Analysis finds that the benefits of opioids for acute pain are limited

Opioids provide only small relief for some acute pain conditions and are no better than a placebo for other conditions, according to a meta-analysis of systematic reviews conducted by researchers at the University of Sydney School of Public Health in Australia.

The review, which was published in February 2026 in Drugs, includes 59 systematic reviews covering more than 50 acute pain conditions.

“Opioids are among the most commonly prescribed treatments for acute pain; however, 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,” Christina Abdel Shaheed, lead author and associate professor at the University of Sydney School of Public Health, said in a news release.

Opioids, such as codeine, morphine, oxycodone and tramadol, are commonly used to manage various pain conditions. However, concerns over opioid use and misuse continue even as deaths from opioid overdose fall.

Shaheed and her colleagues searched electronic databases for randomized trials comparing opioids with placebo or no active treatment for any acute, nonmalignant pain between 2010 and March 2005. Databases searched include MEDLINE, Embase, PsycInfo, CINHAL and the Cochrane Database of Systematic Reviews. In their analysis, researchers included 59 reviews.

What they found was that opioids provide only small, time-limited pain relief for some pain conditions, such as stomach pain, dental surgery, ear procedures, traumatic limb pain, pain following childbirth, caesarean pain and bunionectomy (bunion removal).

But opioids were no better than placebo for some limb surgeries, kidney stone pain, pain after removal of tonsils and pain in newborns on assisted breathing devices. Additionally, opioids were not consistently beneficial over time for heart-related pain, pain following hysterectomy and topical use for dermatological pain.

Furthermore, opioids increased the risk of side effects compared with placebo when used for acute musculoskeletal pain, traumatic limb pain and pain after some types of surgery. Side effects included nausea and vomiting. However, inadequate reporting of side effects in some studies means the true risks of these medicines are likely underestimated.

The researchers cautioned that their analysis only captured reviews since 2010, and some evidence may have been missed. “Our approach to determine the certainty of evidence was to use GRADE [Grading of Recommendations, Assessment, Development and Evaluation recommendations] to provide confidence ratings for pooled estimates. GRADE considers the risk of bias of trials contributing to pooled estimates rather than the overall methodological quality of individual systematic reviews,” they wrote.

Another limitation, they said, was that safety data were missing from many reviews, which could lead to an unequal weight for benefits and harms.

Still, researchers said their review “extends the current knowledge that some opioid analgesics are not safe or effective and is a critical finding that can enhance patient care and should be considered when relevant clinical guidelines are reviewed and updated.”