Pain medicines come in many forms: films you place under the tongue, liquid you inject with a needle, patches you put on your skin and pills, tablets or capsules you swallow. Some are available over the counter, others require a prescription.
The FDA encourages people to buy pain medications only from their doctors and to use them as prescribed. Read medicine labels carefully and store them in a safe location.
Over-the-counter (OTC) pain relievers
Over-the-counter (OTC) pain relievers can help ease headache, arthritis, back, toothache, earache and cold or flu-related aches and pains. The most common OTC pain medicines are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs).
NSAIDs reduce both pain and fever. They work by blocking an enzyme called cyclooxygenase, which produces chemicals that irritate nerve endings and cause the feeling of pain. These medicines also help to decrease inflammation, swelling and redness. The most commonly used NSAIDs are ibuprofen (such as Advil and Motrin), naproxen sodium (Aleve) and aspirin. There are many brand names for each of these medications, and some products contain a combination of acetaminophen and one or more NSAIDs.
The way each type of OTC pain medicine works is different, and some kinds of pain respond better to one type than another. But all pain relievers can have side effects, and how often you take them and your overall health conditions affect how safe they are for you.
For most healthy people who use OTC medicines rarely, the risk-to-benefit ratio is usually fairly good. But if you are taking OTC medicines over long periods of time, or in high doses, you may be at greater risk for serious or even life-threatening side effects.
All medicines have risks, but you can lower your risk of problems by following the directions on the label. Be sure to read labels carefully and talk to your doctor or pharmacist if you have any questions. Also, don’t take more than the recommended amount of any medicine. Taking too much can be harmful, and some OTC medicines interact with each other or have dangerous interactions with certain medical conditions, including heart disease, high blood pressure and liver or kidney problems.
Some OTC medicines can be dangerous if you have certain health conditions or drink too much alcohol. For example, if you take acetaminophen and frequently drink three or more drinks per day, you are at risk for liver damage or failure. Similarly, NSAIDs can cause stomach bleeding and ulcers in some people, especially those with heart disease or high blood pressure.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most common pain medications. They are used to relieve pain, reduce swelling, and reduce fever. NSAIDs can also prevent blood clots. However, NSAIDs can cause stomach ulcers and heartburn. It is important to follow the instructions on the label and take NSAIDs only as prescribed. People with a history of heart attacks or stroke should not use NSAIDs.
NSAIDs are drugs that block the production of prostaglandins, which are chemical compounds in the body that help to control inflammation and other symptoms. NSAIDs are available in many different forms, including gels, tablets, and injections. They are also available in combination with other medicines. NSAIDs are known for their ability to treat many conditions, from arthritis to back pain. They can also help to reduce fever, and they are often effective for treating headaches. However, NSAIDs can have serious side effects and may not be suitable for everyone. Talk to your healthcare provider about whether NSAIDs are right for you.
The pharmacological profile of NSAIDs has been well documented with their exemplary analgesic, anti-inflammatory and antipyretic properties. They are considered to be the best anti-inflammatories for musculoskeletal disorders. However, a growing number of randomized trials and meta-analyses point to the detrimental effect of NSAIDs on the key organ systems that are pivotal in maintaining healthy life. The organs affected by NSAIDs include the gastrointestinal tract, cardiovascular system, hepatobiliary system and kidneys.
NSAIDs belong to the broad class of weak organic acids with an aromatic functional group. The class of NSAIDs is extremely diverse in terms of structural and functional aspects. The NSAIDs can be broadly classified based on their mode of action as PGHS dependent or independent and their bioavailability in the serum.
NSAIDs can be categorized based on their isoform-specific selectivity for PGHS inhibition and their plasma half-life. NSAIDs with short plasma half-lives, such as aspirin and ibuprofen, have quick onset of action, making them suitable for acute pain relief. Those with longer plasma half-lives, such as naproxen and celecoxib, have a more sustained effect.
Opioids
Opioids are natural or synthetic chemicals that interact with opioid receptors on nerve cells in the body and brain to reduce pain signals and feelings of pain. This class of drugs includes the illegal drug heroin, as well as prescription pain medications such as oxycodone, hydrocodone, codeine, and morphine. Because they also produce feelings of euphoria, opioids have a high risk for misuse and addiction.
Symptoms of an opioid overdose can be life-threatening, including respiratory depression, slow breathing, and unconsciousness. The FDA has approved a medication called naloxone that can reverse these effects if it is administered within five minutes of an overdose. Naloxone is available by prescription and as an over-the-counter nasal spray or injectable solution.
In the United States, overdoses from opioids are on the rise. They are a leading cause of death from overdose in the country, resulting in more than 2 million emergency room visits and nearly 90 deaths each day. The FDA is working to curb this epidemic. In addition to collaborating with first responders and state and local agencies, the agency is conducting an education campaign and developing strategies and solutions for communities.
The FDA is also encouraging doctors to use caution when prescribing opioids. They should do a thorough medical assessment, including a patient’s family history, and consider alternative pain relievers that don’t carry the same risk for addiction and dependence. They should also start opioids at a low dose and gradually increase the dosage to monitor the effects. Then they should schedule follow-up appointments to check the progress and watch for signs of problems, such as excessive drowsiness or withdrawal symptoms.
Most people who take opioids for pain don’t get addicted. However, if a person is very depressed or anxious, they may be more likely to become dependent on the drug. People who are chronically ill, older adults, and people with a history of addiction or substance abuse are also at higher risk. In addition, the more opioids a person takes, the greater their chance of becoming dependent and addicted. People who regularly take opioids to treat pain are at increased risk for psychological dependence, which is a strong desire to keep taking the drug even when it causes harm or has negative consequences.
Addiction
If you or someone you know is taking pain medications long after their original treatment plan has ended, that could be a sign of addiction. Talk to an anesthesiologist or other pain medicine specialist about how to use these drugs more wisely and explore alternative options.
Anyone can become dependent on opioids, including those who take them as prescribed by their doctor. However, people who misuse or abuse opioids are at higher risk of developing an addiction because they tend to take larger doses than their doctors recommend and/or more often. Also, using the drugs to get high is a common addiction trigger. Medications like hydrocodone, oxycodone and morphine work by blocking pain signals in the brain while producing a euphoric effect. As you take more and more of the medication, you can build a tolerance, meaning it takes more and more to feel the same effect. This is why it is important to follow your doctor’s orders exactly and never take more than what is recommended.
Another risk factor for prescription painkiller misuse is having a history of substance or alcohol abuse or mental illness, such as depression or post-traumatic stress disorder. Women are at an increased risk of developing a prescription painkiller addiction because they are more likely than men to be prescribed opioids, in higher doses and for longer periods of time. Also, they may be more prone to experiencing chronic pain and have a greater likelihood of suffering from relationship violence.
The symptoms of painkiller addiction can include erratic behavior, such as spending more time and money on the drug than you’re supposed to and neglecting family or social responsibilities. You may also notice changes in mood, such as irritability or restlessness. Your body may even start to experience physical cravings for the drugs.
People who develop a dependency on painkillers are at a higher risk for illegally obtaining them, such as through the black market. These drugs are often laced with life-threatening contaminants and can be just as dangerous and deadly as opioids that are legally obtained. They can also lead to heroin addiction, as many people who struggle with an opioid addiction find they are unable to quit using these drugs and switch to a cheaper illegal option that provides similar euphoric effects.