Analgesics: An Intro
Analgesics are types of medicine used for pain management and are commonly known as painkillers or pain relievers. Typically, these types of drugs provide pain relief but don’t induce sleep or a loss of consciousness. Analgesics can include opioids that kill pain, but there are also many other forms of the substance. While many common analgesics contain opioids, others such as acetaminophen do not. Analgesics are extremely prevalent today due to the multitude of different ailments that they are used to counteract. Some issues that analgesics are prescribed to combat include migraines, osteoarthritis, pain from surgery, trauma, toothaches, nerve damage, fibromyalgia, appendicitis, and cancer amongst others.
Some analgesics are available over-the-counter while others are only available by prescription. Opioids painkillers, also known as narcotics, bind receptors that transmit pain to brain cells from areas of the body like the spinal cord and gastrointestinal system, allowing users to feel relief and only a muted sense of the pain they were previously experiencing. However, while opioid-based analgesics may create a greater sense of relief than non-opioids, it is also more likely that their use can lead to addiction and all of the resulting byproducts of drug dependence. At one point and time, opioid prescription was largely reserved for treating acute pain, but its application has become increasingly common in recent years to treat chronic pain stemming from ailments like arthritis. This reality has likely been a factor in the deadly opiate crisis that has ravaged society in recent years.
The number of opioid medication prescriptions in Canada increased by 6.8 percent between 2012-2016, according to statistics compiled by the Canadian Institute for Health Information. According to those same statistics, 6 opioids accounted for 96 percent of those prescriptions: hydromorphone, morphine, fentanyl, oxycodone, codeine and tramadol, all of which are considered analgesics. The repercussions from the high levels of opioid use and abuse in Canada cannot be overstated as more than 11,500 opioid-related deaths occurred in the country between 2016-2018, according to the Canadian Government. Additionally, similarly unnerving trends have been measured in the United States.
While we know that analgesics are painkillers or pain relievers, there’s much more to the drug category than just that. Understanding analgesics in their many forms is unquestionably valuable considering how prevalent they are becoming in society. Furthermore, with the rise of analgesic use goes the rise of analgesic addiction. It’s possible if not likely that someone close to you may battle analgesic addiction throughout the course of your lifetime, so understanding how to identify the drug category, its addiction and withdrawal symptoms and, ultimately, recovery and treatments options is essential for the vast majority of us.
As we’ve noted, there are many different forms of analgesic drugs. They are used to treat different ailments and range in intensity from relatively subdued forms such as over the counter Tylenol to incredibly strong iterations such as fentanyl. Of course, we can’t talk about this form of drug without once again noting opioids, the use of which is extremely common and increasingly so.
Opioids aside from those we’ve already mentioned that are classified as analgesic drugs include Avinza, Dolophine, Vicodin, Morphine, Demerol and more. As we’ve also noted, opioid addiction and abuse are on the rise and have become a major societal issue across North America.
Acetaminophen, which is the active ingredient in Tylenol, another analgesic drug, may seem relatively painless but its abuse can lead to serious complications for users. In fact, acetaminophen overdose and poisoning can occur and lead to life threatening illnesses including overdose deaths and may require an antidote like N-acetylcysteine. Additionally, the overuse and abuse of Acetaminophen-based drugs like Tylenol can lead to serious liver damage and overwhelm the way the organ typically functions, even leading to liver failure in severe cases.
In addition to opioids and non-opioids, there are also forms of analgesics that are created by meshing them with one another. A combination analgesic can be made by mixing an analgesic drug with another, or by mixing it with other substances like caffeine. For example, KneeRelief is a prescription drug that is a combination of Acetaminophen, caffeine, and magnesium salicylate.
Yet another form of analgesics is what’s called non-steroidal inflammatory drugs (NSAIDs). Common drugs in this category include Advil, Celebrex and Aleve. While drugs like acetaminophen can cause liver complications, addiction or overuse of NSAIDs can cause serious damage to the stomach or intestines. While NSAID use isn’t inherently dangerous, just as with other drugs in this category they can become quite dangerous when abused. NSAIDs work by blocking hormone-like chemicals in the body, which reduces pain and swelling.
Now that we understand some of the different forms of analgesic drugs, it’s important to also understand the impact and effect they can have on users. While we’ve noted the potential for serious long-term impacts like liver, stomach, or intestine damage, these types of drugs also result in a plethora of short-term side effects. The immediate byproducts of this category of drugs is dependent on which type of analgesic drug used, the length of time it is used, and other factors. That being said, some regular symptoms associated with use include constipation, drowsiness, upset stomach, itchiness, and dryness.
