Pain happens, but when it sticks around for a long period of time or feels unbearable, nonaddictive pain medication may sound like a safer alternative to opioids.
Most people have experienced physical pain to some degree, whether it’s something more temporary, like stubbing your toe, or more chronic, like arthritis in your lower back.
How you treat pain depends on its cause and how badly it hurts. When pain is severe, healthcare professionals often prescribe medications called opioids.
Opioids are potent and considered some of the most effective pain medications available, but they come with an addiction warning. It’s natural to be wary of these drugs.
You have choices, however. Many nonaddictive pain medications are available — and even preferred — depending on your source of pain.
Why are opioids addictive?
Opioids are medications originally derived from natural opioid compounds, extracts from the seed of the poppy plant. This group of drugs includes pain medications such as morphine, codeine, and thebaine.
Opioids can create an environment for addiction because they boost reward-specific transmitters in your brain, like dopamine. Over time, your body comes to rely on the opioid to trigger the release of these chemicals, leading to dependence, cravings, and tolerance.
Nonaddictive pain medication classes include:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- muscle relaxants
- local anesthetics
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are medications that manage pain
There are currently more than 20 different NSAIDs on the market. Some of the most common names include:
NSAIDs can be used for a wide range of pain management in conditions like:
- muscle pain
- chronic lower back pain
- menstrual cramping
- acute tissue injury
- cardiac disease
Acetaminophen (Tylenol) is classified as a non-aspirin pain reliever and is a fever and pain reducer, though its exact mechanisms of action are unknown.
While acetaminophen is an active ingredient in hundreds of over-the-counter (OTC) products alone, it’s
Acetaminophen has high safety ratings, however, and is the preferred pain management medication for mild pain.
Experiencing muscle spasms with an injury can add to already existing pain. Muscle relaxants help control spasms to take that variable out of the pain equation.
Whether or not muscle relaxants provide beneficial levels of pain management remains up for debate, however. A
Common muscle relaxants include:
Corticosteroid medications manage pain by controlling inflammation and suppressing immune responses that might lead to inflammation. Typically prescriptions, corticosteroids are often used in conjunction with other medications, including opioids.
You may be prescribed these nonaddictive medications for conditions of bone pain, neuropathic pain, or pain that’s associated with an autoimmune condition.
Also known as antiepileptics, anticonvulsants are used for chronic pain management in conditions with neuropathic pain (pain associated with nerve damage).
Common conditions of neuropathic pain include:
- nerve damage from surgery or trauma
- viral infections
- multiple sclerosis
- vascular malformations
The most common choices are gabapentin and pregabalin, which work by regulating your brain’s pain stimulus pathways.
Antidepressants are medications often used to help regulate mood, but they also have a place when it comes to pain management.
Like anticonvulsants, serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants (TCAs) may be beneficial for conditions of neuropathic pain.
Antidepressants with the
When you need pain relief in an exact spot, local anesthetics like lidocaine can stop nerves in the injured area from sending pain signals to the brain.
Local anesthetics are common when you have an injury that might need stitches, for example, but doesn’t require you to be under full anesthesia.
Some local anesthetics are also available in topical forms for use on minor injuries, dental pain, or muscle aches.
Acetaminophen is the most commonly used non-opioid pain medication in the United States. It’s in more than 600 OTC and prescription medications and is taken in some form by approximately 52 million people every week.
Everyone’s perception of pain is different. What works well for you may not work at all for someone else.
Pain medication strength can be evaluated in a general sense, however, by using a statistical measure known as “the number needed to treat (NNT).”
The NNT is determined by how many people are given a pain medication before it’s seen to be effective. The lower the number, the more effective the treatment is considered.
According to the National Safety Council (NSC), opioids aren’t the most effective pain relievers in terms of the NNT scales. A combination of two nonaddictive pain medications — ibuprofen and acetaminophen — appears to be superior based on emerging research.
Even without this combination, the NSC data indicates that naproxen, an NSAID, has a higher NNT compared with common opioid postoperative pain prescriptions.
Even nonaddictive pain medications come with the risk of mild or serious side effects.
NSAIDs, for example may cause:
- upset stomach
In rare cases, they can cause peptic ulcers or kidney and liver complications.
Acetaminophen has a similar list of adverse effects, including:
- skin rashes/hypersensitivity
- facial swelling
- upset stomach
It can also cause potentially serious liver conditions that may lead to liver failure.
Just because a medication has a low addiction risk doesn’t mean it’s the right or better choice for your pain management needs. Every medication comes with potential side effects.
A healthcare team can help you decide which medications may be safest for you.
Nonaddictive pain medications and substance misuse
While “addiction” is a term often reserved for substances, like opioids, that can create chemical dependence, it’s still possible to experience substance misuse with other medications.
Living with chronic pain can be overwhelming. It can be tempting to take higher amounts or more frequent doses of pain medication to try and manage symptoms. Any use of nonaddictive pain medication that is against a doctor’s recommendations is misuse.
Nonaddictive pain medications come in OTC and prescription form. They’re alternatives to opioids, traditional medications known for their addictive potential.
Acetaminophen remains the most popular nonaddictive pain medication in the United States, but emerging research suggests it may be strongest when combined with ibuprofen.
All types of pain medications come with possible side effects. A healthcare team can help determine which medication is best for your needs.
If you or a loved one are concerned about addiction or substance misuse, you can speak to someone 24/7 by calling the SAMHSA National Helpline at 1-800-662-4357.