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.