My understanding as a layman who’s dealt with workers’ comp cases for 20+ years is that opioids remain very effective for managing severe acute pain such as pain from terminal cancer or pain from surgery. However, the problem is that they were utilized for chronic and ongoing pain and for that, there can be some fairly severe problems.
It’s wrong to say that anti-inflammatories are flatly “better or equal” than opioids, from my understanding. They treat different things and affect pain in different ways.
I’ve deposed a lot of doctors about pain, including numerous specialists in pain management and they agree that pain exists on a continuum. Pain has a range of causes and contributing factors, from the mechanical cause of the pain (tissue damage, inflammation, etc.) up through the peripheral nerve transmission of pain, through the central nervous system transmission of pain, through the brain receiving the signal all the way to the mind interpreting the signal.
Opioids will not do anything for the underlying source of the pain, but if that source is inflammation, then anti-inflammatory meds can help a lot. Conversely if the underlying source of the pain is not related to inflammation or if the pain is generated by the peripheral or central nervous system or by the brain or by the mind, anti-inflammatory meds will accomplish only a placebo effect.
In the long run, serious pain management requires a range of treatments, not just take an ibuprofen and call me in the morning.
There is one common source of pain where both opioids and tylenol are probably not very good compared to anti-inflammatory meds and that is the garden variety non-surgical back strain. It’s one of the most common work injuries, and one of the most common ailments, and anti-inflammatory meds can help a ton. However, if there is real spinal damage, all the ibuprofen in the world ain’t gonna do much in the very long run.