What is the best non-opioid pain medication?
By: Lakeview Health Staff
Published: December 15, 2023

Living with chronic pain is an all too familiar reality for many people. In fact, more than 51 million Americans experience pain every day. This constant discomfort can drastically affect your ability to function at work or take care of your family, and it could create barriers in managing other health conditions and just generally participating in daily life.

While opioids might come to mind as the go-to solution, they aren’t always your best option; non-opioid alternatives can often be more effective and come with lower risks.

For those struggling with opioid use disorder or other addictions, or those worried about addiction and wanting to stay away from opiates, finding safe and effective pain management alternatives is critical. The information below is not medical advice, and you should always speak with a licensed medical provider before beginning, changing, or ending any medications.

Common opioid based medication for pain

Dealing with severe pain can be challenging, and there are a variety of opioid-based medications that doctors might consider prescribing to provide you relief. Some of the most common include: 

Morphine

Morphine is often used in the management of severe pain, especially to alleviate the discomfort from surgical procedures or in advanced stages of diseases like cancer. While it’s highly effective, morphine has a significant potential for addiction and should be used only under careful medical supervision. 

Oxycodone

This is an opioid pain medication that effectively treats moderate to severe pain. It’s often prescribed for a range of conditions following injuries or surgeries, and for chronic illnesses or degenerative diseases. 

Hydrocodone

Hydrocodone is typically combined with another medication like acetaminophen and used for moderate to severe pain. It is commonly used after dental procedures. 

Codeine

Codeine is usually prescribed for mild to moderate pain relief. In addition to use after surgeries, it also an ingredient in some cough and cold medications. 

Methadone

While methadone can be used to manage chronic, severe pain, it is most often prescribed as a part of opioid addiction treatment. When administered correctly under medical supervision, methadone helps to mitigate pervasive withdrawal symptoms and cravings associated with opioid dependency.

Tramadol

Tramadol is often used for moderate pain management. While less potent than many of the other opioids on this list, its effectiveness over longer durations makes it appropriate for more chronic conditions like arthritis. 

Why Opioid Based Pain Medications Are Dangerous

While opioid-based medications can be essential for pain management in certain cases, their usage is not without serious risks, including:

Tolerance Development

Over time, your body will build up a tolerance to opioids and need more of the drug to experience the same level of pain relief. 

Developing a tolerance can be dangerous for several reasons. First, needing more of the drug to achieve the same effects may lead you to use in excess or take it more frequently than is safe. Second, as dosage increases, so does your exposure to risk factors associated with opioids like physical health deterioration, cognitive impairment, and overdose. 

Withdrawal Symptoms

If you stop taking opioids suddenly after using them regularly, you may experience painful and sometimes debilitating withdrawal symptoms, such as diarrhea, restlessness, severe nausea and vomiting, and other flu-like symptoms. It can be incredibly uncomfortable, leading someone back to using opiates to avoid these symptoms. 

Impaired Functioning

Opioid-based medication can significantly impair your mental and motor functioning, as it causes drowsiness, confusion, sedation, or even induces life-threatening respiratory depression in high doses. These complications put you at risk of accidents which could be fatal – for example, if driving while under the influence of an opioid. 

Overdose Risk

Overdoses happen when you take more of the drug than your body can process, which leads to life-threatening situations, as opioids impact portions of the brain that control vital bodily processes like breathing. 

Higher quantities consumed more frequently, or mixing these medications with other substances such as alcohol or benzodiazepines, greatly increases this danger. In critical cases, overdoses lead to loss of consciousness and fatal respiratory depression where breathing slows down significantly or stops completely.

Taking opioid-based medication requires careful management and monitoring by a medical professional due to the potential risks involved. While they can provide substantial relief for acute and chronic pain, it’s essential to understand the serious dangers related to their use. 

Frequency of Opioid Pain Medication Abuse and Addiction

Prescription opioid abuse represents a serious public health issue. It is recognized as an epidemic due to the broad scale of misuse and associated health risks. Here are some key statistics:

  • About 52 million (18%) of Americans aged 12 and above consciously abused prescriptions at least once throughout their lives.
  • Around 6% of Americans over the age of 12 (approximately 16 million people) purposely misused prescription drugs per year.
  • Among individuals who report abusing prescription drugs, around 12%, or close to 2 million Americans, have developed an addiction.
  • A strikingly high number of prescriptions filled at pharmacies contain opioids (about four out of every five).

