How many different types of painkillers are there?

These medications, also referred to as analgesics, are used for the relief of pain in the body. There are four main types of painkillers – namely, opioids, non-opioids, non-steroidal anti-inflammatory and compound treatments.

There is also a variety of generic medication that serves the same purpose, but tends to be far cheaper. Each of the above is recommended depending on the severity (mild, moderate, or severe) and the type of pain. The above mentioned medications are the best painkillers to relief migraines, post-operative pains, stomach aches, fever, injuries causing pain, and inflammation, among other conditions.

Some analgesics are available over-the-counter (OTC); however, most strong painkillers are available on prescription due their stronger effects. Just as other medications, there are common short-term and long-term side-effects when using analgesics.

The short-term side effects usually last for a few days and can be treated, while the long-term side-effects may last longer and be more difficult to treat. Patients who use pain medication over a long period of time may form a dependency, which bring about severe side-effects. It is important to note that severe side-effects may only occur if the medication is misused or abused.

This article focuses on the types of pain medications, how do painkillers work and their side-effects.

Different types of pain medication

There are several different types of painkillers including:

•         Opioids: Opioids are derived from the opium poppy plant and have been in treatment since the primitive years of human civilisation by the people of ancient Mesopotamia. This type of medication is used to treat pain ranging from moderate to severe and may only be available on prescription.

It is usually recommended after other painkillers have been used and were not successful in relieving or reducing pain. This medication is divided into two categories: weal opioids (dihydrocodeine and codeine) and strong opioids (fentanyl, tramadol, morphine, etc.). The strong opioids are at least 10 times stronger; hence, people should not use these for a prolonged period of time.

•         Non-opioids: This medication is available OTC and on prescription. They are easily accessible as you can buy them at a supermarket. These are usually used to treat pain ranging from mild to moderate and is often used for headaches, injuries, and osteoarthritis. It can also be combined with NSAID’s for more severe pain (post-surgery) to produce stronger effects. Non-opioids come in different forms, such as tablets, capsules, suppositories, creams, patches and gels. Common examples of this therapeutic are aspirin and paracetamol.

•         Non-steroidal anti-inflammatory: There are at minimum twenty different NSAID’s available OTC and on prescription. Common examples of this medication are ibuprofen, naproxen and indomethacin. As the name suggests, it is used to relieve pain and reduce inflammation, especially in joints and muscle. These may be combined with non-opioids to produce greater desired effects.

•         Compound painkillers: This medication is made up of a combination of paracetamol and a low dose of opioids. Injuries, headaches and osteoarthritis, among other conditions, are treated by using this medication. Examples of this therapeutic are co-codamol (paracetamol and codeine), co-dydramol (paracetamol and dihydrocodeine) and co-codaprine (aspirin and codeine).

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How do painkillers work?

Painkillers are available as tablets, capsules, suppositories, injections and liquid form. Although there are different forms of this medication, they all work with the end goal of relieving pain and inflammation. Below are ways different painkillers work:

•         Opioids work by reducing feelings of pain and allowing the body to build up a tolerance for the pain caused. They block messages that are sent from the specific area pain is experienced to the brain (via the spinal cord). This action occurs when the medication attaches itself to opioid receptors in the brain, hence, tolerance and relief is experienced.
•         NSAID’s and non-opioids works by slowing down the activity of cyclooxygenase (COX) enzymes, which produce prostaglandins that sometimes cause pain. This is therefore the best painkillers for reducing pain and inflammation, especially in the muscles and joints.
•         Compound painkillers’ activity in the body are a combination of opioids and NSAID’s, they imitate endorphins in the body as well as block pain messages sent to the brain.

Side-effects of painkillers

The side-effects of this medication depend on the person’s medical history, age, interaction with other medication and any co-morbid conditions. These side-effects can be divided into short-term (usually easy to treat) and long-term (usually caused by dependency).

Short-term side-effects:

•         Common side-effects of painkillers: sleepiness, drowsiness, or dizziness, dry mouth, nausea, vomiting, or constipation. People who use NSAID’s experience far more desired effects that side-effects. However, if there are side-effects experienced it would usually be the common side-effects listed above.
•         Loss of concentration, slow heart rate and shallow breathing are side-effects that can occur if an overdose is taken.

Overall, dependency is the number one long-term adverse effect if any of the above-mentioned analgesics are used over a long period of time. Dependency on strong painkillers will cause serious health conditions unless controlled at an early stage. Some of the long-term conditions a person may suffer are:

•         Heart, lung and kidney problems may be caused if compound analgesics are taken over a prolonged period of time.
•         Heart attacks and strokes are more common if people use anti-inflammatory analgesics more than the prescribed period.
•         Long-term use non-opioid analgesics may cause gastrointestinal bleeding.

Side effects apply to a small number of people who usually neglect to adhere to usage guidelines and precautions.

General precautions when using painkillers

Below are some precautions one can take when using analgesics:

•         Make sure to use the medication during the recommended period and only when pain is experienced.
•         Only use the medication according to the dosage prescribed or required, as using too little of the medication may not produce desired effects and an overdose may cause adverse effects. Usually medications like paracetamol are advised to be taken over a few days and at least 4 times a day until desired relief is experienced.
•         If desired effects are to be experienced, the correct dosage must be taken for the correct duration. For example, therapeutics like ibuprofen should be taken over the shortest time possible, with or after food.
•         Most strong painkillers do not interact well with other medication (such as depressants or sleeping pills). Therefore, the co-administration of these medications is usually not advisable, unless otherwise suggested by your doctor.