The Facts of Pain Relievers

What Is an Analgesic and What Type of Pain Does It Help?

Pain Relievers are drugs that relieve pain. The pain relief that Pain Relievers provide is a result of the medication cutting off the pain signals that the body sends to the brain, or it influences the brain’s perception of these signals, without causing unconsciousness. Pain Relievers come in two different classifications: non-narcotic and narcotic.

Some experts also classify aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) as Pain Relievers because they help to relieve pain. In addition to their analgesic properties, aspirin and NSAIDS also act as anti-inflammatory medications.

Non-Narcotic Pain Relievers: The most commonly used non-narcotic analgesic you can get without a prescription is acetaminophen. Its ability to relieve mild to moderate pain and its low price make acetaminophen a well-liked pain reliever. It is important to note that acetaminophen is only safe when it is used properly, according to the label instructions. Not following the instructions can lead to adverse, and even fatal, reactions. For instance, when someone consumes more than 4000 mg per day, there is the possibility of liver damage. Alcohol consumption along with acetaminophen use increases the risk of liver damage. Consult your doctor for information on the maximum recommended dosage and other information about the proper use of acetaminophen.

Most people are unaware that acetaminophen is a component in over 600 non-prescription medications. It is included in many cold, sinus, and cough medicines, along with other active ingredients. If you are taking several medications containing acetaminophen, you must consider the cumulative effect.

How can the liver be damaged by acetaminophen? Acetaminophen is converted into metabolites, which have to be removed from the body. When you take high doses of acetaminophen, your body produces more toxic metabolites than your body is able to eliminate.

Narcotic Pain Relievers: There are two classifications of narcotic painkillers — opiates and opioids (opiate derivatives). Opiates are derived from the alkaloids in opium, the milky white substance found in unripe seeds of poppy plants.

Experts define opioids as those medications that bind the opioid receptors to the gastrointestinal tract or the CNS.

Wikipedia lists the four major classes of opioids:

• Endogenous opioid peptides (the body naturally produces these: endorphins, dynorphins, enkephalins)
• Opium alkaloids (such as morphine, codeine, thebaine)
• Semi-synthetic opioids (such as heroin, oxycodone, hydrocodone, dihydrocodeine, hydromorphone, oxymorphone, nicomorphine)
• Fully synthetic opioids (such as pethidine or Demerol, methadone, fentanyl, propoxyphene, pentazocine, buprenorphine, butorphanol, tramadol, and others)

Opioids have medicinal applications; they are used to treat chronic pain that has a high degree of severity. Ironically, there is no maximum dosage of opioids for the treatment of pain, although any increases in dosage should be gradual, to reduce the risk of having an adverse reaction.

An article on eMedicine states that there are people with extreme pain that take very high doses; the same dosage would probably kill someone who took it that did not have pain. There is also the much-debated issue about the risk for addiction to opioids compared to the benefits that are derived from using them for the treatment of non-malignant chronic pain, like the pain from arthritis. There are some experts who believe that opioids are safe to use and are not a risk for addiction or toxic side effects. You should always consider that the quality of life for the patient may be enhanced with opioids.

Opioids have a distinct set of side effects that are associated with their use. The most commonly occurring side effects are:

• gastrointestinal upset
• fatigue
• dry mouth
• contracted pupils
• drop in blood pressure upon arising
• urinary retention
• constipation

The side effects that are less commonly experienced are:

• disorientation
• hallucinations
• delirium
• hives
• itch
• hypothermia
• decreased heart rate
• increased heart rate
• intracranial pressure
• ureteric or biliary spasm
• muscle rigidity
• flushing

The more severe adverse reactions that can accompany opioids are:

• respiratory depression
• fatal overdose