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Are There any Non-Narcotic Alternatives for Pain Treatment?

Although opioids remain the gold standard for managing many types of pain, including chronic pain, pain from injuries, and post-surgical pain, there are indeed alternatives that fall into the very broad category of non-narcotic pain relievers. Some of them, such as acetaminophen or Tylenol, ibuprofen, and other NSAIDS (non-steroidal anti-inflammatory drugs), such as naproxen, are even available over the counter in smaller dosages forms. Aspirin is a surprisingly effective NSAID derived from willow bark or synthesized in the lab. This article will discuss the following question: are there any non-narcotic alternatives for pain treatment?

Alternatives to Opioids

Opioids aren’t always the best choice for pain. In fact, some types of pain, such as that from fibromyalgia or nerve pain, may respond better to non-narcotic medications like gabapentin or pregabalin. That said, in general terms, opioids still provide the best relief from many kinds of chronic and acute pain. However, less severe pain may respond to non-narcotic drug alternatives and also to non-drug options, such as massage, biofeedback, meditation and acupuncture.

Tricyclic antidepressants or TCAs, normally used for the treatment of depression, may also be used off-label for the treatment of certain types of pain. TCAs are not narcotics or even controlled substances. These drugs are particularly effective for pain of neurogenic origin (the nerves) and migraine. They are thought to work by manipulating some of the brain’s neurotransmitters, calming the pain response.

Other methods for controlling pain could include local, regional or epidural injections of an anesthetic like lidocaine, which may be mixed with a steroid-like cortisone. These injections are long-acting and often quite effective, allowing the patient to greatly reduce or even eliminate narcotic use. Lidocaine can also be used topically or in the mouth to reduce oral pain.

Heat and Capsaicin

Some people may find relief from heat, whether from a heating pad or topical preparation. Some topical creams, available without a prescription, contain a substance called capsaicin, derived from hot peppers. It works by reducing a protein called Substance P, which is associated with pain.


Steroid drugs like cortisone and prednisone often produce dramatic reductions in certain types of pain by reducing the inflammation causing the painful symptoms. However, steroids carry very serious health risks when used chronically, so this drug class is typically limited to occasional use.

Ketamine: New Promise for a Very Old Drug

Ketamine is an old medication used for anesthesia in both human and veterinary medicine. It’s also a highly addictive drug of abuse known on the streets as Special K. Abusers seek its hallucinatory effects, searching for so-called enlightenment. Being deeply under the influence of ketamine, for an abuser, is a desirable state known as “being in the K-hole.” This is essentially a state of being totally detached from reality.

Chronic ketamine abuse also carries a significant risk of irreversible bladder damage, sometimes to the point of completely destroying the organ. When this happens, surgeons must construct a new bladder, and the unfortunate (or foolish) victim must forever urinate with the help of a catheter.

However, ketamine has important medical uses. When used in proper doses under expert medical supervision, it can virtually eliminate certain types of chronic pain all but intractable to standard treatments, even with opioids. The drug blocks a critical brain receptor known as NDMA. This receptor is not associated with the actions of opioids in the brain. The way ketamine acts on NDMA is sometimes described as a type of rewiring of the brain, resulting in dramatic pain relief.

A nasal form of the drug was recently approved for the treatment of depression as well. Ketamine is not a take-home drug. It carries a significant risk of serious side effects, such as terrifying hallucinations. This is why the drug is given only in a clinical setting by medical professionals trained and experienced in its use. In expert hands, the drug is considered safe and effective.

For More Information

If you’d like to avoid the risks of using opioids or would just like to know more about what your options are, we can help. We’re here 24 hours a day, just a phone call away at 844-903-2111. Studies have indicated that as much as half of a person’s risk for addiction overall may be determined by genes. Of course, addiction cannot occur if the person is never exposed to the drug in the first place. We’re professional drug counselors here to serve you and help you sort it all out. Let us help you make the best choices for you and your loved ones.