A new study compared opioids and over-the-counter painkillers in ERs. Opioids didn’t do so well.
For years, doctors have deployed opioids in emergency room settings as a standard response to severe acute pain. A new study, however, is questioning that practice in some cases.
The study, published in the Journal of the American Medical Association this month by researchers at Albany Medical College and Albert Einstein College of Medicine in New York, looked at four alternative approaches to acute pain in an emergency department: three treatments with opioids and one with over-the-counter, non-opioid painkillers. The researchers concluded that “there were no statistically significant or clinically important differences in pain reduction at 2 hours” between the opioid treatments and the non-opioid variant.
In other words, the kind of pain studied — acute shoulder, arm, hip, or leg pain in an emergency room setting — was treated equally well with non-opioids as it was with opioids. That’s promising, given that opioids generally carry greater risks in terms of addiction, misuse, and overdose — as the nation’s opioid epidemic has shown.
Now, the study does not say that opioids have no place in pain care. Andrew Chang, the lead author of the study, told me he’s worried that in the response to the opioid crisis, we may overcorrect and limit opioids too much. “I do also worry that we might be swinging the pendulum too far in the other direction,” he wrote in an email, “and I hope we don’t end up creating arbitrary regulatory restrictions that prevent patients who appropriately need opioids from receiving opioids.”
But his research demonstrates that it may be possible to cut back on the amount of opioids used in at least some acute pain care settings without inflicting harm. As policymakers and health care providers respond to the opioid epidemic, that’s good to know.
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