I read an article today that I am really excited about. It was written by Dr. Donald Teater, M.D. and titled, “Evidence for the efficacy of pain medications.” At first I thought, “I have read a million articles like this.” But I got sucked in pretty quickly as it really discusses some new options and research of which I was unfamiliar.
It starts out with the usual history of opioids, but do not despair, there is new stuff in here! It then discusses the history of aspirin, other NSAIDs and acetaminophen. Since the introduction of acetaminophen we now have three choices of classes of medication when treating pain.
The choice as to which pain medication to recommend is usually made by perceptions of what works or is dictated by a preexisting medical condition, right? If you have advanced liver damage – no acetaminophen. NSAIDs should not be given to an individual with advanced kidney disease or stomach ulcers. Opioids pose a potential risk for anyone with a personal or family history of addiction. We also may choose an opioid because we perceive this class of pain medication is the strongest and is most appropriate for significant injuries, surgery, etc., right?
Wrong! Scientific literature does not support this belief. There are many other treatments that should be utilized for treating pain. Studies have shown that NSAIDs are just as strong as the opioids.
In part 2 of this series I will share some information about a statistical measure used in clinical studies called ‘Number Needed to Treat’ (NNT) and its impact on our choice of which pain medication and which combination works most effectively.