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09 November 2017, 06:06 | Melissa Porter
What started as a case of national over-prescription turned into a full-blown epidemic, with approximately 80 percent of the global pharmaceutical opioid supply being consumed in the US. Considering that every day, opioid overdoses kill an estimated 91 Americans, it could make a big difference.
The editorial, "Opioid vs Nonopioid Acute Pain Management in the Emergency Department", by Demetrios N. Kyriacou, M.D., Ph.D., Senior Editor, JAMA, Chicago; Northwestern University Feinberg School of Medicine, Chicago. The authors suggest that in some cases, medics could simply skip the opioid treatment, offering instead the two very common over the counter drugs. "One way to help decrease the epidemic is to decrease the number of people exposed". "Although this study focused on treatment while in the emergency department, if we can successfully treat acute extremity pain with a non-opioid combination painkiller in there, then we might be able to send these patients home without an opioid prescription".
Results: After 2 hours pain was less in all participants, without any important difference in effect between the four groups.
Patients were randomly assigned to one of two groups; one group got an opioid pill to relieve pain, while the other group got a combination of ibuprofen and acetaminophen -better known as Advil and Tylenol. The assessments were done using an 11-point scale (0 = no pain; 10 = worst possible pain).
The researchers say patients in both groups reported the same reduction in pain. On average, pain scores dropped by 4.3 points for the ibuprofen and acetaminophen group; 4.4 points for the oxycodone and acetaminophen group; 3.5 points in the oxycodone and acetaminophen group; and 3.9 points for the codeine and acetaminophen group.
Those differences were not statistically significant, Change and his colleagues stress.
Study Limitations: The results apply only to pain after two hours. The combination of ibuprofen and acetaminophen may represent an effective non-opioid alternative. However, some patients don't have the luxury of not taking opioids - in the case of people arriving in the emergency room or with broken limbs, opioids are required to ease the excruciating pain.
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