Tox Tuesday: Acetaminophen and other non-opioid painkillers may be as effective as opioids

With more and more people becoming addicted to opioids each year — there are an estimated 91 opioid overdose deaths in the U.S. every day — researching non-addictive painkillers has become a top priority for scientists. If existing drugs, like ibuprofen and acetaminophen, could be used to treat pain, fewer addictive opioid prescriptions may be necessary.

Many who develop opioid addictions do so after taking doctor-prescribed painkillers, even with short-term prescriptions. Now, a new study shows that contrary to prior belief, non-opioid painkillers may be just as effective at treating pain as opioids.

“Some, not all, physicians reflexively think fractures require opioids, but this study lends evidence that opioids are not always necessary even in the presence of fractures,” Dr. Andrew Chang, study author, told Vox.

To figure this out, researchers visited two emergency rooms in New York City, focusing on 411 patients with fractures and sprains in their arms or legs. Patients were randomly given either non-opioid painkillers or one of several opioid drugs. The patients were asked to rate their pain levels twice: before receiving medication, and two hours after.

The average pain rating before treatment was 8.7 out of 11. After receiving non-opioid drugs, the average patient reported a 4.3 point drop in pain. Only one opioid dropped more than that on average: an oxycodone/acetaminophen pill, which came with average drop of 4.4 points (only 0.1 difference compared to the non-opioid pills).

In the future, the researchers hope to expand their study to long-term treatment with and without opioids. Chang stresses, however, that there are limitations to the study and that many situations may require treatment with opioids — for instance, more severe injuries.

Nonetheless, the findings have already influenced the medical practices of the researchers involved, who now discuss opioids more in-depth with patients.

“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,” Chang 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.”

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