The quest to relieve pain is as old as man: from rattles, gongs and the burning of incense, to the application of electric eels and mustard patches, to sawing small holes in the skull to let the pain out. In the Middle Ages, the popular “theriac” consisted of up to 64 different compounds dissolved in a base of honey. Today, hundreds of types of painkillers are available for the asking.
Types of Painkillers
There are three main painkiller categories, based on how they work: type of pain, physiology of the patient, and length of time over which the medication will be used are all factors in choosing. The first two listed below are available over the counter, the third requires a prescription.
1. Non-steroidal anti-inflammatory drugs (NSAIDS) are the most common pain relief medicines. Every day more than 30 million Americans use them to soothe headaches, sprains, arthritis symptoms, and other daily discomforts, as well as to lower fever and reduce swelling. Examples include ibuprofen, diclofenac, and naproxen. Aspirin also falls into this category, but it is mainly prescribed in small doses to help to keep the blood from clotting.
NSAIDs work on a chemical level, blocking the effects of special enzymes that play a fundamental role in making prostaglandins. (Prostaglandins are hormones created during a chemical reaction at an injury site. They are unique among hormones because they are created at the time they are needed directly where the problem exists.) The drug stops your body from making as many prostaglandins, resulting in less swelling and less pain.
2. Paracetamol/acetaminophen is a pain reliever and a fever reducer used to treat conditions such as a headache, muscle aches, arthritis, backache, toothaches, colds, and fevers. This drug works on the parts of your brain that receive pain messages and control your body temperature. Also, it can ease pain and lower a fever, but it won’t reduce any swelling and inflammation. It is less likely to cause stomach issues than other over-the-counter pain-relievers, but excessive use can result in liver damage.
3. Opioids/Narcotics are powerful pain-reducing medications that include oxycodone, hydrocodone, and morphine. (The illegal drug Heroin is also an opioid.) Usually prescribed after a significant injury or surgery, or for health conditions with severe pain like cancer, they are the most powerful pain relievers and are very effective, but they can sometimes have serious side effects. There is also a risk of addiction.
Opioid drugs work by binding to opioid receptors in the brain, spinal cord, and other areas of the body, reducing the sending of pain messages to the brain. They can cause side effects such as drowsiness, mental fog, nausea, and constipation. They may also cause slowed breathing, which can lead to overdose deaths. Because of the risks, they must be used only under a doctor’s supervision. Codeine is considered a “weak opioid” – it doesn’t work well alone but gives good results when used with paracetamol, sold over the counter under the label co-codamol.
Also, anti-depressants (e.g. Amitriptyline), and anti-seizure medications (e.g. Gabapentin) are prescribed to treat pain triggered by damaged or hypersensitive nerves, including sciatica, shingles or nerve pain caused by diabetes.
Clearly, the reason to take a medication is to enhance the quality of one’s life. Every painkiller has side effects, of whatever degree and whether short- or long-term. Understand the potential for harm and make informed choices. Many addicts started out innocently, with a prescription from a doctor they trusted. The prevalence of opioid pain relievers has led to an addiction crisis.
As stated by Per Wickstrom, CEO, and founder of A Forever Recovery: “Drug rehabilitation is essential to reinstating the values of our country. Our mission is to make rehabilitation available to everyone.”