After doctors cut their opioids, patients turn to a risky treatment for back pain

The anti-inflammatory drug methylprednisolone acetate (Depo-Medrol—Pfizer) is growing in popularity among people with back pain as doctors turn away from opioids. The drug is approved for injection into muscles and joints.

The anti-inflammatory drug methylprednisolone acetate (Depo-Medrol—Pfizer) is growing in popularity among people with back pain as doctors turn away from opioids. The drug is approved for injection into muscles and joints. Doctors have long given methylprednisolone acetate close to the spinal cord for painful backs, necks, and conditions like spinal stenosis. However, Pfizer—faced with hundreds of complaints about injuries and complications related to the injections—asked FDA to ban that type of treatment 5 years ago. The company cited the risk of blindness, stroke, paralysis and death—a request that neither the agency nor Pfizer made public. FDA declined to issue a ban but toughened the label warning. Other countries—including Australia, Brazil, Canada, France, Italy, New Zealand, and Switzerland—heeded Pfizer's request. After concerns were raised about the off-label treatments, use of the injections declined. But the opioid epidemic appears to be spurring their popularity despite risks known to public health officials and doctors. The number of Medicare providers giving steroid injections along the spine increased 13% in 2016 from 2012. The number of Medicare beneficiaries receiving these injections is up 7.5%. The Department of Veterans Affairs reported a 17% increase in the injections from 2015 to 2017. Total sales of methylprednisolone acetate grew 35% to $185 million from $133 million from 2015 to 2017, according to the IQVIA Institute for Human Data Science.