Drug­store pain pills as ef­fec­tive as opi­oids in ER pa­tients

South Florida Times - - HEALTH - By LINDSEY TANNER

CHICAGO (AP) - Emer­gency rooms are where many pa­tients are first in­tro­duced to pow­er­ful opi­oid painkillers, but what if doc­tors of­fered over-the­counter pills in­stead? A new study tested that ap­proach on pa­tients with bro­ken bones and sprains and found pain re­liev­ers sold as Tylenol and Motrin worked as well as opi­oids at re­duc­ing se­vere pain.

The re­sults chal­lenge com­mon ER prac­tice for treat­ing short-term, se­vere pain and could prompt changes that would help pre­vent new pa­tients from be­com­ing ad­dicted.

The study has lim­i­ta­tions: It only looked at short­term pain re­lief in the emer­gency room and re­searchers didn’t eval­u­ate how pa­tients man­aged their pain af­ter leav­ing the hos­pi­tal.

But given the scope of the U.S. opi­oid epi­demic — more than 2 mil­lion Amer­i­cans are ad­dicted to opi­oid painkillers or heroin — ex­perts say any dent in the prob­lem could be mean­ing­ful.

Re­sults were pub­lished Tues­day in the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion.

Long-term opi­oid use of­ten be­gins with a pre­scrip­tion painkiller for short-term pain, and use of these drugs in the ER has risen in re­cent years. Pre­vi­ous stud­ies have shown opi­oids were pre­scribed in nearly one-third of ER vis­its and about 1 out of 5 ER pa­tients are 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,” Dr. Demetrios Kyr­i­a­cou, an emer­gency medicine spe­cial­ist at North­west­ern Univer­sity, wrote in an ac­com­pa­ny­ing edi­to­rial.

The study in­volved 411 adults treated in two emer­gency rooms at Mon­te­fiore Med­i­cal Cen­ter in New York City. Their in­juries in­cluded leg and arm frac­tures or sprains. All were given ac­etaminophen, the main in­gre­di­ent in Tylenol, plus ei­ther ibupro­fen, the main in­gre­di­ent in Motrin, or one of three opi­oids: oxy­codone, hy­drocodone or codeine. They were given stan­dard doses and were not told which drug combo they re­ceived.

Pa­tients rated their pain lev­els be­fore tak­ing the medicine and two hours later. On av­er­age, pain scores dropped from al­most 9 on a 10-point scale to about 5, with neg­li­gi­ble dif­fer­ences be­tween the groups.

Ibupro­fen and ac­etaminophen af­fect dif­fer­ent pain re­cep­tors in the body so us­ing the two drugs to­gether may be es­pe­cially po­tent, said Dr. An­drew Chang, an emer­gency medicine pro­fes­sor at Al­bany Med­i­cal Col­lege in up­state New York, who led the study.

He noted that a pill com­bin­ing ibupro­fen and ac­etaminophen is avail­able in other coun­tries; his find­ings echo re­search from Canada and Aus­tralia test­ing that pill against opi­oids for pain re­lief .

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