A patient with a history of drug and alcohol use presents in pain. What is the BEST analgesic (no mention of cirrhosis)?

Without known liver disease (cirrhosis), ibuprofen is preferred because chronic alcohol abuse increases risk of acetaminophen hepatotoxicity (even at normal doses). Ibuprofen should be used cautiously with GI or renal concerns, but is safer than acetaminophen in alcohol users without liver disease. Opioids risk addiction in this population.