A new report in the Journal of the American Medical Association gauges the effectiveness of opioids for pain relief, and WKSU’s Kabir Bhatia reports on what researchers found out about the highly addictive medications.
Drugs like oxycodone, hydrocodone and codeine were each combined with acetaminophen in the study of pain relief in ER patients. Then, ibuprofen was mixed with acetaminophen for an opioid-free combination. The study found that mix is just as effective when dealing with injuries like broken bones and sprains.
Dr. Baruch Fertel is director of quality for Cleveland Clinic’s emergency departments, and has evaluated the report. He says in cases like the ones studied, alternatives to opioids should be considered.
“If someone breaks their wrist, there’s going to be some pain. But looking at other opportunities: local anesthesia, nerve blocks, other forms of safer analgesia that don’t come with the risks of opioids.”
Dr. Fertel says there are many reasons opioids gained favor, including how they used to be viewed in medical schools.
“We were taught that pain should never occur. Pain is the fifth vital sign. And that opiates are safe medications. In reality, we know that that’s not really the case. And setting expectations to have zero or no pain is oftentimes dangerous because it builds dependencies on these medications.”
Dr. Fertel points out that the study’s authors looked at pain reduction only within the first two hours of a patient entering the ER. In the future, they plan to conduct trials on longer-term pain relief and on more serious injuries. He adds that opioids -- which were initially developed for chronic pain in cancer patients -- can still have a role in treatment. He cites people who need pain relief after surgery so they can start moving around again. In those cases, Dr. Fertel says the opioids should be de-escalated quickly once they’re no longer needed.
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