Over-the-counter pain relievers are alternatives to opioids

Jan 30, 2019 | Richard H. Rho, M.D. | @richardrho | Comments (6)

OTC medication aisleOpioid medications are among the most powerful pain relievers available and can be effective in managing severe short-term pain and cancer pain.  However, side effects including nausea, vomiting, sleepiness, constipation, and dizziness leading to falls are common.  Opioid addiction and death from overdoses are very serious issues that can occur with the use of opioids.  If pain episodes can be managed using pain medications other than opioids, side effects and addiction risk can be minimized.

What evidence would support this?

A recent medical study revealed that in the emergency department, ibuprofen and acetaminophen (over-the-counter pain relievers) were shown to be as effective in managing moderate to severe short-term pain as opioids.  Of the 104 study participants, only about 18% required an opioid due to failure of the ibuprofen/acetaminophen to manage the pain.

How does this apply to me?

There are many scenarios of moderate to severe short-term pain that can be successfully managed with ibuprofen/acetaminophen, without any need for opioids.  In many cases, addiction to opioids often begins with short-term use of opioids.  If opioids can be avoided altogether, serious side effects, as well as addiction and death from overdoses can be avoided.  In most cases, acute pain episodes are time limited, and many patients can successfully get through the episode by taking over-the-counter pain relievers instead of opioids.

The people in the study aren’t like me and my pain is different.

The study patients had pain due to acute injuries involving their extremities (i.e. arms and legs), but it would be medically reasonable to apply the same concepts to many other conditions such as acute low back pain and other bodily aches and pains.  It is important to note that severe pain, such as pain due to surgery or cancer, may require treatment with opioids.   Furthermore, different types of pain (i.e. nerve pain) may respond better to other non-opioid, prescription pain medications.

What do I do if over-the-counter pain relievers aren’t working for me?

The first place to start is by visiting your primary care provider to make sure that there is not an underlying medical issue that is causing your pain, that might require a different treatment other than taking pain relievers.  If there are no worrisome underlying conditions, then your primary care provider can refer you to the Pain Medicine Clinic, which can offer the full spectrum of treatments available.  The treatments might include medications, physical therapy, cognitive behavioral therapy, injections, or possibly implanted devices to help manage the pain.

 

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can I get help here to to start getting off hydromophone and the doctors are now giving me escitalopram oxalate 10 mg and clonazepam .5 mg I WAS ON OXYCODONE FOR 10 YEARS WHEN THEY SWITCHED ME TO HYDROMORPHONE AND i THINK i WAS HAVING BAD WITHDRAWALS SO THEY PUT ME ON THE CLONAZEPAM AND ESCITALOPRAM AND i HAVE HAVE HAVE BAD LUNGS AND AM ON OXYGEN AND MY BREATHING IS GETTING VERY BAD no strength to do anything without getting severely out of breath, will cbd help in withdrawals if I cut back on them myself

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@jackboatj9p

can I get help here to to start getting off hydromophone and the doctors are now giving me escitalopram oxalate 10 mg and clonazepam .5 mg I WAS ON OXYCODONE FOR 10 YEARS WHEN THEY SWITCHED ME TO HYDROMORPHONE AND i THINK i WAS HAVING BAD WITHDRAWALS SO THEY PUT ME ON THE CLONAZEPAM AND ESCITALOPRAM AND i HAVE HAVE HAVE BAD LUNGS AND AM ON OXYGEN AND MY BREATHING IS GETTING VERY BAD no strength to do anything without getting severely out of breath, will cbd help in withdrawals if I cut back on them myself

Jump to this post

Good evening @jackboatj9p, welcome to Connect. As you may realize, Connect is an online community of patients, providers, and caregivers. We attempt to share our medical situations and experiences that just might help others.

