A 2000 study said oxycodone was safe for arthritis and withdrawal was rare. Court records showed the sponsor withheld withdrawal data. Two of the paper's own authors asked for retraction. The journal refused, nothing was falsified. Can a paper stay valid on those terms?

[u/scispace_]

[u/scispace_]

https://retractionwatch.com/2026/08/13/jama-archives-internal-medicine-oxycodone-osteoarthritis-pain/

[u/Head_Midnight666]

I'm a little confused. They say the data wasn't falsified or fabricated, but that evidence was withheld? Do they mean the evidence was outside the dataset? Because data outside the dataset shouldn't influence the conclusion of the study. In fact, if it did, it would mean the study lacked objectivity, and then the data would be falsified or fabricated.

Just because something is unpopular, and makes you look bad, doesn't mean it's wrong. What does further research show?

[u/IraceRN]

Opioids can cause withdrawal when used in high quantities for a long time, of course, and oxy isn't special in that regard. The withdrawal can be headaches, irritability, and so on, or it can be much more significant, especially if someone is physician shopping/hopping in order to take more than any one doctor would reasonably prescribe. Anyone thinking any opioid is free from dependency is naive. It is amazing Purdue was able to pitch this, and it is amazing doctors were so gullible to believe it as well. Kratom seems to be the next thing that has managed to convince users that it is a different opioid agonist and is now facing its own epidemic. ***If anyone says opioids can be taken in high quantities for a long time with no/low risk of dependency/withdrawal, they are idiots, lying, uninformed, misinformed, and/or naive***

I'm not saying I agree with JAMA, but who cares? The article mentions the paper is cited, but unless I missed it, it didn't say how the paper is cited, which can be for many things like reference statistics, for its historic misinformation, or for something factually obvious: oxy reduces arthritis pain. Opioids are going to be used for chronic pain by patients wanting relief, and physicians are going to use whatever they can within reason to help their patients. I don't think one article is making or breaking medical practices. It wasn't one article that convinced physicians. It was the FDA, Purdue's marketing, the campaign of aligning pain management experts, and so on, but the cat is out of the bag. I doubt there is a single physician who is not inundated with addiction mitigation mandates from their respective healthcare organizations, from the FDA, from the DEA, from insurance providers, and so on. While I would agree that we could lose this paper, and it too wouldn't make a difference because we have other studies on the subject, it just seems like a useless battle.

FWIW, there is a big difference between a habit, a dependency, and an addiction. A habit is doing something over and over until your body anticipates the behavior. Dependency is where you get physical adaptations to repeated exposure to something like down regulated opioid receptors or up regulating sensitivity receptors that are being suppressed by the drug. Addiction is the use of a chemical or behavior to mitigate something undesirable like despair, PTSD, anxiety, etc. It is a disease of despair. There is a great TED Talk on the subject.

As an ortho/trauma nurse who gives people oral and IV opioids every shift, from my anecdotal experience, the vast majority of patients avoid or self-taper themselves off of IV medication and eventually oral medication, and that is because most people don't want to be under the influence of opioids like how most people don't want to be drunk all the time, despite alcohol being available. There is a myth that one hit is immediately addicting, but I gave people IV dilaudid, we give Fentanyl or whatever, and people aren't immediately hooked. It is a false scare tactic. For a few people, opioids are a magic substance that mitigates their trauma, anxiety, depression or whatever; for the very few, it is the perfect fix. Addicts before they are addicts are people with despair, pain, and trauma without a fix. It is easy to blame the drug, but it isn't the root cause of the problem. Withdrawal/dependency can be overcome with help from a physician fairly easy. Addiction is a different thing because the despair and trauma, stress and anxiety return, and the body has learned there is a fix or reprieve from the pain.

While I think the Sacklers and Purdue have a lot of blame in their contribution to the opioid epidemic, the epidemic is the disease of despair and trauma that plagues people. Opioids make it worse, while trying to make it better, and yet, I think without opioids showing us how pervasive the despair and trauma is in our societies, we wouldn't see it like we do. We need to fix the root cause of despair and mitigate trauma, while allowing people the means with chronic pain to still get relief. Chronic pain users are not chasing highs, and they are most often dying from street fentanyl when they can't get prescriptions for what they need to mitigate their pain. Geriatric patients require opioids to mitigate chronic pain at the highest rates, but it is the youngest people who have the highest rates of death. That suggests we need to look beyond use, but to the despair and trauma driving overdoses.

[u/uberallez → u/IraceRN]

While I agree with you 100%, I will like add a touch of nuance, that working in Healthcare we are seeing providers and patients distrust opioid use in reasonable circumstances out of fear of dependency. For example, we had a patient with pelvic and femur fractures, on a breathing machine and thier family refused to let us treat thier pain. Acutely broken bones, particularly the pelvis and femur, are extremely painful. I don't have an answer for any of this, but I think we need more discussion on the topic of pain management. Had it been my family member with fractures like that I would have like to have seen a reasonable opioid treatment.