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Comparing Pain Relievers For Chronic Pain: Opioids, NSAIDs, and Cannabis

17 January 2023

Hand of a senior man holding different pills

Key Points

  • Painkillers (or analgesics) are medications that relieve pain. They can be used as a short-term treatment for acute pain or as long-term therapy for chronic pain.
  • There are many different types of painkillers, and they may be taken by mouth, injected into the bloodstream, or applied directly to the skin (topical).
  • Pain relief medications are grouped into two: over-the-counter (OTC) and prescription. OTC medications are available without a prescription, while prescription ones require a doctor to prescribe it and are used for more intense pain.
  • The major downside of using conventional pain relief medications is that they can be addictive and may cause serious side effects. Overuse of these medications can lead to physical dependence and withdrawal symptoms.
  • Alternatives to pain medications include medical cannabis for chronic pain. It has been shown that cannabis may be effective for managing chronic pain, especially when used in conjunction with other treatments such as physical therapy and exercise.

Introduction

Chronic pain is a complex and debilitating condition that can cause severe problems with daily activities. In order to treat chronic pain, many people rely on medications such as opioids and other painkillers. Each kind has its advantages and disadvantages, but finding one right for your condition can be difficult.

To make things more complicated, many people find that the medications they take have limited effectiveness and cause side effects. This often leads to them taking even more medication, which can make the problem worse.

In this article, we examine different types of pain medication and explain what they do. We also go through the side effects of each kind and explain how they can affect your health.

What is pain medication?

Pain medications or pain relievers refer to any type of medication that can be used to reduce pain. They’re also called different names, such as analgesics, narcotics, and pain medicines.

Their purpose is to help people who are suffering from acute or chronic pain to experience less discomfort and regain a higher quality of life.

Pain relievers can be taken as pills or liquids, but also as patches that can deliver the medication slowly over time. Some are injected directly into the bloodstream. There are also analgesics applied to the surface of the skin (topical).

What are the types of pain medications?

Pain relievers are often classified into two groups:

  • Over-the-counter These are pain relievers that can be purchased without a prescription. They work well for mild to moderate pain and include ibuprofen (e.g. Nurofen) and paracetamol (e.g. Panadol).
  • Prescription These medications require a doctor’s order. They’re stronger than over-the-counter ones and are usually used for more severe pain. Some prescription analgesics include codeine, morphine, and fentanyl.

Over-the-counter (OTC) pain relievers

Close-up of man’s hand taking medicine from a pill bottle

OTC pain relievers are medications that can be used to treat mild to moderate pain. They are available without a prescription and include aspirin, ibuprofen, and naproxen sodium.

OTC analgesics are available in two main forms:

  1. Paracetamol – Also known as acetaminophen, paracetamol is one of the most common OTC pain relievers. It works by reducing the activity of your brain’s pain centres. Paracetamol is available in liquid and pill form, and it’s often combined with other ingredients to make products like cold and flu remedies.
  2. Nonsteroidal anti-inflammatory drugs (NSAIDs) – They are a group of medications that reduce pain and inflammation. They include aspirin, ibuprofen, and naproxen sodium. NSAIDs work by blocking the production of prostaglandins in your body.

Though generally safe when taken as directed by a doctor or pharmacist, OTC medications still carry some risks with them.

They can cause side effects and make you more susceptible to other health problems. Some common side effects of pain relievers include drowsiness, dizziness, and stomach irritation.

These medicines may also interact with other medications in unexpected ways. For example:

  • Aspirin may decrease the effectiveness of other medications by blocking blood clotting. This means you should not take aspirin if you’re taking warfarin or another blood thinner, such as clopidogrel.
  • Ibuprofen may increase the bleeding time if taken with other blood thinners such as warfarin, atorvastatin, prasugrel, or ticlopidine.
  • Naproxen sodium may increase the risk of bleeding if taken with other blood thinners such as warfarin, clopidogrel, and aspirin.

