September 01, 2018

Nonprescription pain relievers are alternatives to opioids

Opioid drugs are among the most powerful pain-relieving drugs available and play an important role in relieving severe short-term pain and cancer pain. However, they can cause many side effects including dizziness, tiredness, constipation and falls. These side effects especially prevalent in older adults. Opioid dependence and overdose death also are serious issues.

In the search for ways to manage pain without opioids, one recent study shows that in certain emergency department settings, the simple combination of ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others) can be as effective in relieving short-term pain as can several common opioid and acetaminophen combination drugs.

The study involved about 100 people seeking emergency care with moderate to severe arm pain, such as from a fracture or sprain. All were given identical-looking pills for their pain that differed only in the medications they contained. Pain levels were assessed after one hour and two hours.

In the end, there was no meaningful difference in pain relief obtained from the combination of ibuprofen and acetaminophen, compared with the opioid and acetaminophen combination drugs. About 18 percent of those in the study did eventually need a stronger rescue dose of an opioid drug to achieve pain control.

Mayo Clinic experts say there are many situations of moderate to severe short-term pain in which ibuprofen and acetaminophen can achieve effective pain control without the risk related to opioids. They note that long-term misuse of opioids often begins with short-term use for short-term pain.