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Randomised controlled trial
Non-opioid analgesia is as effective as opioid management in acute pain and supports a change in prescribing practice to help address the ‘opioid epidemic’
  1. Amelia Swift1,2
  1. 1 Department of Nursing, University of Birmingham, Birmingham, UK
  2. 2 Integrated Clinical Academic Office, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, United Kingdom
  1. Correspondence to Dr Amelia Swift, Department of Nursing, University of Birmingham, Birmingham B15 2TT, UK; A.Swift{at}

Statistics from

Commentary on: Chang AK, Bijur PE, Esses D, et al. Effect of a single dose or oral opioid and non-opioid analgesics on acute extremity pain in the emergency department: a randomised controlled clinical trial. JAMA 2017;318:1661–7.

Implications for practice and research

  • In some emergency department patients, combinations of non-opioid analgesia may be as effective in reducing pain as opioids.

  • Using non-opioid analgesia as a first-line treatment in short-term moderate to severe trauma pain might contribute to reducing long-term dependence on opioids.

  • Further research into dosing, adverse events, patient satisfaction and analgesia combinations in other patient groups is required.


Opioid analgesics are the first-line treatment for moderate to severe pain in the emergency department (ED) despite …

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