NSAIDs vs. Opioids: The Key Differences
In the high-stakes arena of pain management, tensions are flaring over go-to analgesics.
As the opioid epidemic continues to rage, these addictive pain meds have fallen out of favor.
But are alternatives like nonsteroidal anti-inflammatory drugs (NSAIDs) the remedy for chronic pain?
The answer is complicated at best—and it may vary from person to person, according to experts.
Big Differences in How Each Drug Class Works
While both of these medication classes are commonly prescribed, they differ significantly in safety, potential risks, effectiveness at pain relief, and appropriate use.
Safety
NSAIDs such as ibuprofen, naproxen, and aspirin are generally considered the safer choice, available over-the-counter in lower doses. However, long-term use risks gastrointestinal issues, kidney problems, and complications for those with preexisting conditions.
Opioids, which include codeine, oxycodone, and morphine, have higher risks overall—they are controlled substances with the potential for dependence and addiction. Improper or extended use further increases the chances of adverse effects.
Health Risks
Both NSAIDs and opioids carry health risks.
The greater danger of opioids lies in their addiction and misuse potential. Their potent pain relief can readily lead to physical and psychological dependency. Over time, people may need higher and higher doses to achieve the same pain relief—perpetuating a hazardous cycle of dose escalation.
Pain Relief Effect
NSAIDs and opioids have distinct pain relief mechanisms.
Opioids potently block pain signals, making them highly effective at managing severe pain from cancer, fractures, surgery, or nerve damage.
It’s worth noting that individual responses to pain medications can vary. The most suitable option depends on a personalized evaluation of each person’s unique pain profile and needs.
When Is Either More Appropriate?
When choosing between NSAIDs or opioids, there is no universal best option, according to Dr. Kevin Zacharoff, faculty member, clinical instructor, and course director of Pain and Addiction at the Renaissance School of Medicine at Stony Brook University.
The most appropriate medication depends on the individual patient.
The choice further depends on pain severity, type, patient risks, and individual factors.
“NSAIDs are typically the first-line treatment for mild to moderate pain due to their safety profile, ease of access, and effectiveness for most common pain conditions,” he explained.
Opioids, due to their potential risks and addictive properties, are usually reserved for severe pain, acute injuries, post-surgical recovery, or severe chronic pain that has not responded to other treatments, Dr. Zacharoff said. But there are exceptions.
“In some cases, a combination of both medications may be used cautiously and under close medical supervision,” he added. This approach can enable lowering opioid doses while maintaining pain control.
Confusion Around Pain Treatment Guidelines: Expert
Dr. Zacharoff said he believes we are in a confused state regarding pain treatment. The push to reduce opioids may actually be worsening pain relief outcomes, he added.
“We’re starting to see a lot more in the scientific literature about this, and it’s a very large problem for a certain percentage of patients.”
However, Dr. Zacharoff cautions against perceiving NSAIDs as universally safer alternatives. For many older adults, those with hypertension or coronary artery disease, NSAID use is often contraindicated due to risks.
“I think that people don’t realize that NSAIDs and acetaminophen—which is not an NSAID, by the way— … carry their own level of risk,” he said. “Whether we like it or not, every treatment option carries risk.”
Ultimately, while NSAIDs and opioids are both effective for pain relief, they do differ in terms of safety, potential risks, and appropriate uses.
It’s crucial to consult with a health care professional to determine the most appropriate pain management approach based on your individual needs and circumstances.
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Dave
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High CBD cannabis is all you need for pain management. Cannabis reduces inflammation also.
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VOWG
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As an arthritis sufferer I tried it, it didn’t work, not as smoke or edible. No relief. If forgetting the pain is considered relief for a brief period, forgetting is not worth the effort. Advil (ibuprofen) will give several hours of relief if I take 600 mg. I have found it more effective than any prescriptions my doctor ever wrote for the problem.
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Dave
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Better keep tabs on your Liver health.
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Dave
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Hopefully this info will help. See below.
If you have medical cannabis dispensaries in your area go get you Med recommendation from your doctor. The Med. Cannabis dispensaries have people that are there to help their patients with the various questions about their ailment and what’s the best recommendation and type of medical cannabis for their condition. See this article about CBD from one of the best growers in the area of the state I live. Good luck!!
https://curiowellness.com/what-is-cbd-unlock-the-mystery-of-cannabidiol-and-its-benefits/?_kx=a6VAgNJLFtlP4lTw_rIuRfkp5aBM1isZau0j8cBHGVo%3D.XaUs5D
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Jerry Krause
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Hi VOWG and other Readers,
George wrote: “The answer is complicated at best—and it may vary from person to person, according to experts.”
One should not need an expert to tell one that most all people, except identical twins, have a unique DNA molecule. Hence life science is totally different than physical science were there are less than 100 naturally occurring elements and some of these elements can be grouped into ‘families because of common, but not identical chemical and physical properites.
And if life scientists (doctors) ignore the fact that most individuals are different, confusion reigns.
Have a good day
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