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Intravenous (IV) acetaminophen (1000 mg) alleviates severe pain — but not as well as 1 mg of IV hydromorphone — in young adults in the emergency department (ED; NEJM JW Emerg Med Oct 2018 and Ann Emerg Med 2019; 73:133). Older patients tend to receive lower doses of IV opioids (and treatment delays) when they present with severe pain, because of concerns for medication side effects and interactions. Investigators randomized 162 older ED patients (age, ≥65) with acute severe pain to receive either 1000 mg of IV acetaminophen or 0.5 mg of IV hydromorphone in a double-blind study. Patients with chronic pain or those with recent use of pain medications were excluded. Pain-score change of ≥1.3 on a 10-point scale was considered to be a clinicall…