Millions of Americans are in pain, and every year millions of prescriptions are written for pain medications. Many of the prescriptions are for powerful opioids that can cause serious side effects and lead to addiction. However, there are many non-opioid medications available for pain, including over-the-counter and prescription drugs.
What are Non-Opioid Pain Medications? Why are They Important?
Non-opioid medications do not contain an opioid, which allow the patient to avoid the negative effects of taking an opioid medication.
In most cases, opioid medication should be avoided, as evidenced by the current opioid addiction epidemic in the U.S. Though sometimes necessary when treating severe pain and following surgery, opioid medications are not suitable for reducing all types of pain. In some cases, opioids can actually increase the perceived intensity of pain.
Opioids medications are rarely a permanent solution to chronic pain and usually do not take away all of the pain. By far, the preferred method of treating pain is with non-opioid pain treatments, which include non-opioid pain medications.
Non-Opioid Pain Medications
Non-opioid pain medications, like acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), control mild to moderate pain. Many are available without a prescription (over-the-counter). However, these medications are stronger pain relievers than many people realize.
In many cases, a non-opioid medication is all that is needed to relieve pain, especially if you start taking the medication early rather than waiting until the pain is severe. Waiting until the pain significantly intensifies can make it more difficult to treat.
Effective Non-Opioid Pain Medications
Here are some of the non-opioid medications available today:
- Non-steroidal anti-inflammatory drugs (NSAIDs) reduce pain, inflammation, and fever. They work a lot like aspirin and are more potent than acetaminophen. Either alone or with other medicines, NSAIDs are most effective for mild to moderate pain that’s accompanied by swelling and inflammation. They also help lower fever and reduce inflammation.
- Acetaminophen reduces pain and fever, much the same way NSAIDs do, but do not reduce inflammation as well as NSAIDs. Acetaminophen is the active ingredient in Tylenol and a common over-the-counter drug for mild to moderate pain.
- COX-2 inhibitors are commonly used for arthritis and pain resulting from muscle sprains, strains, back and neck injuries, or menstrual cramps. They are as effective as NSAIDs and may be the right choice if long-term pain control is required without the risk of stomach damage.
- Corticosteroids (“steroids”) are useful in treating both acute and chronic pain by decreasing inflammation, swelling, and pain. They are effective for patients with arthritis, back injuries, nerve pain, and cancer. However, steroids can cause unwanted side effects like weight gain, high blood pressure, and a weakened immune system. Taking low doses short-term, or using injections and creams just at the site of pain (instead of pills), can help to reduce the side effects.
- Serotonin and Norepinephrine Reuptake Inhibitors (SNRI) are a type of anti-depressant appropriate for treating nerve, muscular, and skeletal pain. They are often recommended for pain management of fibromyalgia, diabetic peripheral neuropathy, and chronic musculoskeletal pain.
- Anticonvulsants are often the first-line treatment for neuropathic pain and traditionally used to treat epilepsy. Anticonvulsants can also relieve neuropathic pain by suppressing pain signals from the brain. But it is unclear how well they work since some patients find them very helpful while others experience no benefit at all.
- Tricyclic antidepressants (like imipramine, nortriptyline, and amitriptyline) can help lessen the pain from damaged nerves (including back pain, fibromyalgia, and diabetes-related nerve pain). Because chronic pain can cause several problems that can lead to depression, antidepressants may also benefit pain and mood symptoms. Anti-depressants can also help patients sleep.
- Topical NSAIDs are often used for osteoarthritis and musculoskeletal pain (like a sprained ankle or pulled muscle). They can help with pain management of minor strains, sprains, and contusions. Applied as gels, creams, sprays, or plasters to unbroken skin, topical NSAIDs penetrate the skin and enter tissues or joints, reducing the processes causing pain in the tissue. Because topical NSAIDs are applied at the spot of the pain, rather than taken orally, drug levels in the bloodstream are typically lower, minimizing the risk of harmful side effects.
Controlling Pain with Non-Opioid Medications
While there isn’t always a cure for chronic pain, there are many effective pain treatments available to help restore function and regain an active lifestyle. No two cases of chronic pain are the same. Every patient is unique, so what works for one patient may not work for another.
Taking a prescription opioid is not always the best option. A comprehensive analysis of non-opioid and opioid medications by the CDC underscores the need for insurers to encourage the utilization of safe, effective alternatives to prescription opioids. The study discussed the importance of beginning treatment with a non-opioid medication rather than an opioid medication.
It is essential to work with a medical professional to find the best solution for pain management. Keeping medication risks to a minimum will help you enjoy a pain-free life.
Novus Spine & Pain Center
The Novus Spine & Pain Center is in Lakeland, Florida, and specializes in treating chronic pain with non-opioid pain medications. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.
Our Mission Statement: To provide the best quality of life to people suffering from pain, by providing state of the art treatments, knowledge and skill, compassion, and respect for all.
Non-Opioid Medications Resources
Non-Opioid Treatment (American Society of Anesthesiologists)
Non-opioids and Other Drugs Used to Treat Cancer Pain (American Cancer Society)
Medications: opioids vs non-opioids (UC Davis Health)
Analysis of insurance coverage for back pain shows missed opportunities to prescribe non-opioid medications (NIH/National Institute on Drug Abuse)
CDC Guideline for Prescribing Opioids for Chronic Pain (Centers for Disease Control and Prevention)
Pain Management: Non-Opioid Medications (Pharmacy Times)
Topical non-steroidal anti-inflammatory drugs for acute musculoskeletal pain in adults (Cochrane)