Can Over-The-Counter Pain Meds Be As Effective As Opioid Painkillers?

By Paul Fuhr 11/09/17

A new study revealed potentially game-changing insights into pain management.

Woman holding pills in one hand and glass of water in the other.

While President Trump’s recent declaration of a public health emergency brings increased attention to the drug crisis, opioid overdoses continue to claim more than 90 lives every single day in America. But as lawmakers fight painkiller overprescription, physicians find themselves increasingly challenged to treat pain.

According to a new study, however, researchers have concluded that basic over-the-counter pain medications are just as effective as opioids. “The results did surprise me,” the study’s author Dr. Andrew Chang told Time. “Most physicians reflexively give opioids to patients with fractures or broken bones. This study lends evidence that opioids aren’t always necessary even in the presence of fractures.”

According to Time, the findings could be a potential game-changer when it comes to pain management.

The study focused on more than 400 patients (from 21 to 64 years in age) in two Bronx, New York-based emergency rooms. All of the patients were seeking treatment for strains, sprains or fractures. Those patients were “randomly assigned to receive either non-opioid painkillers—a combination of ibuprofen and acetaminophen (Tylenol)—or one of three variations of opioid-based painkillers.”

Two hours later, doctors asked the patients to rate their pain on an 11-point scale. Interestingly, when the responses were compared, there weren’t any appreciable differences between the two groups.

Time noted that the results were “a revelation,” given the risk of addiction that comes with opioid use. In fact, almost 19% of everyone who visits an emergency room walks away with an opioid prescription, Time added.

Chang emphasized that the research study only focused on “severe acute extremity pain.” He contended that the study’s findings could be expanded to treat other types of pain and further reduce opioid prescriptions. Chang was also quick to point out that the study only gauged patients’ pain after two hours, though Time observed “that’s when pain from sprains or fractures can be acute.”

Still, the study’s results have convinced Chang to prescribe painkillers differently. He now has discussions with patients about pain management with non-opioid options, reserving opioids as a secondary option if the pain becomes too much to bear.

“I also have a discussion with them about the risks of addiction because we know that a certain percentage of patients exposed to opioids are going to become addicted,” he told Time. “One way to help decrease the epidemic is to decrease the number of people exposed. And changing physician prescribing practices is also an important way to control the epidemic.”

The new research study echoes similar findings in other areas of medicine, too. Dentists, for one, have been wrestling with the opioid crisis for years. A recent New York Times story even charged dentists with being a huge, little-known driver of the opioid crisis. The Times claimed that dentists are "major prescribers of opioids" for those aged 10 to 19, an age range where the brain is “particularly susceptible to being taken over by opioids.”

Even though many dentists are aware that anti-inflammatories like ibuprofen, naproxen and aspirin are better at combating pain, a 2014 study revealed that 85% of dentists continue to prescribe opioids.

The American Dental Association has since issued an official statement on opioid use which calls for dentists to take measures like utilizing prescription database monitoring programs and to "consider" using NSAIDS as "the first-line therapy for acute pain management."

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Paul Fuhr lives in Columbus, Ohio with his family and two cats, Vesper and Dr. No. He's written for AfterParty MagazineThe Literary Review and The Live Oak Review, among others. He's also the host of "Drop the Needle," a podcast about music and addiction recovery. More at You can also find Paul on Linkedin and Twitter.