A comprehensive review led by researchers from the University of Sydney has found that opioid pain relievers, often prescribed for acute pain, provide only small and short-lived relief for many conditions. The study, which includes an analysis of 59 systematic reviews covering over 50 acute pain conditions in both children and adults, was published in March 2026 in the prestigious journal Drugs.
The review indicates that while opioids such as codeine, morphine, oxycodone, and tramadol are among the most commonly prescribed treatments, they do not significantly outperform placebo in the vast majority of acute pain situations. According to lead author Christina Abdel Shaheed, an Associate Professor at the University of Sydney’s School of Public Health, “Opioids did not provide large or lasting pain relief compared with placebo for the vast majority of acute pain conditions, with pain relief typically lasting only a few hours.”
Key Findings on Efficacy and Risks
The research highlights that oral opioids were only marginally more effective than placebo for acute musculoskeletal pain within the first six to 48 hours of treatment. Furthermore, opioids were associated with increased risks of side effects, including nausea and vomiting, especially when used for acute musculoskeletal pain, certain types of post-surgical pain, or traumatic limb pain.
The review revealed that opioids only offered limited pain relief for conditions such as stomach pain, dental surgery, and pain following childbirth or caesarean sections. Notably, they were no more effective than placebo for several key conditions, including some limb surgeries and kidney stone pain.
“By showing that the benefits are generally small, short-lived, absent for many common conditions, and sometimes harmful, our research challenges the widely held belief that opioids are the most effective ‘go-to’ option for acute pain,” Abdel Shaheed stated.
Concerns About Long-term Use
The study raises significant concerns regarding the frequent prescription of opioids for acute pain management. Dr. Stephanie Mathieson, co-first author and a researcher at the University’s Institute for Musculoskeletal Health, warned about the rapid development of persistent opioid use, which can occur within days of first-time use.
“Patients must be informed about the potential harms of opioids when prescribed these medications,” Mathieson emphasized. She urged healthcare providers to prescribe opioids judiciously, recommending the lowest effective dose for the shortest duration necessary.
Co-first author Associate Professor Joshua Zadro echoed these sentiments, stating that the findings are crucial for patients of all ages experiencing acute pain, as well as for healthcare professionals and policymakers tasked with regulating opioid use in the community.
The study highlights the urgent need for better reporting of opioid-related side effects in clinical trials. It underscores the importance of exploring safer and more effective alternatives for managing acute pain, as regular opioid use poses significant risks, including dependence and overdose.
As the medical community continues to grapple with the implications of opioid prescribing practices, this comprehensive review serves as a critical resource in reassessing the role of opioids in acute pain management.