Prescription pain relievers

For more severe cases of chronic pain, a doctor may prescribe a prescription pain reliever. These medications include:

  • Opioids – Examples include codeine, morphine, and oxycodone (OxyContin). They are usually prescribed for acute pain, such as post-surgical or cancer pain. Opioids are also prescribed for chronic pain, but they are generally considered a last resort because they’re highly addictive.
  • Prescriptions NSAIDs –Some prescription NSAIDs, like diclofenac and naproxen (Naprosyn, Stirlescent), are also available over the counter in low doses. People with stomach or liver problems, high blood pressure or asthma may not be able to take these medicines.
  • Antidepressants – This class of medications works on the brain to help reduce the perception of pain. They work best for cases involving migraines, nerve pain (neuralgia), and chronic pain caused by fibromyalgia. Common examples of antidepressants used for pain include serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and other types of antidepressants.
  • Anti-epileptic medicines – These medications are used to treat seizures but may also be used for chronic pain that is not caused by epilepsy. They include gabapentin (Neurontin) and pregabalin (Lyrica).
  • Steroids – These are strong medicines that work by altering the body’s immune system and reducing inflammation. They can be used to treat pain caused by conditions such as rheumatoid arthritis and lupus.
  • Topical analgesics – These are creams, sprays or ointments that can be rubbed on the skin to relieve pain. They are most often used for the relief of muscle sprains, strains, and backache but may also be used for other types of pain. Examples include capsaicin (Zacin, Axsain), lidocaine (Denela, EMLA, LMX4, Nulbia), and diclofenac (Dicloflex, Diclomax).

Though effective, prescription analgesics come with some serious risks. They can be highly addictive and habit-forming.

They can lead to serious side effects such as nausea, vomiting, headaches, drowsiness, and dizziness. Once a patient has developed a tolerance for a certain type of painkiller, it may no longer work for them. They must then take more and more of the substance to get the same relief, thus increasing the chances of an overdose.

Some prescription medications also interact negatively with many other substances – even over-the-counter medications such as Tylenol and ibuprofen. It’s of the utmost importance to consult with a doctor before trying any prescription medication. A full medical history and blood work are necessary to ensure that a person doesn’t have any contraindications for taking the medication.

The most appropriate pain medication for you may depend on various factors

Your physician can help determine the best pain medication for you. Your doctor will take into account your age and other health issues, as well as what types of medications have worked in the past.

Some factors considered for the best pain medication for you may include:

  • If you have an allergy or sensitivity to certain medications
  • How long you’ve been taking any specific type of medication
  • If it’s been effective in the past
  • Whether you have other medical conditions or are taking other medications
  • How well the medication works for you and how quickly it starts to act
  • History of substance use, addiction, or mental health conditions.

With painkillers, what works for one may not work for another. Some people may be allergic to certain medications, some may not react well to certain types of substances, and others may have a medical condition that makes it unsafe for them to take certain medications.

It’s important to check with your doctor before taking any medication or supplement – whether prescription or over-the-counter (OTC). If you’ve been prescribed medication for pain, it’s important to take it as directed. If you don’t understand how to use it, ask your doctor or pharmacist for more information.

Are painkillers safe for long-term use?

Some pain medications are part of pain management routines that include short-term use and tapering off. Other painkillers, however, are designed for long-term use. These medications can be especially useful for people with chronic pain problems or conditions that require constant management.

Long-term use of painkillers can be risky, and it’s important to discuss the potential consequences with your doctor. If you’re taking painkillers for a long time, it’s important to see your doctor regularly. This will allow him or her to monitor your progress and make sure that the medication isn’t causing any side effects.

What about alternative pain relief

If a medication-based solution is something that you’re not comfortable with, there are other options available. Alternative pain management can include meditation, cognitive-behavioural therapy (CBT), and more.

Most alternative options for pain relief do not have the same side effects as traditional medications, and they are often safer for long-term use. With that said, it’s important to discuss your options with your doctor before making a decision about which path is right for you.

Medical cannabis for chronic pain: Is it better than OTC or prescription medications?

Cannabis oil, capsules and hemp leaves on a white surface

There is a growing awareness of the benefits of medical cannabis for chronic pain. There is also a growing interest in using medical cannabis for pain management, especially among people who don’t respond well to conventional medications.

Medical cannabis as an alternative pain medication

In a 2016 study published in Journal of Pain, researchers found that people with chronic pain who used medical cannabis reported lower pain levels after using the substance. The researchers concluded that medical cannabis might be a good option for people with chronic pain who are looking for alternatives to prescription medications or OTC painkillers.

In various clinical studies, cannabis has been shown to help with symptoms of chronic pain, such as nausea and vomiting, muscle spasms, and sleep problems. It can also be used in conjunction with other medications to treat these conditions. With medical cannabis, many have reported feeling an overall improvement in quality of life.

One of the benefits of medical cannabis is that it’s well-tolerated. A 2018 clinical study suggests that the side effects caused by cannabis treatment for pain are less frequent and less severe as opposed to other pain treatments. It’s also been shown to reduce the need for other medications, such as opioids.

How does medical cannabis work as a pain medication?

