There are many persons and institutions that bear responsibility for America’s opioid epidemic, including drug companies and their distributors, dishonest physicians who operate “pill mills,” and even the Department of Justice. However, in too many cases, opioid addiction starts with a trip to the emergency room in the wake of a sudden injury, such as a broken bone or dislocated shoulder. In such a high-pressure, fast-moving environment, ER doctors usually give patients a quick dose of a narcotic pain medication. While these are intended for short-term use, a 2015 study appearing in the Annals of Emergency Medicine found that 17 percent of ER patients who had started on opioid medications for short-term pain were still taking them a year later.

Unfortunately, emergency room personnel often fail to realize just how addictive opioid-based painkillers can be. The good news is that a recent study shows non-narcotic analgesics – specifically, a pair of relatively inexpensive over-the-counter products – are just as effective. Furthermore, these non-opioid OTC medications are not addictive.

The study, published this week in the Journal of the American Medical Association, compared three different opioid-based painkillers with two paracetamol medications (ibuprofen and acetaminophen). The three opioids studied were oxycodone, hydrocodone and codeine. Using data gathered from over 400 emergency room patients, the researchers determined that a “cocktail” of ibuprofen and acetaminophen do as well or better as the opioid alternative when it comes to managing pain.

Prominent pain specialist Dr. David Clark of Stanford University was surprised that nobody had thought to investigate this issue before now. “I would have thought that people who came to an ER with pain that could be managed with just pills wouldn’t be given opioids,” he said, adding “The fact that investigators thought the question needed to be answered is sort of an indicator of how oriented we are to using opioids for pain, even when simpler and safer approaches might work just as well.” He believes the result of the new study could be a game-changer in how pain is treated in an ER setting.

Lead author Dr. Andrew Chang points out that the study was limited to patients suffering pain from limb injuries – and the assessment took place only two hours after they had been admitted, when such pain is the most severe. However, the findings have broad implications, suggesting there are other situations in which the use of opioid-based medications could be minimized. He plans to follow up this study to learn whether or patients continue to enjoy pain relief after leaving the ER as compared to those who are given narcotic painkillers.

K.J. McElrath is a former history and social studies teacher who has long maintained a keen interest in legal and social issues. In addition to writing for The Ring of Fire, he is the author of two published novels: Tamanous Cooley, a darkly comic environmental twist on Dante's Inferno, and The Missionary's Wife, a story of the conflict between human nature and fundamentalist religious dogma. When not engaged in journalistic or literary pursuits, K.J. works as an entertainer and film composer.