| There are two primary types of analgesics: | | | | with chronic pain who are taking opioids are able |
| narcotic (opioid) and non-narcotic (nonopioid) | | | | to maintain their dosage level without increasing |
| analgesics. | | | | the amount taken. |
| Non-narcotic analgesics are drugs that have | | | | Physical dependence is an automatic consequence |
| principally analgesic, antipyretic, and | | | | of taking opioids over time. Physical dependence is |
| anti-inflammatory actions. Acetaminophen is the | | | | apparent when one abruptly stops taking the drug |
| most commonly used over-the-counter | | | | or reduces the amount taken, which leads to |
| non-narcotic analgesic. Other drugs are not | | | | withdrawal reactions. |
| technically part of the analgesic family, but are | | | | Non-opioid pain relievers are often preferred for |
| nonetheless considered analgesics in practice. | | | | most types of chronic pain, because they do not |
| These include nonsteroidal anti-inflammatory drugs | | | | produce tolerance or physical dependence and are |
| (NSAIDs) such as aspirin. | | | | not associated with abuse or addiction. However, |
| Acetaminophen and NSAIDs can effectively | | | | they have two serious drawbacks. The first |
| relieve mild to moderate headache and pain of | | | | drawback has to do with ceiling effects. |
| musculoskeletal origin. For moderate to severe | | | | Non-opioids have upper limit of pain relief that can |
| pain, they can be used in combination with opioid | | | | be achieved. Once that upper limit or ceiling is |
| drugs to enhance pain relief. | | | | reached, taking additional medication will not |
| Opioids are stronger analgesics that are used | | | | provide any further pain relief. Opioids, on the |
| when pain signals are too severe to be controlled | | | | other hand, tend not to have a ceiling. That is, the |
| by non-narcotic analgesics. | | | | more you take, the more pain relief you will get. |
| The primary difference between opioids and | | | | It is for this reason that non-opioids are effective |
| non-opioids is in the way how they produce their | | | | only for mild to moderate pain, whereas opioids |
| analgesic effects. The opioid drugs reduce pain by | | | | are useful for more severe pain intensity. |
| working on special pain receptors in the nervous | | | | The second major drawback of the non-opioids |
| system, primarily located in the brain and spinal | | | | are their side effects. Although most non-opioids |
| cord. The non-opioids, on the other hand, work | | | | are quite safe when used for temporary acute |
| more directly on injured body tissues. The opioids | | | | pain, problems may arise when people take them |
| decrease the brain's awareness of the pain, | | | | over a long period of time (for chronic pain). This |
| whereas the non-opioids affect some of the | | | | is especially true when large quantities of |
| chemical changes that normally take place | | | | non-opioids are taken. Most are aware of the |
| wherever body tissues are injured or damaged. | | | | adverse effects of these drugs on the |
| These chemical changes at the site of the injury | | | | gastrointestinal system. However, excessive use |
| typically result in inflammation and increased pain | | | | of the non-opioids can also damage your liver or |
| sensitivity. | | | | your kidneys. Opioids have negative side effects |
| The long-term use of opioids can lead to | | | | as well. However, it is interesting that many pain |
| tolerance, dose escalation, and physical | | | | specialists now believe that opioids, when used as |
| dependence. Tolerance refers to the fact that the | | | | prescribed, are often safer than the non-opioids. |
| drug loses itТs pain relieving effectiveness | | | | Side effects of the opioids include respiratory |
| when used over time. That is, tolerance occurs | | | | depression, dizziness, nausea, vomiting, |
| when you need to take more of the drug in | | | | constipation, sedation, and mental clouding. Many |
| order to obtain the same degree of pain relief. | | | | of these side effects can be minimized or |
| However, tolerance is not considered to be a | | | | eliminated with proper medical management. |
| problem by most pain specialists. Many patients | | | | |