Drugstore pain pills as effective as opioids in ER patients

November 7, 2017 by Lindsey Tanner
Drugstore pain pills as effective as opioids in ER patients
This Thursday, Nov. 2, 2017 photo shows tablets of ibuprofen in New York. A study released on Tuesday, Nov. 7, 2017 found that over-the-counter pills worked as well as opioids at reducing severe pain for emergency room patients with broken bones and sprains. (AP Photo/Patrick Sison)

Emergency rooms are where many patients are first introduced to powerful opioid painkillers, but what if doctors offered over-the-counter pills instead? A new study tested that approach on patients with broken bones and sprains and found pain relievers sold as Tylenol and Motrin worked as well as opioids at reducing severe pain.

The results challenge common ER practice for treating short-term, and could prompt changes that would help prevent new patients from becoming addicted.

The study has limitations: It only looked at short-term relief in the emergency room and researchers didn't evaluate how patients managed their pain after leaving the hospital.

But given the scope of the U.S. —more than 2 million Americans are addicted to painkillers or heroin—experts say any dent in the problem could be meaningful.

Results were published Tuesday in the Journal of the American Medical Association.

Long-term opioid use often begins with a prescription painkiller for short-term pain, and use of these drugs in the ER has risen in recent years. Previous studies have shown opioids were prescribed in nearly one-third of ER visits and about 1 out of 5 ER patients are sent home with opioid prescriptions.

"Preventing new patients from becoming addicted to opioids may have a greater effect on the opioid epidemic than providing sustained treatment to already addicted," Dr. Demetrios Kyriacou, an emergency medicine specialist at Northwestern University, wrote in an accompanying editorial.

The study involved 411 adults treated in two emergency rooms at Montefiore Medical Center in New York City. Their injuries included leg and arm fractures or sprains. All were given acetaminophen, the main ingredient in Tylenol, plus either ibuprofen, the main ingredient in Motrin, or one of three opioids: oxycodone, hydrocodone or codeine. They were given standard doses and were not told which drug combo they received.

Patients rated their pain levels before taking the medicine and two hours later. On average, pain scores dropped from almost 9 on a 10-point scale to about 5, with negligible differences between the groups.

Ibuprofen and acetaminophen affect different pain receptors in the body so using the two drugs together may be especially potent, said Dr. Andrew Chang, an emergency medicine professor at Albany Medical College in upstate New York, who led the study.

He noted that a pill combining ibuprofen and acetaminophen is available in other countries; his findings echo research from Canada and Australia testing that pill against opioids for pain relief.

Explore further: What you can do to help fight the opioid epidemic

More information: Effect of a Single Dose of Oral Opioid and Nonopioid Analgesics on Acute Extremity Pain in the Emergency Department, JAMA. 2017;318(17):1661-1667. DOI: 10.1001/jama.2017.16190 , https://jamanetwork.com/journals/jama/article-abstract/2661581

Related Stories

What you can do to help fight the opioid epidemic

September 13, 2017
(HealthDay)—Proper disposal of prescription painkillers and use of safe alternatives to manage pain could help combat America's opioid abuse epidemic, doctors say.

When is an opioid safe to take?

June 26, 2017
(HealthDay)—Many people in pain are apprehensive about taking an opioid painkiller to ease their suffering, and rightfully so.

Patients who get opioids in the ER are less likely to use them long-term

September 26, 2017
Compared to other medical settings, emergency patients who are prescribed opioids for the first time in the emergency department are less likely to become long-term users and more likely to be prescribed these powerful painkillers ...

Day-supply of opioid Rx factor in likelihood of long-term use

August 24, 2017
(HealthDay)—The days supplied is far more important than the dosage level or even the type of pain being treated in risk of opioid use disorder following opioid prescription, according to a study published recently in The ...

Depressed patients more likely to be prescribed opioids

June 20, 2017
A new study shows that patients with low back pain who were depressed were more likely to be prescribed opioids and receive higher doses. Understanding these prescribing patterns sheds new light on the current opioid epidemic ...

Even small quantities of opioids prescribed for minor injuries increase risk of long-term use

May 17, 2017
Overprescribing of opioid medications for pain has contributed to a record-high number of drug-related deaths in the United States in recent years. A significant part of the issue, experts say, is the vast amount of variation ...

Recommended for you

Discovery opens door for synthetic opioids with less addictive qualities

June 1, 2018
Making opioids from sugar instead of from field grown opium poppies has the potential to solve many of the problems associated with manufacturing strong pain killers.

US doctors prescribing fewer opioid painkillers: report

May 31, 2018
US doctors reduced the number of prescriptions for opioid painkillers last year, continuing a five-year trend, in an effort to reverse a deadly drug abuse epidemic, a report released Thursday said.

Researchers publish study on new therapy to treat opioid use disorder

May 22, 2018
Better delivery of medications to treat opioid use disorder (OUD) is key to addressing the opioid crisis and helping the 2.6 million Americans affected by the disease.

Could nonprofit drug companies cut sky-high prices?

May 17, 2018
(HealthDay)—Generic prescription drugs should be cheap, but prices for some have soared in the United States in recent years. Now a group of U.S. hospitals thinks it has a solution: a nonprofit drug maker.

Fewer antibiotics for kids, but more ADHD drugs

May 15, 2018
(HealthDay)—American kids are taking fewer prescription medications these days—but certain drugs are being prescribed more than ever, a new government study finds.

Opioid makers' perks to docs tied to more prescriptions

May 14, 2018
Doctors who accept perks from companies that make opioid painkillers are more likely to prescribe the drugs for their patients, new research suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.