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A Surprising Result

A Surprising Result


In July, 2015 a randomized trial commenced, comparing the results of Tylenol and Advil to opioids for acute pain. The results were surprising. A combination of the two worked just as well as opioids.

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416 men and women who had an average pain score of 8.7 in their arms or legs from sprains, strains, fractures or other injuries. They were randomly assigned one of the drug combinations below. After 2 hours, they were asked what their pain level was. These are the results.

Oxycodone/acetaminophen (5/325)   4.4

Hydrocodone/acetaminophen (5/325) 3.9

Codeine/acetaminophen (30/300)   3.9

Ibuprofen/acetaminophen (400/1000)   4.3

The lead author, Dr. Andrew Chang, a professor of emergency medicine at Albany Medical College, states on average, even for severe pain of fractures, non-opioids worked just as well as the opioids more commonly prescribed.

Inclusion Criteria includes:

  • Complaint of acute pain of < 7 days duration
  • Location of pain in one or more extremities defined as distal to and including the shoulder joint in the upper extremities and distal to and including the hip joint in the lower extremities;
  • Radiologic evaluation is planned


Some exclusion Criteria includes:

  • Past use of Methadone
  • Chronic condition requiring frequent pain management
  • History of an adverse reaction to any of the study medications
  • Opioids taken in the last 24 hours
  • Ibuprofen or acetaminophen taken in the last 8 hours
  • Pregnancy/ Breastfeeding
  • History of Peptic ulcer disease
  • Reported use of prior use of narcotics
  • Medical condition that might affect the metabolism of medications
  • Taking of any medicine that might interact with one of the study meds.

Maybe it’s time to start looking at where a lot of addiction starts. Appropriate treatment from the start, can make all the difference in the patient’s future.

Last modified: December 11, 2020

2 thoughts on “A Surprising Result

  1. I find this surprising. But it does make sense. When I have a major pain Tylenol or Advil always works better than Hydrocodone for me.

    1. They used a mixture of the two in this study. Though they both have side-effects, none of them are tolerance or addiction. Also if you ever require surgery, the opiate medications will work much better for you with no tolerance issues.

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