NPR

Questions And Answers About Opioids And Chronic Pain

Are opioids the best way to manage long-term pain? NPR's Ari Shapiro talked with Dr. Ajay Wasan, a pain specialist at the University of Pittsburgh Medical Center, to find out.
When it comes to chronic pain, how do patients and doctors find the right treatment?

Millions of Americans use opioids to relieve pain. But many also struggle with addiction.

This week, a report in JAMA, the journal of the American Medical Association, found that nonopioid painkillers — like acetaminophen and ibuprofen — were as effective as opioids at treating chronic back, hip and knee pain, and with fewer side effects.

The findings raise a lot of questions about the right approach to managing pain, particularly chronic pain. So earlier this week, we asked listeners on Facebook and Twitter to share their questions about treating chronic pain.

For answers, NPR's Ari Shapiro turned to Dr. Ajay Wasan, professor and vice chair for pain medicine at the University of Pittsburgh Medical Center.

Questions and answers have been edited for length and clarity.

Isn't it true that ... acetaminophen can be very damaging to the liver, particularly with daily long-term use? — Emma Juneau

For treatment of chronic pain, especially arthritis pain, higher doses of acetaminophen have been recommended, and there are good studies supporting that it can be quite effective for pain. You get a cumulative effect with the

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