# Higher opioid doses for back pain linked to increased overdose risk

- Published: 2026-11-08 14:24 UTC
- Section: Life & Health › Medicine
- Tags: opioid use disorder, back pain treatment, overdose risk, nonpharmacologic therapy, Medicaid study
- URL: https://realtech.media/news/rt-8a852eb82ddf375b38f8330d_higher_opioid_doses/

**A study finds that higher initial opioid doses for acute low back pain significantly raise the risk of opioid use disorder and overdose.**

![Higher opioid doses for back pain linked to increased overdose risk](https://realtech.media/media/2026/11/b7466f77b9b08be2.jpg)
*U.S. Department of Agriculture, Wikimedia Commons, Public domain*

A retrospective cohort study published in JAMA Network Open examined the incidence of new opioid use disorder (OUD) or overdose diagnosis among opioid-naive Medicaid patients treated for acute low back pain (aLBP) from January 1, 2016, to December 31, 2019. The study included 399,500 adults under 65 years old, with a median age of 39, and 59.5% were female. The cumulative incidence of OUD or overdose diagnosis was 1.4% at 7 months and 2.3% at 13 months.

## Opioid Treatment Risks
Initiating treatment with higher-dose opioids (greater than 50 mg of morphine equivalent) was associated with a 146.6% increased risk of OUD or overdose compared to not initiating opioids. Lower-dose opioids prescribed for more than 7 days also increased the risk by 105.2%, while gabapentinoids raised the risk by 101.6%. In contrast, nonpharmacologic therapies, such as chiropractic care and physical therapy, were linked to reduced risks of OUD or overdose diagnosis.

## Nonpharmacologic Benefits
Chiropractic care was associated with a 32.8% reduction in risk, while physical therapy showed a 31.1% decrease. These findings suggest that nonpharmacologic treatments should be prioritized as first-line therapy for aLBP. The study highlights the importance of treatment choices in managing pain and the potential long-term consequences of opioid prescriptions.

## Sources

1. [JAMA Network Open](https://doi.org/10.1001/jamanetworkopen.2026.39420)
2. [knowridge.com](https://knowridge.com/2026/11/higher-opioid-doses-for-back-pain-tied-to-greater-overdose-risk)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-8a852eb82ddf375b38f8330d_higher_opioid_doses/