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Managing pain without opioids is possible — and often safer for many people. If you’re worried about developing opioid use disorder (OUD), are in recovery, or want to avoid opioid risks, non-opioid pain medications may be a good option. These medications can lower the risk of dependence linked to opioids. Many also have fewer or milder side effects, such as less drowsiness, nausea, or constipation, compared to opioids.
Non-opioid pain medications can often be used alongside medications for OUD, supporting your recovery and helping you stay comfortable. Choosing non-opioid options can also help you avoid the stigma or judgment that sometimes comes with opioid use.
This article covers several non-opioid pain medications approved by the U.S. Food and Drug Administration (FDA), how they work, and what to ask your healthcare provider.
Acetaminophen is a non-opioid painkiller used for mild to moderate pain and to reduce fever. People often take acetaminophen to relieve headaches or manage arthritis pain. You can buy acetaminophen over the counter at most drugstores, and you don’t need a prescription. It’s usually taken by mouth as a pill, but it can also be given intravenously (through a vein) in a hospital setting for faster relief.
Researchers aren’t entirely sure how acetaminophen works. It’s an analgesic (pain reliever), but it doesn’t reduce inflammation like some other pain medicines. Some research suggests that acetaminophen may also affect certain systems in the brain that help control pain.
Taking high doses of acetaminophen can cause serious liver damage. Do not take more than 3,750 milligrams per day, and avoid combining it with alcohol. Acetaminophen can also cause rare allergic reactions, including skin rash, itching, or hives.
Nonsteroidal anti-inflammatory drugs, or NSAIDs, are a group of non-opioid medicines used to treat pain that’s caused by inflammation. People often use NSAIDs for back pain, minor injuries, arthritis, or menstrual cramps and to reduce fever.
Common examples include:
NSAIDs are available over the counter, but a healthcare provider can prescribe stronger doses if needed. Most NSAIDs are taken by mouth as a pill, but some are available as topical creams or gels you can apply to your skin to help with muscle aches or sprains.
NSAIDs block COX enzymes (proteins in the body), which help create chemicals that cause pain, swelling, and fever. These enzymes also protect your stomach and help your kidneys work well. That’s why NSAIDs can sometimes affect those organs.
Taking NSAIDs for a long time or at high doses can irritate your stomach, cause ulcers, or raise your blood pressure. Talk to your healthcare provider before taking NSAIDs if you have liver disease or heart failure or are pregnant. Children and teens under 19 should not take aspirin, as it can cause Reye’s syndrome, a rare but serious condition that can damage the brain and liver.
Duloxetine (brand name Cymbalta) is a serotonin-norepinephrine reuptake inhibitor (SNRI) originally developed as an antidepressant. It’s also approved to treat chronic (long-term) pain, including nerve pain and muscle pain. Duloxetine comes in a capsule and must be prescribed by a healthcare provider.
Duloxetine is a non-opioid medicine that increases serotonin and norepinephrine in your brain. These chemicals help boost mood and also reduce pain signals.
Side effects of duloxetine are typically mild, but it can include nausea, drowsiness, and dizziness. Other possible side effects include constipation or diarrhea. Duloxetine may not be a good choice if you have certain health conditions, such as bipolar disorder, liver disease, or kidney disease. Duloxetine may also increase the risk of suicidal thoughts in some people, particularly those under 25.
Note: If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or chatting online.
Duloxetine might take two to four weeks to work before you start feeling the full benefits. You can sometimes take it with other pain medications. However, talk to your healthcare provider before taking NSAIDs with duloxetine because the combination can raise your risk of bleeding.
Gabapentin (Neurontin) is an oral medication used to prevent seizures in people with epilepsy. It’s also approved to treat nerve pain after shingles. It’s often prescribed for other types of nerve pain, such as diabetic neuropathy (nerve pain in the legs or feet due to diabetes) and, in some cases, restless legs syndrome. Gabapentin is available only with a prescription from a healthcare provider.
Gabapentin works by calming overactive nerves. It helps reduce pain signals from nerves to the brain and can prevent seizures. Because it takes time to calm the nerves, you may not feel relief right away — it can take a few weeks.
Gabapentin can cause side effects like dizziness or sleepiness. Some people may also notice coordination or vision problems. You should avoid drinking alcohol while taking gabapentin, as it can increase drowsiness or dizziness.
Before starting gabapentin, talk to your healthcare provider if you have breathing problems, kidney disease, or changes in mood or mental health.
Suzetrigine (Journavx) is a relatively new drug, available by prescription. It’s approved to treat moderate to severe acute pain. Suzetrigine is taken by mouth as a tablet.
Suzetrigine is different from many older pain medicines because it prevents pain signaling in the brain. It blocks a particular sodium channel on pain-sensing neurons in the body, which helps to interrupt pain signals sent to the brain. By acting only on this channel, suzetrigine may reduce pain with fewer side effects than some other pain relievers.
Because suzetrigine is new, its long-term risks and benefits are still being studied. So far, the most common side effects seen in early research have been skin rash, itching, and muscle spasms. Avoid eating grapefruit or drinking grapefruit juice while taking suzetrigine — grapefruit can affect how the drug is processed in your body and may increase side effects.
Tell your healthcare provider if you have kidney or liver disease before starting suzetrigine.
The approval of medications like suzetrigine shows that new treatment options are emerging for pain management. Because there are options, opioids are usually a last resort for chronic pain.
These advancements could mean that the future of pain care will be less dependent on opioids, which is especially important for people who live with OUD or are working toward recovery. Choosing the right pain relief option can support your OUD recovery goals and help you manage pain without fear of relapse.
On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.
Which non-opioid pain medication has helped with your pain? Let others know in the comments below.
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When Was Suzetrigine Approved By The FDA?
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If nsaids worked and acetaminophen worked as you described no one would be on opioid, the fact that there a joke and we need things like oxytocin..
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