment with full disclosure of being a placebo, might be a promising strategy for medication dosage reduction. OLPs have been shown to be an effective treatment in CNCP syndromes, with patients exhibiting significant improvement in pain relief. However, there is a lack of trials that examine OLP as adjunctive treatment for the reduction of opioid medication in the CNCP population.
Methods
The following study conducts a mind-body intervention involving open-label placebos. It is structured as a randomized, controlled single-center trial comprising two parallel groups. Eligible participants must have experienced CNCP for a minimum of six months and have been on opioid medications for over three months. Both groups will record their daily opioid intake throughout the six-week study period, with the intervention group receiving oral placebo pills as the investigational product. The primary outcome is the quantity of opioid analgesics taken in the last week compared to intake at the beginning of the study. Secondary outcome variables include, among others, subjective opioid withdrawal, pain severity, pain interference, and pain experience.
Results
Results are anticipated. The study setup is currently in progress, with recruitment scheduled to commence in March. We expect to have initial results by August 2024, which can be presented at the IASP congress. We hypothesize that at the end of the study, the opioid dosage will be significantly lower in the OLP intervention group compared to the control group. Additionally, we hypothesize that the OLP intervention group will experience significantly fewer opioid withdrawal symptoms at the end of the study compared to the control group.
Conclusions
OLPs are suitable for the controlled reduction of long-acting opioids that are embedded in the planned reduction regimen, and could provide a means of harnessing analgesic placebo effects in patients with CNCP, without any loss in pain management efficacy. The major goal of our study is therefore to support participants in their aim to reduce their opioid intake.
References
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Presenting Author
Kiara Bodonyi
Poster Authors
Kiara Bodonyi
MSc
University of Zürich
Lead Author
Topics
- Placebo