Opioids vs OTC pain relievers

A recent report in BMJ looked at the case of a 28-year-old male triathlete with hyperhidrosis (excessive sweating). After surgery to sever sympathetic nerves in order to control the problem, he couldn’t escape postoperative pain, despite taking medication and doing physical therapy. So he went to a spot where he’d started triathlons and jumped off a cliff into the icy seawater below. He returned to shore pain-free. Talk about a do-over!

We don’t recommend jumping off a cliff to manage chronic pain, but there are smart ways to deal with it. We mention this because of recent headlines about a randomized clinical trial of 240 patients from a Veterans Affairs hospital who had moderate to severe chronic back, hip or knee pain. The researchers provided an opioid-taking group with immediate-release morphine, oxycodone or hydrocodone. A non-opioid group took acetaminophen or a nonsteroidal anti-inflammatory drug.

The researchers found that the opioid medications “did not result in significantly better pain-related function over 12 months” than non-opioid medications.

But there’s one thing the study didn’t mention: While there are complications and potential for addiction from opioids, NSAIDs aren’t without long-term problems. For example, taking NSAIDs for more than two weeks can cause intestinal bleeding, fecal incontinence, headaches and elevated blood pressure. High-dose, long-term acetaminophen usage is associated with liver toxicity.

Our recommendations: For chronic pain, get to a pain management specialist who explores medication choices along with meditation, acupuncture and physical therapy. Self-medication can be like jumping off a cliff! It may work, but there also may be serious side effects.

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. To live your healthiest, tune in to “The Dr. Oz Show” or visit www. sharecare.com.