We would like to thank the editors for providing us an opportunity to further the discussion regarding opioid use for management of acute gout and Dr. Schlesinger and colleagues for highlighting yet another study describing the burden of opioid prescription for gout management. As appropriately pointed out, opioids do not reduce the inflammation of an acute gout attack and conventional anti-inflammatories like colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), and steroids can substantially reduce pain within the first 24 hours of administration.