Introducing our 2023 finalists: Dr Caitlin Jones

It is an honour to be celebrating Australia’s research talent at this year’s Health and Medical Research Awards. Generously sponsored by Griffith University, the Discovery Award recognises an early-career researcher who is already making an important impact with their work.

Among the Discovery Award finalists for 2023 is Dr Caitlin Jones, who was awarded her PhD earlier this year and has already demonstrated research excellency through her leading role in the OPAL trial: a 12-month long study on the use of opioids for treating back pain.

BACK PAIN AND OPIOID PRESCRIPTION: MORE HARM THAN GOOD

 Lower back and neck pain are two of the most burdensome conditions among adults. Over 619 million people worldwide experience back pain at any one time[1] and between 40-70% of those who present for care are prescribed an opioid.[2]

Despite opioid prescription being common, there is little evidence to support its effectiveness for back pain. The harms from opioid use range from minor side effects like constipation, dizziness and nausea, to long-term harms such as dependence, addiction, and overdose. In Australia alone, opioid use causes 50 hospitalisations, 14 emergency department admissions, and 3 deaths every day – at a cost of over $5 billion each year.[3]

 A WORLD FIRST STUDY AND A CALL FOR CHANGE

Dr Jones was the first author on the OPAL trial, published in The Lancet earlier this year. OPAL was a study of 347 people with acute non-specific back and/or neck pain in which half of the participants received an opioid (oxycodone/naloxone) and the other received a visually identical placebo. The groups were treated for up to six weeks, monitored for 12 months, and evaluated at the 2, 4, 6, 12, 26, and 52 week marks. Participants also reported daily pain scores for the first 12 weeks.

Dr Jones and the team discovered that those in the opioid group had worse outcomes compared to the placebo groups in several measures including pain, quality of life/mental health and physical function.

Current clinical guidelines recommend the prescription of opioids when other treatments have failed or are not appropriate. However, the OPAL trial clearly shows that they should not be used at all for this condition.

“OPAL is the world’s first and largest placebo-controlled trial of opioids for acute back and neck pain. The previous guidelines for opioid use were based on indirect evidence,” explains Dr Jones.

“The OPAL trial will help shift international guidelines and, as a result, reduce the many unnecessary harms caused by opioid prescriptions.”

The winners of Research Australia’s Health and Medical Research Awards will be announced at a gala award ceremony in Sydney on November 2.

[1] World Health Organisation. (2023, June 19). Low back pain. World Health Organisation. https://www.who.int/news-room/fact-sheets/detail/low-back-pain

[2] Ferreira GE, Machado GC, Abdel Shaheed C, et al. (2019). Management of low back pain in Australian emergency departments. BMJ Quality & Safety, 28(10), 826-834.

 [3] National Drug Research Institute. (2020). The cost of opioid use to Australia: $15.7 billion and 2203 deaths. NDRI News.