Guide to Over-the-Counter & Alternatives to Hydrocodone

Medically Reviewed

Hydrocodone is a powerful prescription pain reliever. It is an opiate drug often found in combination with medications like Vicodin, Lorcet, Zohydro, and Norco that also typically include an over-the-counter (OTC) painkiller such as acetaminophen. Hydrocodone is a potent narcotic that also acts as an antitussive or a cough suppressant.

Prescription-strength pain relievers are regularly misused. The National Survey on Drug Use and Health (NSDUH) reports that in 2016, hydrocodone-containing products were the most regularly abused type of prescription painkillers, as nearly 7 million people in the United States abused one in the prior year.

Hydrocodone and opioid drugs interact with brain chemistry by binding to opioid receptors in the brain, which helps to block pain sensations. But they also increase levels of dopamine, which serves to enhance feelings of pleasure and makes these drugs a target for misuse.

Opioids are highly addictive. In 2015, more than 2 million Americans struggled with opioid addiction.

Due to the number of side effects related to hydrocodone, it is often desirable to come up with an alternative for managing pain and suppressing cough. A multitude of over-the-counter products is marketed for these purposes. Some levels of pain can also be controlled through natural methods.

If you are already taking hydrocodone or an opioid drug, talk to a medical professional about weaning off it safely before stopping it suddenly. Pain management is something that should be discussed with your doctor to ensure the chosen methods will be safe and effective.

OTC Pain Relievers and Cough Suppressants

In general, there are two main forms of OTC pain relievers: those containing acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Acetaminophen is found in the brand-name drug Tylenol, which comes in a variety of formulations, strengths, and products designed to control pain.

Acetaminophen is often the first choice for medical professionals when it comes to treating mild-to-moderate pain, Mayo Clinic explains. It does not reduce inflammation, and it also does not cause stomach bleeding or pain like other options can. High doses of acetaminophen can damage the liver over time, however, and it should not be mixed with alcohol. It also may not be as effective on severe pain or pain related to swelling.

NSAID medications include products containing ibuprofen (Motrin and Advil), aspirin (containing acetylsalicylic acid), and naproxen (Aleve). NSAIDs help to reduce inflammation, which is a common source of pain. When taken in large amounts, NSAIDs can cause nausea, stomach pain, and even stomach bleeding, ulcers, and kidney problems. NSAID medications are commonly beneficial for mild-to-moderate pain related to injuries, arthritis, and menstrual cramps.

The journal PT in Motion published a study done by the Journal of the American Medical Association (JAMA) indicating that non-opioid medications were found to be just as effective as opioids for improving functions and pain related to knee or hip osteoarthritis or chronic back pain.

Several herbs and natural remedies that may act as pain relievers as well include:

  • Turmeric: This curry spice acts as an anti-inflammatory to reduce pain.
  • Willow bark: It contains salicin, which is converted to the primary active ingredient in aspirin (salicylic acid). Therefore, it acts as an anti-inflammatory and helps to reduce fevers and pain.
  • Ginger: This natural remedy has both anti-inflammatory and antioxidant properties.
  • Capsaicin: Found in chili peppers, it can be used as a topical gel or cream pain reliever for muscle, joint, or knee pain.
  • Valerian root: Commonly drank as a tea, it has calming and natural tranquilizing effects that can help with the pain.
  • Magnesium: This is a mineral many people are deficient in that can aid in muscle healing, calm muscle spasms, and promote healthy sleep to decrease pain.
  • Fish oil: It has anti-inflammatory properties that can reduce swelling and, therefore, pain.

There also are many topical OTC pain-relieving products that can be rubbed directly into a particularly tender spot. Products containing lidocaine (Aspercreme) and methyl salicylate (Bengay, which also contains camphor and menthol) have local anesthetic properties when placed directly on the skin and can temporarily reduce pain.

Hydrocodone also acts as a cough suppressant, and there are many OTC cough medications on the market. A common antitussive is a dextromethorphan, which is found in products like Robitussin, Triaminic, and Vicks 44. Dextromethorphan is a product that can be abused as well. It needs to be taken as directed, as misuse can lead to overdose, drug dependence, and addiction.

Natural Remedies for Pain

There are a few different types of pain, and depending on the cause and root of the pain, the method for treating it may differ. Pain-related to injuries, for example, is short-term pain, and it often includes a fair amount of swelling and inflammation. Ice, rest, and elevation of the injured area above the heart are common remedies for a sprain, strain, or joint injury. Ice is effective, easy, cheap, and a great method for reducing pain, and the same is true for heat.

The general rule is ice for an immediate injury and heat for chronic pain, muscle aches, or stiffness, Pain Science explains. A heating pad or taking a hot bath can be a great way to reduce stiffness, alleviate soreness, and reduce pain naturally.

Massage, chiropractic care, and acupuncture can all be alternative therapies for pain relief. Both massage and chiropractic practices use physical body manipulation to reduce tension, and therefore, ease aches and pains. Acupuncture aids in enhancing blood flow and helps the body and brain to perform as optimally as possible by placing specialized needles in specific pressure points on the body.

Yoga and mindfulness meditation has been shown to minimize the physical pain. Psychology Today publishes studies indicating a reduction in chronic pain of nearly 60 percent using mindfulness meditation. This form of meditation puts you in tune with your body and how you are feeling to create balance and more self-awareness. In so doing, brain chemistry can be regulated and pain influenced.

“Pain can often be, at least partially, the result of nerve firings and a chemical imbalance in the brain. Controlling pain can, therefore, likely be managed with efforts to stabilize this. Physical and aerobic exercise can release endorphins that help to minimize pain, as can relaxation techniques.”

Biofeedback uses electronic sensors that can help a person to determine what they are feeling and when to enhance relaxation and learn how to better understand, and therefore, control, feelings, and physical sensations. As published in the journal Practical Pain Management, when provided by a trained professional, biofeedback can be a beneficial tool in helping to manage chronic pain.

Pain is the No. 1 cause of disability in the United States, and the National Institute of Health (NIH) publishes that more than 75 million Americans have chronic pain. Pain is something that can interfere with daily activities and quality of life.

Taking a drug like hydrocodone long-term can be dangerous, so it is helpful to have alternatives for managing pain that does not involve potent narcotics. Pain management methods should be discussed with a medical professional.

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