Opioids, which are sometimes referred to as narcotics, are a group of medications used to treat severe pain. Opioids like Percocet, fentanyl, codeine, hydrocodone, and oxycodone can be great for pain management, but they can be addictive and aren’t meant to treat everyday aches and pains. Non-narcotic pain meds are alternatives to opioids that are not addictive and can effectively reduce pain.
When are prescription opioids necessary?
Opioid medications should only be necessary under certain circumstances. Many physicians are hesitant to prescribe them because of their addictive nature, which has resulted in a national opioid epidemic. According to the Centers for Disease Control and Prevention (CDC), more than 11.5 million Americans reportedly misused prescription opioids in 2016. Misuse can lead to overdose and death.
“Opioid pain medications have a very important role in the management of certain types of pain,” says Lawrence Iteld, MD, a plastic surgeon and owner of Iteld Plastic Surgery in Chicago. “These include sudden, unexpected pain—such as an injury or trauma—cancer pain, and end of life situation. The development of highly effective non-narcotic pain meds and pain strategies have allowed us to eliminate, or at least dramatically reduce, the need for narcotic pain medication following many elective, planned surgeries, and medical procedures. Additionally, many of these strategies apply to mild or moderate unexpected injuries, such as back strains, and other musculoskeletal injuries. The days of relying on bottles full of narcotic pain pills are, hopefully, behind us.”
8 non-narcotic pain meds
1. Aleve (naproxen)
Aleve is the brand name of a generic over-the-counter medication called naproxen. Naproxen belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs) that relieve pain by reducing the production of prostaglandins in the body. Naproxen is also available in higher strengths that require a prescription.
- Uses: Aleve can be used to treat pain from arthritis, menstrual cramps, low back pain, headaches, and other minor aches and pains. It can also reduce fevers.
- Dosage: The standard dose of Aleve for adults is 220 mg taken by mouth every eight to 12 hours while symptoms last. Do not take Aleve for more than 10 days in a row for pain control and further usage should be discussed with a healthcare provider.
- Side effects: It may cause side effects like heartburn, nausea, indigestion, water retention, and ringing in the ears.
2. Bayer Aspirin (aspirin)
Bayer Aspirin is a brand name of a generic over-the-counter medication called aspirin. Aspirin is an NSAID and blood thinner. Aspirin can reduce pain, fevers, and inflammation.
- Uses: People often take aspirin for pain relief from migraines, menstrual cramps, and arthritis pain.
- Dosage: Higher doses of aspirin for adults (325 mg to 650 mg) can be taken by mouth once every four to six hours for short-term pain relief. It may be safe to take low-dose aspirin daily on a long-term basis for cardiovascular health if approved by a healthcare provider. Otherwise, only use aspirin occasionally for mild aches, pains, and injuries.
- Side effects: Aspirin may cause side effects like an upset stomach, nausea, and indigestion.
3. Motrin, Advil (ibuprofen)
Motrin and Advil are some brand names of the generic medication ibuprofen. Ibuprofen is another NSAID that’s available over the counter under numerous brand names, or in a generic form. Ibuprofen is also available in higher strengths that require a prescription. It reduces pain, fevers, and inflammation.
- Uses: Ibuprofen is mainly used for muscle aches, menstrual cramps, toothaches, arthritis pain, and other aches and pains.
- Dosage: The standard dose of ibuprofen for adults is 200 mg to 400 mg taken by mouth every four to six hours. Do not take ibuprofen for longer than 10 days in a row unless otherwise approved by a medical professional.
- Side effects: Ibuprofen can cause side effects like dizziness, headaches, nausea, and upset stomach.
4. Tylenol (acetaminophen)
- Uses: Tylenol can be used to treat pain from backaches, neck aches, toothaches, menstrual cramps, colds, sore throats, headaches, and minor injuries.
- Dosage: The standard dose of Tylenol for adults is 650 mg taken by mouth every four to six hours while symptoms last. Do not take Tylenol for longer than 10 days in a row unless otherwise approved by a medical doctor.
- Side effects: Acetaminophen can cause side effects like nausea, vomiting, insomnia, itchiness, and stomach pain.
Commonly prescribed corticosteroids include hydrocortisone and prednisone. Corticosteroids are anti-inflammatory prescription drugs that treat chronic pain and inflammation.
- Uses: Corticosteroids may be prescribed for pain associated with osteoarthritis, rheumatoid arthritis, Crohn’s disease, and lupus.
- Dosage: The standard dose of a corticosteroid will depend on the specific medication being used and what it’s prescribed to treat. Corticosteroids are only okay for long-term use if approved by a medical professional.
