United Kingdom

Ibuprofen kills pain BETTER than codeine with fewer side effects, study finds

Ibuprofen provides better pain relief than the more widely-prescribed codeine, a new study has suggested.

Researchers said the cheap, over-the-counter drug is also less addictive and causes fewer side effects than codeine.

More than 5,000 people across 40 trials took part in the study, which found that patients given a non-steroidal anti-inflammatory drug (NSAID) felt far less pain within six to 12 hours than those taking codeine. 

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Effective: Ibuprofen provides better pain relief than codeine, a study has found. Researchers in Canada also said ibuprofen is less addictive and causes fewer side effects than codeine


Opioids originally came from the sap of the poppy plant and  include codeine, morphine and heroin. 

They help numb acute pain such as a broken bone by acting on the opioid receptors in the brain, blocking pain signals from the rest of the body. 

However, the dangers of long-term opioid use are that it puts you at increased risk of constipation, memory loss, addiction and even accidental death by overdose.

NSAIDs such as ibuprofen, meanwhile, work by blocking your body's production of certain natural substances that cause inflammation.

Ibuprofen was discovered 60 years ago in a small test lab in a house in Nottingham.

It is used to decrease pain or fever and is taken by sufferers of osteoarthritis and rheumatoid arthritis, as well as injured sportspeople, professional and amateur.

'In all surgery types, sub-groups and outcome time points, NSAIDs were equal or superior to codeine for postoperative pain,' said Dr Matthew Choi, associate professor of surgery at McMaster University in Canada.

'We found that patients randomized to NSAIDs following outpatient surgical procedures reported better pain scores, better global assessment scores, fewer adverse effects and no difference in bleeding events, compared with those receiving codeine.' 

Codeine is Britain's most commonly prescribed opioid — with usage of it having risen five-fold in the last decade. There are 2,456 prescriptions per 10,000 citizens. 

Those findings sparked fears the UK could soon face an addiction crisis similar to the one taking place in the US, where overdose deaths from prescription opioids rose from 3,400 in 1999 to about 17,000 in 2017. 

Earlier this year, the UK's medicines watchdog, the National Institute of Health and Care Excellence (NICE), recommended that millions of patients suffering chronic pain with no known cause should not be prescribed painkillers amid addiction fears.

While codeine is only available on prescription in Britain, it can be bought at pharmacies in the form of the lowest strength co-codamol, when it is combined with paracetamol — or Nurofen Plus, when it is mixed with ibuprofen. 

Ibuprofen is sold over the counter for around 50p for 16 200mg tablets. 

Widespread: Codeine is Britain's most commonly prescribed opioid — with usage of it having risen five-fold in the last decade . There are 2,456 prescriptions per 10,000 citizens (stock)

The NSAID works by blocking your body's production of certain natural substances that cause inflammation, and is used to decrease pain or fever. 

Researchers also found that as well as being more effective at relieving pain than codeine, NSAIDs also caused fewer side effects such as nausea, vomiting, dizziness and headaches.

They said the drugs should be used as an alternative to opioids for patients who have undergone dental and surgical procedures.

'These findings are of general importance to any clinician performing painful medical procedures,' the researchers said.


The opioid crisis in the US has been caused by soaring numbers of prescriptions for the powerful painkillers.

Prescriptions for them are popular because they're effective, well-tolerated painkillers. 

But as people build up tolerance to the drugs they run the risk of taking too much.

In 2017 and 2018, opioids were involved in more than 47,000 deaths, according to the US Centers for Disease Control and Prevention – overdoses directly caused around 17,000 deaths in each of those years.

In 1999, by comparison, there were fewer than 4,000 opioid overdose deaths.

Many overdoses are caused by the drug fentanyl, which is dozens of times stronger than morphine and can take users by surprise.

As people spend longer taking opioids, which they may have originally been prescribed after an injury or operation, their tolerance gets higher and they have to take more to have the same effect.

This can cause people to ultimately take too much and kill themselves or to try switching to a more powerful drug and overestimating how much they should take.

One brand, OxyContin, which is a drug called oxycodone, has been blamed for many of these deaths by critics who claim it ran an aggressive marketing campaign in the 1990s which drove prescriptions up.

Its producer, Purdue Pharma, owned by the billionaire Sackler family, is facing more than 2,000 lawsuits for which it has offered to pay out up to $12billion (£9bn).

Purdue filed for bankruptcy in September in a bid to help it pay out in the gigantic court battle. 

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