Opioids for Acute Pain: New Research Questions Common Practice

A comprehensive global review of opioid use for acute pain is challenging long-held beliefs about the effectiveness of these widely prescribed drugs. The research suggests that opioids may provide less relief for acute pain than commonly assumed, and in some cases, may not work at all.

Largest Review of Its Kind

Researchers at the University of Sydney led the largest analysis ever conducted on opioid pain medications used for acute pain. The investigation examined the benefits and risks of opioid pain relievers – including codeine, morphine, oxycodone, and tramadol – compared to a placebo in over 50 different acute pain conditions affecting both children and adults. The findings were published in the medical journal Drugs on February 25, 2026 DOI: 10.1007/s40265-026-02284-3.

Modest and Short-Lived Relief

“Opioids are among the most commonly prescribed treatments for acute pain, but, our review found that they 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,” said lead author Associate Professor Christina Abdel Shaheed, from the School of Public Health at the University of Sydney.

Where Opioids Show Benefit – and Where They Don’t

The analysis revealed a nuanced picture of opioid effectiveness:

• Modest, Short-Term Relief: Opioids were associated with only modest, short-term pain relief for certain conditions, including stomach pain, dental surgery, ear procedures, traumatic limb pain, pain after childbirth, cesarean pain, and bunionectomy.
• No Better Than Placebo: For other conditions, opioids performed no better than a placebo. These included some limb surgeries, kidney stone pain, pain after tonsil removal, and pain in newborns requiring assisted breathing.
• Inconsistent Benefits: Benefits were not consistent over time for heart-related pain, pain following hysterectomy, or the topical use of opioids for skin pain.

Increased Risk of Side Effects

The review too found that opioids increased the likelihood of side effects, such as nausea and vomiting, when used for acute musculoskeletal pain, traumatic limb pain, and certain types of post-surgical pain. The authors noted that side effects may be underestimated in clinical trials due to inconsistent reporting.

Potential for Harm and Dependence

While short-term opioid use may reduce pain in some acute situations, the researchers emphasize the risks associated with ongoing use, including tolerance, dependence, misuse, overdose, hospitalization, and even death.

Concerns About Long-Term Use

“Persistent use of opioid medicines can develop quickly following first-time use (sometimes within days), and may arise from regular use for acute pain,” said co-first author Dr. Stephanie Mathieson from the University of Sydney’s Institute for Musculoskeletal Health and School of Pharmacy. She stressed the importance of informing patients about potential harms and prescribing opioids judiciously – at the lowest effective dose for the shortest possible time.

Implications for Patients and Healthcare Providers

Associate Professor Joshua Zadro from the University’s Institute for Musculoskeletal Health and School of Health Sciences added, “These findings are important for patients across all age groups who experience acute pain, doctors treating these conditions, and policy makers who regulate the safe use of these medicines in the community.”

Key Takeaways

• Opioids offer only modest, short-lived relief for many types of acute pain.
• For some conditions, opioids are no more effective than a placebo.
• Opioid use is associated with an increased risk of side effects.
• Long-term opioid use carries significant risks, including dependence and overdose.
• Healthcare providers should carefully consider the risks and benefits of opioids before prescribing them for acute pain.