(Patrick Sison/AP)
The question

People treated in the emergency room for a sprain, strain or fracture are generally given opioids to help them cope with the pain, often leaving with a prescription for opioids, too. Might non-opioid painkillers work just as well as these addictive drugs?

This study

The study involved 416 adults (average age, 37) who had gone to an emergency department with an extremity injury causing moderate to severe pain (averaging 8.7 on a scale of 1 to 10).

For pain, they were randomly assigned to take acetaminophen along with a non-opioid — ibuprofen — or with one of three commonly prescribed opioids: oxycodone, hydrocodone or codeine.

Within two hours, all participants reported essentially identical declines in pain, about four points on the scale. Even for people who initially had rated their pain as a 10 (for the worst pain possible) or had broken a bone, there was virtually no difference in pain reduction between those who had and had not taken an opioid.

Who may be affected?

Adults with arm or leg pain caused by a sprain, strain or fracture. Research has shown that even short-term opioid use, such as that stemming from an initial prescription for pain from an injury or surgery, can make people predisposed to a dependence on the powerful drugs — partly from their effectiveness at relieving pain and partly from the euphoria they produce. Abuse of opioids has become an epidemic in the United States, with opioids now causing 60 percent of drug overdose deaths.


Data on pain came from the participants' ratings; no information on side effects was collected. The study did not assess longer-term pain reduction.

Find this study

Nov. 7 issue of JAMA (jama.com; click on "Issues")

Learn more

Information on opioids can be found at drugabuse.gov (click "Drugs of Abuse," then "Opioids") and at familydoctor.org (search for "opioid addiction").

The research described in Quick Study comes from credible, peer-reviewed journals.