While opioid-based medications offer important solutions for acute and chronic pain, their high risk of addiction and abuse underscore the necessity of careful prescription practices, educating patients about the risks, and providing effective treatments for those battling opioid addiction. 

The Most Powerful Non-Opioid Based Medication For Serious Pain

While opioid-based medications are commonly used for severe pain, there are non-opioid alternatives that can also provide substantial relief for certain conditions. Some common examples include:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

This includes commonly known drugs like ibuprofen or naproxen. NSAIDs are effective for swelling and pain related to inflammatory conditions such as arthritis. They block enzymes that promote inflammation, thereby reducing discomfort. 

Steroids

Steroids such as Prednisone can be instrumental in dealing with inflammatory conditions. They help to curb the excessive immune responses which can serve as sources of pain. 

Tricyclic Antidepressants (TCAs)

TCAs like amitriptyline and nortriptyline are also used in treating persistent, chronic pain — especially nerve pain which often develops due to unregulated neuronal activity.  

Often these non-opioid alternatives can be combined with other methods of management to increase their efficacy. 

Common and Effective OTC Pain Medication

Over the counter (OTC) pain medications can be a highly effective way to manage minor pain and discomfort. Common examples include the following: 

Acetaminophen

Commonly known by its brand name, Tylenol, Acetaminophen is an analgesic that’s used for combating mild-to-moderate pain. 

Ibuprofen

Often sold under brand names such as Advil and Motrin, ibuprofen is a type of nonsteroidal anti-inflammatory drug (NSAID) that’s particularly effective for pain relief. It’s also useful in managing inflammation and it works to reduce fever.

Naproxen

Naproxen is another example of NSAIDs that are available over the counter. This medication reduces inflammation and alleviates pain. In some cases, a higher dosage is available through a prescription. 

Topical Analgesics

Over-the-counter topical analgesic products like Icy Hot or BenGay can also be helpful in managing localized physical pain, especially in the form of muscle aches and joint issues.

While the challenges of managing severe pain and addiction can seem overwhelming, understanding alternatives to opioids is incredibly helpful. 

Treatment Options for People With Addictions to Opioid Based Pain Medication

For those grappling with an addiction to opioid-based medications, there are a variety of treatment options at your disposal.

Detoxification Programs

This is the initial step in the treatment process where patients stop taking opioids to remove these substances from their body. This period can be accompanied by uncomfortable, but treatable, withdrawal symptoms. The process should happen under medical supervision, usually within a specialized health facility to ensure the patient’s safety. 

Medication-Assisted Treatment (MAT)

In this approach, medications like methadone or buprenorphine are used to manage withdrawal symptoms and reduce cravings for opioids. These should be used as part of a comprehensive recovery program. 

Counseling and Behavioral Therapies

Counseling and behavioral therapies – like cognitive behavioral therapy and other evidence-based therapies – can provide skills and understanding in managing addiction. It teaches individuals to understand triggers behind substance use, devise strategies to address these effectively, and manage related mental health conditions if applicable. 

Inpatient or Residential Treatment Programs

These programs offer 24/7 structured care to people undergoing addiction recovery. By living in a residential setting, patients can access around-the-clock support from health professionals and engage in intensive therapies related to their addiction and recovery.

Outpatient Treatment Programs

These programs provide the necessary therapy and support while residing at home. This entails visiting a clinic or hospital regularly for treatment services, providing flexibility in maintaining activities like work or education while managing the recovery process. 

Support Groups

Peer-based addiction recovery groups such as Narcotics Anonymous (NA) provide a supportive environment by fostering shared understanding, feedback, and encouragement from those who have had similar experiences. They can be extremely helpful in maintaining long-term recovery. 

Holistic Therapies

Approaches such as yoga, meditation, and other breathing and relaxation exercises help to reduce stress and increase relaxation during the recovery process. While they should not replace conventional therapies, incorporating these practices can serve as a valuable component of an overall treatment plan by supporting mental well-being.

Overall, diverse treatment alternatives are available that could integrate medication, therapy, and lifestyle changes to support recovery from opioid addiction.

Navigating pain, especially chronic discomfort, while addressing the risks of opioid addiction can seem like an impossible journey. However, by understanding different treatment options and non-opioid alternatives available, these challenges become more manageable. It’s important to discuss your pain management plan thoroughly with your medical provider so you remain in full control of the decisions that impact your health and overall quality life.

If you’re struggling with dependence or addiction, seeking help is always encouraged – with help comes relief, recovery, meaningful support, and lifestyle modifications.