In regards to your major question, let's see if I have it correct. You are asking if you can just take CBD to handle the withdrawal symptoms that you face from opioids and other medications. Frankly, I don't have an answer for you. I was already into year five of using medical cannabis when I decided to withdraw from Nortriptyline. I did increase my cannabis dosages and worked with my clinician to ensure that the withdrawal went well. This year I withdrew from half of my gabapentin doses with guidance from my PCP. She actually rearranged the time I was taking other medication to get better results. It seemed to take a long time and yet it was quite successful. I added a nighttime cannabis topical for my hands and wrists.

Are you currently using medical cannabis? Have you ever used it? If so, how did your body react to your choice of cannabis support?

One thing I am sure of Jack is that you simply must have the support of your doctor when you decide to withdraw from any medication. I will double down on that suggestion with the knowledge that you have lung and breathing issues.

I will be here to help and support you as a Connect member. I can share my experiences. Your experience has been and will continue to be different from mine and anyone else's. Please seek and secure professional support.

May you be safe and protected from inner and outer harm.

Chris

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To me this is really a sad state where our medical treatments are, when it comes to pain relief. The response seems to be to throw more chemicals at it to the point where those chemicals may start having negative affects on the patient. This is not a criticism of the medical profession, it is just the limited knowledge in treating pain.

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@jackboatj9p

can I get help here to to start getting off hydromophone and the doctors are now giving me escitalopram oxalate 10 mg and clonazepam .5 mg I WAS ON OXYCODONE FOR 10 YEARS WHEN THEY SWITCHED ME TO HYDROMORPHONE AND i THINK i WAS HAVING BAD WITHDRAWALS SO THEY PUT ME ON THE CLONAZEPAM AND ESCITALOPRAM AND i HAVE HAVE HAVE BAD LUNGS AND AM ON OXYGEN AND MY BREATHING IS GETTING VERY BAD no strength to do anything without getting severely out of breath, will cbd help in withdrawals if I cut back on them myself

Jump to this post

I’m in the process of weaning myself off oxycodone utilizing THC & CBD combo. It’s taken me a year to figure out a formula that works for me. I started with high THC and low CBD but did not get desired effect. Now I’ve pretty much switched my amounts to high CBD and low THC and I think I’ve got it. I’m down to one pill every other day. But as winter approaches and my OA ramps up from cold I’ll have to see what adjustments are needed. Since you have bad lungs consider tinctures of pills if available to you. Good luck.

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@jenatsky

I’m in the process of weaning myself off oxycodone utilizing THC & CBD combo. It’s taken me a year to figure out a formula that works for me. I started with high THC and low CBD but did not get desired effect. Now I’ve pretty much switched my amounts to high CBD and low THC and I think I’ve got it. I’m down to one pill every other day. But as winter approaches and my OA ramps up from cold I’ll have to see what adjustments are needed. Since you have bad lungs consider tinctures of pills if available to you. Good luck.

Jump to this post

Hi i will have to get back later but thank you very much i know you are going to be a great help i have to get to some pet scan now to check for cancer sorry have to go or i will be late will be back later today i really need some help jack

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@jackboatj9p

can I get help here to to start getting off hydromophone and the doctors are now giving me escitalopram oxalate 10 mg and clonazepam .5 mg I WAS ON OXYCODONE FOR 10 YEARS WHEN THEY SWITCHED ME TO HYDROMORPHONE AND i THINK i WAS HAVING BAD WITHDRAWALS SO THEY PUT ME ON THE CLONAZEPAM AND ESCITALOPRAM AND i HAVE HAVE HAVE BAD LUNGS AND AM ON OXYGEN AND MY BREATHING IS GETTING VERY BAD no strength to do anything without getting severely out of breath, will cbd help in withdrawals if I cut back on them myself

Jump to this post

As a pain patient for over 22 years who’s been on narcotics the whole time, I didn’t find CBD very useful. My body built up a tolerance for my medication and I think that made the CBD less effective. When I tried it, I had to take huge amounts of it in order for it to help. It was terribly expensive and without much benefit.

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