Oxycodone tablets, narcotic

For years, emergency departments have dispensed narcotic analgesics to ease acute pain. Now in the middle of an opioid epidemic, some experts are asking whether there might be safer ways to alleviate acute pain. The concern is that some people who start taking a narcotic for immediate pain relief might find it difficult to quit the drug in a few weeks or months.

The Test of NSAIDs vs Narcotics:

In a recent study, non-narcotic pain relievers performed as well as opioids in the emergency room (Chang et al, JAMA, Nov. 7, 2017). More than 400 patients who arrived at Montifiore Medical Center in the Bronx with extremity pain from dislocated shoulders, sprained ankles or injured knees participated. They were randomly assigned to get different types of pain-relieving medication. A combination of ibuprofen and acetaminophen worked as well as opioids to reduce the pain within two hours.

The researchers prescribed the narcotics Percocet (oxycodone plus acetaminophen), Vicodin (hydrocodone plus acetaminophen) or Tylenol #3 (codeine plus acetaminophen). The investigators used a dose of 400 mg ibuprofen and 1000 mg acetaminophen at one time. People treating themselves at home should not exceed 4000 mg of acetaminophen in a day.

This helpful research does not address what to do for people who suffer chronic pain. Many have been told they will have to get along without narcotics. At the same time, they have not been offered viable alternatives for pain relief. That will be crucial for the future.

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  1. mary

    I have had a radical nephrectomy for renal cell cancer, and have been instructed to NEVER take any NSAID because of their damaging effect to kidney(s). Acetaminophen does nothing for me, and I was told never to take more than 3000mg per day because of liver toxicity . So what to do??? I take turmeric, and quite frankly, suffer, as do many folks with legitimate chronic pain, caught in the current “opioid crisis”.

  2. MARY

    I’ve been on some sort of narcotics since 2010 and with very little relief. I would welcome anything that would do as well as these narcotics.

  3. Janie
    Freeland WA

    Also not addressed is those of us who have liver disease of one sort or another and should not be taking Ibuprophen or Acetominophen. In my case, for other medical reasons, I have to avoid even aspirin

  4. Mary

    Here in California where it is legal, many people with pain, including chronic pain, resort to the use of “medical Marijuana”–primarily CBD which is extracted from Marijuana–with reportedly good results. Yet in all the discussion of pain meds, I seldom (if ever) see it mentioned in publications outside outside California, Colorado and other states that have “legalized” it. Of course, this is somewhat understandable given all the legal restrictions still existing in many states.

    Still, I have seen an increasing us of CBD as an anti-pain med and am encountering more and more people who swear that it has worked for them in terms of alleviating pain. I think it may be time for everyone interested in finding or developing better less harmful ways of dealing with pain to take a look at it.

    It is generally used in our state by people seeking pain relief.

  5. Pat

    I had surgery for breast cancer this year and was prescribed Tramadol because I requested it instead of hydrocodone. I took it a couple of days after I got home, then, because of the constipation effect, I started taking plain acetaminophen. To my amazement, it worked just as well as Tramadol, with far fewer side effects. Doctors and hospitals are far too generous with opioids.

  6. Joan
    St Petersburg

    For many years I took various OTC meds for Rheumatoid arthritis. The meds the Dr prescribed for it never worked, and then the price went sky high. (FDA). I was taking Mobic but then a heart problem stopped me from taking that. I took naproxin, advil and Tylenol. Against Drs advice. They had no real effect except to upset my stomach. It got to the point that there was nothing for me to take because of the stomach and heart problem.

    Finally the Dr gave me vicodin. I felt like a new woman. I’m 78 and have been taking vicodin for several years. I could not function without it. Now the do-good DEA wants to take it away. Is there any more of an epidemic now from opioids than there was 10 years ago? This so called epidemic didn’t start with vicodin. Let the family Drs, who have been treating seniors like me, have the say on what helps our pain and not the do-gooders who want to make a name for themselves. I hear about the young people who died using drugs. This isn’t me. I use them responsibly and only when needed. Some mornings I can’t get out of bed without taking a pill. I would fall and have a broken hip just trying to get to the bathroom. Vicodin does NOT make me high. It just relieves the pain and keeps me functioning and independent.

  7. Pata

    I have osteoarthritis. Nsaids tear up my stomach, narctics constipate and leave me woozy. Tylenol does nothing. Please give your thoughts regarding my type of pain and ginger and or tumeric. I have heard amazing results but have not tried because I don’t know how much or what kind.

  8. GmaA

    I had arthritic back and hip pain severe enough that walking more than 50 feet was too painful, and I was considering an electric scooter. Then I heard about CBD oil, a supplement available from my ND doctor. I bought a dropper bottle, and within 15 minutes of my first small dose, my pain was relieved. That was two months ago, and as long as I take two doses a day I remain pain free except for extended standing. Amazing stuff!

  9. Cathy

    Cannabis is being used for pain and healing around the world. It’s truly an amazing plant!

  10. Peggy B.

    I recently had knee replacement surgery, and I can say that NSAIDS don’t compare with the hydrocodone combination I was prescribed for the first six weeks, and am now tapering off. If the pain seems to be related to inflammation (the site is hot and throbbing), NSAIDS do help. But other kinds of pain (perhaps from the affected nerves?) do not respond to Tylenol, Aleve, or Ibuprofen in my case. I often feel that kind of pain at night when I wake up, and that’s when I resort to the prescription medicine. This happens less frequently as time goes by. (It has been 2 months since my surgery, and my doctor says this is normal.)

  11. Elizabeth
    Ft Worth

    NSAIDS should not be taken by people with sprains or especially with broken bones. These drugs can suppress the needed inflammatory response thus slowing regrowth of bones and soft tissue.
    Do your research!

