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. Carol
    NC
    Reply

    I think with surgical pain a 7 to 10 day limit on a narcotic, then move to Ibuprofen, Tylenol or Naproxen.

  2. SNH
    Reply

    Reading comments here makes me feel sorry for physicians. It’s pretty standard for docs to prescribe a fairly strong med for post surgical pain (which should be fairly limited).
    What are they to do? Tell you “Your surgery went fine. I’m discharging you home. Take some tylenol for the pain. If that doesn’t work, call me in the middle of the night when you’re in really severe pain, and then you can hop over to the drugstore and get something better”.
    Don’t we all know that by that time, even vicodan might not work?
    Then there’s the patient with pain that is uncontrolled or not alleviated by current meds.
    What’s the doc to do but try a different (and maybe stronger) one?

    Seems to me, there’s a shared responsibility here. The doc prescribes a med for your pain. You use it judiciously. “As needed”.

    The opioid “crisis” is not caused by physicians and their patients behaving responsibly.

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