OTC painkillers as effective as opioids in the ED

Opioid alternative focus of Albany Med doctor's study

One of the study's limitations is that it only evaluated short-term pain relief while the patients were in the ER. The non-opioid treatment reduced the pain scores by 4.3, according to the study. Patients who participated in the study came with a variety pain concerns such as leg fractures, leg and arm strains, and sprains.

But given the scope of the US opioid epidemic - more than 2 million Americans are addicted to opioid painkillers or heroin - experts say any dent in the problem could be meaningful.

With opioids being prescribed in nearly one-third of all ER visits even though more than 2 million Americans are already addicted to opioids or heroin, this study could help curb a national epidemic.

"Preventing new patients from becoming addicted to opioids may have a greater effect on the opioid epidemic than providing sustained treatment to patients already addicted", Dr. Demetrios Kyriacou, an emergency medicine specialist at Northwestern University, wrote in an accompanying editorial. The randomized clinical trial, conducted at two EDs in the Bronx, New York, included 416 adults with moderate-to-severe acute extremity pain.

Patients were randomly assigned to one of two groups; one group got an opioid pill to relieve pain, while the other group got a combination of ibuprofen and acetaminophen -better known as Advil and Tylenol. All the patients were given standard doses and were not told which drug they received. However at 2 hours, the mean NRS pain score dropped by 4.3 in the ibuprofen and acetaminophen group; by 4.4 in the oxycodone and acetaminophen group; by 3.5 in the hydrocodone and acetaminophen group; and by 3.9 in the codeine and acetaminophen group.

The study by Dr. Andrew Chang and his colleagues compared three opioid-based pain treatments with a non-opioid treatment in patients with extremity pain.

Researchers found that a combination of over-the-counter medicines ibuprofen and acetaminophen is an effective pain management therapy in emergency departments.

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