- Side effects: They may cause side effects like acne, mood changes, bruising, insomnia, weight gain, fluid retention, changes in blood sugar and blood pressure, and an increased risk of infection.
6. Muscle relaxants
Muscle relaxants are stronger than over-the-counter pain medications and work by sedating the central nervous system. They can treat more serious pain from muscle spasms and cramps. Examples of commonly prescribed muscle relaxants include Robaxin (methocarbamol) and Fexmid (cyclobenzaprine).
- Uses: Many people with conditions like neck pain, back pain, fibromyalgia, and multiple sclerosis may benefit from taking muscle relaxants.
- Dosage: The proper dose of a muscle relaxant will depend on what it’s being prescribed to treat.
- Side effects: Muscle relaxants can cause side effects like drowsiness, fatigue, dizziness, dry mouth, and mood changes.
7. Tricyclic antidepressants
Healthcare providers may prescribe antidepressants off-label for long-term pain because they affect the way the brain processes pain. These medications typically take several weeks for people to notice optimal pain relief. Tricyclic antidepressants like Elavil (amitriptyline) and Pamelor (nortriptyline) affect serotonin and norepinephrine levels in the body.
- Uses: Tricyclic antidepressants act as painkillers for diabetic neuropathy, arthritis, shingles, fibromyalgia, and other chronically painful conditions.
- Dosage: The exact dose of a tricyclic antidepressant that someone needs to take will vary based on the specific type of pain and what’s causing it. Tricyclic antidepressants are safe for long periods of time if approved by a doctor.
- Side effects: These antidepressants can cause side effects like dry mouth, dizziness, weight gain, drowsiness, and constipation.
Neurontin (gabapentin) and Lyrica (pregabalin) are examples of anticonvulsant and antiepileptic drugs that can treat nerve pain. People with nerve pain can experience a burning sensation or stabbing pain that is often sudden. Anticonvulsants can interfere with the pain signals caused by overactive or damaged nerves.
- Uses: Certain anticonvulsants can treat nerve pain caused by diabetes, chemotherapy, fibromyalgia, shingles, or the herpes virus.
- Dosage: The standard dose of Neurontin for nerve pain is 300 mg to 1,200 mg taken by mouth three times per day. The standard dose of Lyrica for nerve pain is 300 mg to 600 mg taken by mouth per day in divided doses.
- Side effects: Neurontin and Lyrica may cause side effects like dizziness, loss of coordination, drowsiness, weight gain, dry mouth, and double vision.
Other non-opioid pain management tips
There are other ways to manage pain that don’t require taking medication. While it may be necessary to take some form of medication, you may be able to reduce the usage of non-narcotic pain meds by trying some other pain management strategies. Some people can even completely eliminate their need for pain medications. Here are some of the best ways to manage pain without opioids:
- Alternative medicine: Alternative medicine is anything outside the realm of Western medicine. It includes acupuncture, chiropractic adjustments, and massage therapy. Acupuncture is a popular alternative medicine where a professional inserts thin needles into the skin to stimulate nerves and muscles. Studies have shown that acupuncture can provide pain relief and enhance the healing process, but more research still needs to be done to solidify the efficacy of acupuncture.
- Home remedies: Some people find relief from their mild or moderate pain by using natural and home remedies. These options might include taking turmeric, topical capsaicin, or magnesium to relieve pain. Supplements like these reduce inflammation and pain over time and can help treat muscle soreness, muscle tension, and joint pain.
- Nerve blocks: Nerve blocks are injections of numbing medications that stop nerves from feeling and sending pain signals to the brain. Nerve blocks are useful for short-term pain, chronic pain, or pain after surgery. According to a population cross-sectional study published by Practical Pain Management, 94% of patients in the study said nerve blocks helped with their overall pain management.
- Physical therapy: Physical therapy can be useful for chronic or acute pain management after injuries or surgeries. Physical therapy can help improve strength, flexibility, endurance, power, and agility, all of which help the body function better and process pain more efficiently. Many people notice an improved quality of life after regular physical therapy sessions.
- Surgery: Although it’s rare, surgery is sometimes necessary for people with chronic pain. Someone with a compressed spinal disk, for example, may need surgery to correct the issue. Or someone with a severely arthritic or injured knee may need a knee replacement to alleviate pain.
- Topical options: Pain relief creams, ointments, gels, and patches are great options for people experiencing pain in a specific area of the body. These are also ideal for people that have difficulty swallowing medicine by mouth or people that need to avoid unwanted side effects of oral medication. Some examples include lidocaine patches, Voltaren gel (diclofenac), Aspercreme, and Icy Hot.