There are times when a little medication is needed to resolve things like headaches or pain from injuries. When these things happen, we usually reach for an over the counter medication such as ibuprofen or acetaminophen. These are low dosages and can be taken without instructions from a doctor. Each of these also has aprescription counterpart that is higher strength or has another pain medication added to it. Prescription pain killers consist of things like opioids and narcotics. These are meant to mask severe pain in the hospital and at home after surgery.
These medications are meant to relieve inflammation. Inflammation is caused by prostaglandins in the body. These chemicals are made by cells and help when your body needs healing by causing inflammation. They are produced by cyclooxygenase (COX) and enzyme in your body. During an illness or injury, however, this also presents as fever and pain. Prostaglandins also help the blood platelets clot and guard the stomach from acid damage. Nonsteroidal anti-inflammatory drugs (NSIADs) work by blocking the COX enzymes. This causes there to be less prostaglandins in the body. The lack of protection from stomach acid, however, can lead to ulcers with long-term use of NSAIDs. Common names for these types of medications are aspirin, ibuprofen, and naproxen.
Acetaminophen is a pain reliever that does not reduce inflammation. It does, however, relieve pain and fever. It can be easier on the stomach than NSAIDs, yet it can still cause liver damage over time. It is often called a non-aspirin pain reliever. Acetaminophen is recommended for children’s fevers before ibuprofen. This drug works by inhibiting the ability of prostaglandins to deliver messages. The messages meant to transmit pain signals or cause a fever are cut off. Scientists still do not understand exactly how acetaminophen works, as it does not block all the messages sent by prostaglandins. The difference that has been noticed is the ability of acetaminophen and ibuprofen to work on different tissues. Acetaminophen works mostly in cells that are in the nervous system.
Overdoses of any drug can be fatal. Acetaminophen is not toxic in its original form; however, it breaks down in the liver into a toxic compound. This is what makes an overdose of acetaminophen dangerous. The compound is called N-acetyl-p-benzoquinonimine. The liver detoxifies it and excretes it from the body in small amounts. Large amounts overwhelm your detoxification system kill liver tissue. The most common brand name of acetaminophen is Tylenol.
The terms opioid and narcotic are often used interchangeably to describe prescription medications that are given after surgery or during severe illness. Opiates are drugs derived from nature’s opium source, the poppy. Example of these are morphine and codeine. Synthetic versions are called opioids. These are sometimes mixed with the natural form as a hybrid medication. These are drugs such as fentanyl and methadone. Heroin is a derivative of morphine and is not used as a prescription. Heroin is only found in illegal situations. Oxycodone and hydrocodone are semi-synthetic, or a hybrid. Opiates and opioids work by seeking out receptors in different parts of the body.
The term narcotic is a broad term that covers both medications, however, the negative connotation of the word has led to limited use in the medical field. The term comes from the feeling of narcosis, which is an insensibility. These drugs can be addictive, and use is highly regulated. You may notice if you ever have a prescription for one that it is rather small. Patients are normally sent home with only enough for a few days.
These medications bind to opioid receptors that exist throughout your body. These are often found in the brain and spinal cord, however, there are many more. They help by not allowing messages of pain to reach the brain. They also lessen the feeling of pain. People may say things like it “takes the edge off”. The state of narcosis makes it where you may not be as concerned about pain, even though you still feel it to some extent. These drugs work on pain that does not diminish with over the counter medications. Morphine is the most common pain relief option for severe pain when you are in the hospital. It is administered intravenously for a fast response.
Opioids and your Brain
Opioids are normally created naturally in your brain. Your body, however, is unable to make enough of them to combat severe pain. You body also cannot produce an amount that would cause an overdose. Opioids do more than relieve pain. They give you a sense of calm and act as an anti-depressant. They also slow your breathing. This is a part of why taking too many is dangerous. This calming effect is part of what causes addictions. Addicts often start out with prescription drugs given for a legitimate reason. They may find themselves craving that calming effect more and more.
Opioids can work on the receptors since their chemical structure mirrors a natural neurotransmitter. They trick the receptors into letting them in, and then they can stimulate the nerve cells. This activation scrambles the original messages of pain. Opioids also give your brain a wash of dopamine. This chemical is the feel-good chemical, and a euphoria is reached. The reward system of the brain gets involved. Drug use is rewarded by the brain in this scenario, leading to an addiction.