Limited role for opioids in non-cancer pain

He Ako Hiringa
2 October 2023

There is little evidence to support the use of opioids for chronic non-cancer pain. If used long-term, opioids carry a significant risk of poor outcomes, are not any more effective than simple analgesics, and may worsen pain.1–4

When opioids are used for the treatment of acute pain, they should be used for the shortest duration possible because the risk of chronic opioid use increases with each additional day of supply.5

Opioid overdose deaths in Aotearoa have increased in recent years, making it even more important that these medicines are supplied and used appropriately.6

Explore opioid use – which medicines have been dispensed, trends over the last four years, duration of use, and concomitant use with sedatives – on the EPiC Opioids dashboard


  1. Krebs EE, Gravely A, Nugent S, et al. Effect of opioid vs nonopioid medications on pain-related function in patients with chronic back pain or hip or knee osteoarthritis pain: The SPACE Randomized Clinical Trial. JAMA 2018;319:872–82.
  2. Jones CMP, Day RO, Koes BW, et al. Opioid analgesia for acute low back pain and neck pain (the OPAL trial): a randomised placebo-controlled trial. Lancet 2023;402:304–12.
  3. Brown V. How to treat: Persistent pain. New Zealand Doctor Rata Aotearoa, August 2023.
  4. Schug SA, Scott DA, Mott JF, et al. APM:SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. Acute Pain Management: Scientific Evidence (fifth edition 2020), ANZCA & FPM, Melbourne: 2020.
  5. Shah A, Hayes CJ, Martin BC. Characteristics of initial prescription episodes and likelihood of long-term opioid use – United States, 2006–2015. Morbidity and Mortality Weekly Report 2017;66:265–69.
  6. NZ Drug Foundation. Fatal overdoses in Aotearoa 2017-2021.