Patients receiving over the counter pain medicine in the emergency room for broken bones and sprains are able to manage pain as well as those receiving powerful opioid painkillers, according to a new study published in the Journal of American Medical Association (jamanetwork.com). The study results may prompt emergency rooms to consider use of such pain relievers like Motrin and Tylenol to treat short term severe pain from these types of injuries. The study results are preliminary since it only looked at short term pain relief, not how patients managed their pain once they left the hospital.
More than 2 million Americans are addicted to opioids and heroin in the United States. Studies have shown that long term opioid use often begins with a prescription pain medicine for short term pain. Finding alternatives to manage pain may help get a handle on the epidemic of opioid addiction in the United States. The use of opioid drugs is on the rise in the emergency room with nearly one third of emergency room visits resulting in patients being 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 patients already addicted,” said Dr. Demetrios Kyriacou, an emergency medicine specialist at Northwestern University, who wrote an editorial accompanying the study.
The study analyzed 411 patients with an average age of 37 who were treated in two emergency rooms at Montefiore Medical Center in New York City. All the patients admitted to the emergency room had leg and arm fractures or sprains. The patients examined were given standard doses of acetaminophen, the main ingredient in Tylenol plus either ibuprofen, the main ingredient in Motrin or one of the following opioids: oxycodone, hydrocodone or codeine. The patients did not know which drug they were given.
The combination of having both acetaminophen and ibuprofen affects different pain receptors in the body, and working together to reduce pain is potent, said Dr. Andrew Chang, emergency medicine professor at Albany Medical College who led the study. He noted that other countries prescribe pills that have both ibuprofen and acetaminophen, and the study confirms other research done in Canada and Australia that tested the effectiveness of these drugs against opioids.
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