Opioids are meant for moderate to severe pain management, but in reality are often used for mild to moderate pain as well. Opioid use is also complicated because of poor tolerance (codeine is the least tolerated opiate and has been removed from many formulations) and because of the high risk of patients developing opioid dependence. For these reasons, opioids should be second-line therapy.
Combined medications such as acetaminophen and an NSAID or combined opioid and nonopioid pain relievers have shown effectiveness in pain treatment—however, prescribers are limited both by the fixed dosing of manufactured combinations and the toxic limits and side effects of each component. More research should be conducted on new or nontraditional combinations such as gabapentin and ibuprofen.
For more information, the researchers’ full guidelines can be seen at the links below.
- Meeks NM, Glass JS, Carroll BT. Acute pain management in dermatology: Mechanisms and pathways. Journal of the American Academy of Dermatology. 2015; doi:10.1016/j.jaad.2015.03.061.
- Glass JS, Hardy CL, Meeks NM, Carroll BT. Acute pain management in dermatology: Risk assessment and treatment. Journal of the American Academy of Dermatology. 2015; doi:10.1016/j.jaad.2015.04.050.