Medical cannabis works as a pain medication by interacting with the body’s endocannabinoid system (ECS). The ECS is a network of receptors that are located throughout our brains and bodies.

There are two main types of receptors in this system: CB1 and CB2. When THC binds to these receptors, it activates them and produces a variety of different effects, such as reducing inflammation or pain.

CBD, the non-psychoactive component, interacts with these receptors to produce similar effects. The cannabinoid has also been shown to help reduce anxiety and depression in patients dealing with chronic pain.

How to access medical cannabis painkillers?

Medical cannabis for pain is a prescribed treatment for patients who suffer from a variety of conditions, such as chronic pain, cancer, and epilepsy. The treatment is usually administered in either a pill or oil form.

To access medical cannabis painkillers, you need to be prescribed by a doctor who can recommend the appropriate dosage for your condition. Your doctor will need to assess your medical history and determine if it’s safe for you to take medical cannabis.

At Lyphe, we have a team of medical professionals who can help you get the treatment you need. Our doctors will assess your pain levels, determine which type of medical cannabis is best for your condition and issue a prescription.

Conclusion

Chronic pain is a serious condition that can be treated with powerful pain medications. The best choice depends on the patient’s needs and how long they have had their condition. Some people need to take medication for only a few months, while others may need it for much longer periods.

We recommend speaking with your doctor about their experience and expertise in these matters before making any decisions about treatment options. An expert opinion will reduce the risk of adverse side effects.

If conventional pain medication is ineffective, medical cannabis may be a viable alternative. The use of medical cannabis has been shown to reduce the severity and frequency of pain. It may also help people with chronic pain to sleep better and improve their mood.

Lyphe is a great starting point for anyone considering medical cannabis. Our expert staff can help you navigate the process of finding a doctor, learning about your condition, and choosing the right dosage for your needs. Schedule a consultation with a specialist today and get started on the path towards chronic pain management.

Frequently Asked Questions (FAQs)

What is the preferred treatment for chronic pain?

The preferred treatment plan for chronic pain is a combination of physical therapy, exercise, and lifestyle modifications. If these approaches are not working for you, you should discuss your options or medications with your doctor.

What medications are best for relieving severe pain?

NSAIDs and opioids are the two medications that are most commonly used to relieve severe pain. However, NSAIDs have side effects that can be dangerous in some patients, and opioids have a high risk of addiction.

What to do if pain medication is not working?

If the pain medication is not working, you should discuss it with your doctor. You may need a higher dose or a different type of medication.

What narcotic is used for severe pain?

The most commonly used narcotic for severe pain is morphine. Despite their effectiveness, narcotics are not used for long-term pain management because of their addictive nature.

Why won’t my doctor give me pain meds?

Your doctor will not prescribe you pain medication if they think that it is not safe for you to take them. If you are pregnant, have a history of substance abuse or addiction, or have an underlying medical condition, your doctor may be wary of prescribing pain medication.

References

Haleem, R., & Wright, R. (2020). A Scoping Review on Clinical Trials of Pain Reduction With Cannabis Administration in Adults. Journal of clinical medicine research, 12(6), 344–351. https://doi.org/10.14740/jocmr4210

NHS. (n.d.). NSAIDs. NHS choices. Retrieved November 4, 2023, from https://www.nhs.uk/conditions/nsaids/

NHS South Tees Hospital. (n.d.). Pain Medications. Retrieved November 4, 2023, from https://www.southtees.nhs.uk/services/pain-management/pain-medications-2/

NHS. (n.d.). Paracetamol for adults. NHS choices. Retrieved November 4, 2023, from https://www.nhs.uk/medicines/paracetamol-for-adults/ 

Savage, S. R., Romero-Sandoval, A., Schatman, M., Wallace, M., Fanciullo, G., McCarberg, B., & Ware, M. (2016). Cannabis in Pain Treatment: Clinical and Research Considerations. The Journal of Pain. Elsevier BV. https://doi.org/10.1016/j.jpain.2016.02.007

Vučković, S., Srebro, D., Vujović, K. S., Vučetić, Č., & Prostran, M. (2018). Cannabinoids and Pain: New Insights From Old Molecules. Frontiers in Pharmacology. Frontiers Media SA. https://doi.org/10.3389/fphar.2018.01259

Ware, M. A., Wang, T., Shapiro, S., Collet, J.-P., Boulanger, A., Esdaile, J. M., … O’Connell, C. (2015). Cannabis for the Management of Pain: Assessment of Safety Study (COMPASS). The Journal of Pain. Elsevier BV. https://doi.org/10.1016/j.jpain.2015.07.014

 

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