Feature Article

Alternatives to injectable opioids for acute analgesia

Sarah N Hilmer, J Paul Seale



Acute pain relief similar or superior to that provided by injectable opioids can be obtained from noninjectable opioids or other pharmacological and non-pharmacological means.

Key Points

  • General practitioners manage the majority of patients with acute pain in the community.
  • After a full clinical assessment, patients with acute pain should receive a multimodal management plan to control the acute pain and reduce recurrence or development of chronic pain.
  • Opioids may form part of this plan if the pain is moderate to severe and not relieved by other measures.
  • There are noninjectable alternatives to injectable opioids, and these are at least as efficacious, better tolerated and less addictive.
  • Of the injectable opioids, pethidine is the least reliably efficacious and the most toxic, most prone to drug interactions and most addictive, and so should be avoided.