  12. Tony

    Many who suffer chronic and severe pain are on anti-coagulants like wafarin. They can not take NSAIDS so what can they take other than opiods?

  13. Carol N.

    I have Deg Disc Disease in the last joint of my spine , along with five bone spurs approx 1 and 1/2 inch each long. I hate taking meds to make me sleep all day. My Dr. prescribed Baclofen. It takes the edge off, and I don’t fall asleep. It only works for abt 4 hours. I hope I can make this work always for me, but I worry someday I may have to consider stronger meds.

  14. David

    The best non-narcotic in my 50 years of practice were the propoxyphene products, Darvon etc. Thanks to Ralph Nader and his buddy Sidney Wolfe those are no longer available. Women used to get old “perky”, Percodan post partum and get dizzy or sleepy and drop their babies. When Percodan was replaced with propoxyphene the incidence was rare. If you think NSAIDS or that product that was introduced as a fever reducer is adequate, I would like to give the investigators their choice. Thanks Ralph for being judge, jury, and executioner of a great line of products.

  15. Sally

    I recently had oral surgery that involved slicing the gum and scraping the bone to get rid of an infection after a post was inserted. The surgeon prescribed four Advil tablets every six hours, to be reduced when possible. I had no pain at all and gradually reduced the dose and was completely finished in two weeks.

  16. Debbie
    Rockton, IL

    I have had bilateral hip replacements with three revisions over a period of sixteen yeats. For the first four procedures, I had morphine & narcotics in the hospital & was sent home with a prescription for Vicodin. I hate opiates because becuase they make me sluggish, sleepy & constipated. So after 4-5 days at home I would stop their use & take NSAIDs instead. This worked fine, except for several nights of insomnia due to narcotic withdrawal. After my fifth surgery, for reasons unknown to me, my surgeon put me on a Toradol drip in the hospital. When I told him how effective this was in controlling my pain, I asked him if it was available in pill form; he prescribed it for me to take home instead of a narcotic. Since Toradol is a heavy duty NSAID, I only took it for about a week before switching to an OTC NSAID. My recovery at home with an NSAID vs narcotic was a thousand percent better than previous experiences. I was pain free, had all my wits about me, was not nodding off all day & not constipated. I felt alert & normal except for having just had hip surgery. NSAIDS worked extremely well for me. FYI, I am a 67 y/o female.

  17. Noah V.
    Chapel Hill, NC

    Nor does that study address the dangers in taking such large doses of acetaminophen. I suppose that goes to chronic pain which is what most of the older people are suffering from. Personally, ibuprofen really upsets my stomach.
    For joint/muscle pain I have found that a CBD ointment really alleviates the pain for several hours at the least. And it begins to work in a very few minutes. It is topical and non-systemic as well as being a “natural” remedy.

  18. nope
    Mebane, NC

    legalize marijuana. works for pain. not physically addictive. grows like a weed.

  19. Peggy

    I cannot take NSAIDS except for the 81 mg aspirin. So it’s prescription pain meds for me. I try to minimize my use of them even though I have chronic back pain and other issues.

    Thanks for pointing out that people should not take more than 4K mg of acetaminophen per day. One of my doctors has me on a regimen of 2 RS Tylenol (acetaminophen) 3 times per day. My other doctors don’t understand it but won’t mess with it!

  20. Clare
    Raleigh, NC

    I fell and hurt my shoulder, tearing one bicep off as well as one and a half rotator cuffs. After surgery, I was given Vicodin and Percocet, neither of which helped with the pain. All I experienced were the side effects, such as nausea, dizziness and general abdominal pain. I asked the doctor if there was anything else he could prescribe, and he gave me Tramadol which also did not help. I asked if I could take ibuprofen, and that worked perfectly with no side effects.

    When my sister was in the hospital for hip replacement surgery, she was extremely nauseated, constipated and dizzy and had a dry mouth. She could not eat due to her dry mouth. She was given laxatives and anti-nausea medications. When I took her home, I convinced her to stop taking the Percocet, and her symptoms went away in about 24 hours. Her pain was easily handled by Tylenol.

    I wonder why doctors prescribe these drugs when they do not alleviate pain in everyone. My sister and I both had severe side effects. I have talked to a few other woman who also get no pain relief from these drugs.

  21. christine
    Bellmawr, nj. 08031

    For new Chronic pain patients I say try alternative medication. I’ve walked this long rd. For two decades & have tried from surgery physical therapy injections of a few types. Have taken many alternative medications. Im a 60 yr old mother & without opioids I’d have never been able to physically or mentally provide the support my children needed. I don’t feel I should be forced into an existence (not life) of being a bed-bound person when my past 17 yrs proves I benefit as well as my children do from my having prescribed opiates. Why should I be forced into a bed-bound existence of only suffering from actions of other ppl. I’ve never abused these medication & deserve to have a functioning life again without being grouped with this small group of ppl who chose to throw away lives that were re- gifted by dr prescribing opiates for chronic pain. Thank you.

    • christine

      I feel that all PM patients should not be grouped into only one group as drug abusers. Opiates gifted my life to me after many yrs of only unending suffering. I gave birth to 4 children, and my chronic pain kept me from mentally connecting with them. Pain uncontrolled can destroy life. In two decades I’d never dreamt of abusing my life or my medications. Please stop listening to so many stories of opiate abuse & listen to facts of those ppl who were honestly given a new life life from an existence of only unending severe pain . Not ppl in stories of heroin & opiate abuse and never hearing of patients over many yrs whose lives were saved by proper use of opiates.

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