Over-The -Counter Pain Relievers Better Than Opioids

Pain relievers such as Advil and Tylenol are as effective at relieving pain as opioids, but without the addiction, according to a recent study.  Results published in the journal JAMA explored which combination of four oral analgesics provided more effective reduction of moderate to severe acute extremity pain.





Pain: Study Protocol

Researchers conducted a randomized clinical trial at two urban emergency departments (EDs) in The Bronx, New York. They studied 416 patients aged 21 to 64 years old between July 2015 to August 2016 who arrived at the ED with a mean pain score of 8.7 on a scale of 0-10. They reported acute pain in their shoulders, arms, hips or legs. About 20 percent of trial participants were diagnosed with a bone fracture. The rest suffered injuries such as a sprained ankle, a dislocated shoulder or a banged-up knee.


Pain: Treatments:

Participants were randomly and equally distributed into one of four groups and prescribed one of the following drug combinations:

  • 400 mg of ibuprofen and 1000 mg of acetaminophen,
  • 5 mg of oxycodone and 325 mg of acetaminophen,
  • 5 mg of hydrocodone and 300 mg of acetaminophen, or
  • 30 mg of codeine and 300 mg of acetaminophen.


Pain: Results

For patients presenting to the ED with acute extremity discomfort, there were no statistically differences in discomfort reduction at 2 hours among single-dose treatment with either ibuprofen and acetaminophen or with three different opioid and acetaminophen combination analgesics.

Basically, all treatments were equally effective. But, most importantly, the acetaminophen and ibuprofen combination avoids the risk of addiction, suggesting a viable over-the-counter pain treatment plan.

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