Pain medications are prescribed to treat suffering, but there are significant concerns about side effects, addiction, tolerance, and potential for regulatory action.
There are two main groups of pain medications.
- Analgesics – These are drugs specifically used in treating pain. Analgesics include opioids, non-opioids, and combination medications.
- Adjuvant medications are those with primary uses other than pain relief, but help with pain relief. These include anticonvulsants, muscle relaxants, and antidepressants.
It is recommended by the World Health Organization to start pain treatment with non-opioid medications such as aspirin, acetaminophen (Tylenol), or anti-inflammatory medications such as ibuprofen or naproxen. These are over the counter medications, however, there are some additional non-opioids such as Prednisone which fall into this group but need a prescription.
Opioids and combination drugs are the most prescribed meds available today for patients with chronic pain. They are the most powerful pain relief medications available. Opioids include morphine, codeine, oxycodone, hydrocodone, hydromorphone, methadone, buprenorphine, fentanyl, meperidine, etc. The combination drugs are those that include the opioid medication plus something like acetaminophen.
The World Health Organization along with the American Academy of Pain Medicine have endorsed narcotics where necessary for either cancer pain or as part of a pain management plan.
Opioids come from opium, which is a bitter, grainy powder from the poppy flower seedpod.
These days, most opioid pain medications are synthetic. In the past, even pilgrims grew poppies and mixed them with whiskey to relieve pain. In the early 1800’s, people figured out how to isolate morphine from opium and then medicines were created to treat pain, diarrhea, and colic in babies and infants. Kids were happy!
Even Sigmund Freud was one of many doctors who believed that opioid use was a great remedy for lots or medical problems. Heading into the 1940’s, opioids became tightly controlled and necessitated prescriptions from physicians for usage. Also inappropriate prescribing could result in disciplinary action so doctors became reluctant to prescribe them. Pain became undertreated.