With isolated use, any one of the analgesic drugs named thus far may be taken in a healthy manner, particularly when following the directions or instructions denoted by a healthcare professional. However, it’s the addiction to so many of these substances that can create deeply rooted issues not only for the individual affected but for society as a whole. Because addiction to these substances can lead to serious issues or even death,we mus all be able to ascertain and understand addiction symptoms so that we can identify them and work towards correcting them when possible.
Some cases of addiction to painkillers may be easy to spot while others are extremely difficult to detect. It’s important to remember that individuals experiencing addiction may be embarrassed or ashamed to admit it, or there’s the possibility that they may not even know that they are addicted. Therefore, it’s important to identify the symptoms of addiction so that we might recognize it amongst our friends, family and loved ones. This will allow us to urge those affected to seek help to tackle the issue head-on and ideally resume leading a completely healthy life.
As with addiction itself, some of the symptoms may be easier to detect than others. One clear sign that may signal addiction is when users take different amounts of painkillers than prescribed by their doctors or as advised on the label. This may denote a built-in tolerance to the painkiller, meaning that the user needs more than the prescribed amount to achieve a certain level of comfort. This is, of course, a major issue as overuse can lead to serious health complications as noted.
A more obvious indication of addiction is what’s considered “doctor shopping” or seeking out multiple doctors to have prescriptions multiplied. There should be no acceptable reason that a regular doctor wouldn’t prescribe enough of the substance as needed, so this signals an abnormal need and dependence on the analgesic.
Another symptom of addiction is the prolonged use of painkillers even after the initial pain, injury or condition has subsisted. When no longer using the drug for its prescribed purpose, an addiction is inferred for the simple reason that users no longer need the drug but rather crave it.
Certain behavioural symptoms like exhibiting anger when someone is confronted about their painkiller use or irritability or extreme moodiness may be yet another indication of an addiction problem. In addition to all of these common symptoms of addiction, there may be others that aren’t on this list. If you or someone you know appears to be exhibiting signs of painkiller addiction, it’s advisable that you consult your healthcare professional or an addiction helpline to ascertain whether your suspicions may be correct. While the symptoms of addiction may be an initial indicator of an issue, withdrawal symptoms may also be noticeable if the user is trying to wean themselves off the drug or if they simply haven’t been able to get their hands on it for some time.
Withdrawal from analgesics, particularly opioid-based ones, is often difficult but is a barrier that will need to be hurdled on the road to recovery. One of the most common and difficult withdrawal symptoms associated with painkiller addiction is an intense craving to use those painkillers once more. It goes without saying that staying strong in the face of this withdrawal symptom is paramount when it comes to recovery. While avoiding relapsing and using the analgesic itself is half the battle, other withdrawal symptoms, both physical and psychological, must be countered in order to achieve recovery.
Common withdrawal symptoms associated with many different forms of painkillers can include nausea, cramping, depression, agitation, and anxiety. As many users experience withdrawal, there can be “early symptoms” and “late symptoms.” Early symptoms of withdrawal in those addicted to opiates can take effect anywhere from 6-30 hours after last use and can include muscle aches, sweats, fevers. and more. Late symptoms can include diarrhea, cramping, and depression.
While withdrawal may be incredibly difficult to take on, it’s important for those addicted to keep in mind that recovery and return to a healthier lifestyle may be coming in the near future. Once the withdrawal symptoms have subsided, it may be time to undergo whichever treatment or recovery methods that best align with an addict’s unique addiction situation. Deducing what methods those are can be difficult, however, with the help of a healthcare professional and with the support of loved ones, navigating this difficult situation can be achieved in most cases.
Treatment for painkiller abuse can include chemical-based recovery strategies and psychotherapy methods. One example of the former is the application of methadone in opioid users, which is a specially prescribed drug that simulates opioid use but without the same high effect. This can lead to a prevention of addiction symptoms and the easing of drug cravings. Shorter-acting chemical treatment for painkillers like opiates is buprenorphine, which impacts the same receptors in your brain as methadone but with a more dulled effect. Some forms of buprenorphine include Suboxone, Buprenex, Butrans patches and Probuphine. Additionally, Naltrexone is another chemical drug taken orally or by injection that blocks opiate receptors and can be prescribed to wean addicts off analgesic drugs.
Aside from chemical treatments, other methods are always a possibility depending on the patient. Inpatient detox followed by inpatient rehab is a common form of treatment, particularly in serious cases where users need to be monitored by healthcare professionals or addiction specialists. In addition to these hands-on treatment methods, therapy such as cognitive-behavioural therapy or group therapy such as 12-step programs can also be effective depending on the individual that’s affected.
Despite the harsh realities of analgesic drug addictions and their resulting consequences, help is always available to those who seek it. Some of the aforementioned treatment methods, both chemical and non, are popular options on the road to recovery. Meanwhile, helplines can also be consulted, as well as the guidance and support that can be offered by friends, family and loved ones. It’s important to remember you are never alone in the battle to curb addiction.