• Gary M Ruoff.
• Gary M. Ruoff, MD, Clinical Professor of Family Medicine, Homer Stryker MD School of Medicine, Western Michigan University, Kalamazoo, Michigan.
• J Fam Pract. 2022 Jul 1; 71 (6 Suppl): S29-S33.

Key TakeawaysThe use of opioids in acute pain may be appropriate in some situations, but there are opportunities to reduce exposure to opioids with equally effective monotherapy and combination therapy over-thecounter (OTC) medications. There are a number of OTC analgesics that are readily accessible and costeffective options to treat pain. The American College of Rheumatology Osteoarthritis Guideline "strongly" recommends the use of topical nonsteroidal antiinflammatory drugs (NSAIDs) and oral NSAIDs to treat arthritis pain, and it conditionally recommends against the use of opioids (other than tramadol). The American Headache Society suggests that OTC NSAIDs and combination medications such as acetaminophen, aspirin, and caffeine are Level A recommendations for reducing migraine pain and other symptoms. Nonopioid OTC analgesics, such as NSAIDs and the NSAID/acetaminophen combination, are safe and effective firstline options for managing acute dental pain according to the American Dental Association. The American College of Physicians supports the use of NSAIDs as first-line therapy for the treatment of low back pain.

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