Besides these two types of analgesics there are also other medications (aspirin and particular non-steroidal anti-inflammatory drugs) known as painkillers. They provide some pain relieving effects but their primary purpose is elimination of inflammations, so including them to the class of analgesics is wrong.

Non-narcotics

Of all over-the-counter, non-narcotic painkillers the most popular is definitely acetaminophen. It is found in over 600 drugs, combined with other active elements for example in cold, flu or sinus infection medications. It is also available as a stand-alone drug. So when using it make sure you are not exceeding the dosage by combining it with drugs that contain acetaminophen, because an increased intake of this substance may damage your liver.

Narcotics

Narcotic painkillers divide in two main types: opiates and opioids (that are derived from opiates). Opiates are the active chemicals that are contained in opium.

Opiates were previously widely used in medicine prior to the creation of effective opioids. But apart from analgesics effects the opiates provided, there were numerous unpleasant side-effects that are very common for narcotics: delirium, hallucinations, loss of orientation, etc. This is why the use of painkillers in early days was quite limited and the effectiveness was traded for a certain price.

Opioids are considered any substance that affect the opioid receptors in the central nervous system or gastointestinal tract. Opioids are usually divided into four main groups:

• Endogenous opioid peptides (substances produced within the human body such as endorphins, enkephalins, dynorphins)
• Opium alkaloids (thebaine, morphine, codeine)
• Partially-synthetic opioids (heroin, hydrocodone, hydromorphone, nicomorphine)
• Fully synthetic opioids (demerol, tramadol, methadone, propoxyphene, buprenorphine, butorphanol)

Opioids (e.g. tramadol) are used as very effective painkillers in cases of chronic or severe pain. In contrast to opitates, opioids don’t have the negative narcotic side-effects and also don’t exhibit an upper limit in dosage. If increased gradually the dosage of opioids used can be that high that it would be fatal for a person if taking any other medications with such concentration.

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The figures show that in the last year of the study the US population has consumed over 200,000 pounds of such painkillers as codeine, hydrocodone, meperidine, morphine, and oxycodone. If put in per capita perspective that means that every American consumed about 300 milligrams of analgesics.

One of the most used painkillers from that number were those containing oxycodone, which is the active element in the painkiller OxyContin. There was an astronomical increase of 600 per cent in sales in only 8 years of the study. Previously oxycodone was called “hillbilly heroin” because it was primarily traded over the counter in the Appalachia region and used for recreational purposes. However, today it is widely sold in big metropolitan areas from East to West.

Specialists suggest that there is a set of reasons behind such a skyrocketing use of analgesics among US citizens:

• The nation becomes older in age group proportions.
• Drugs have become much wider and more aggressively marketed with almost a triple increase in advertising spendings during the last ten years.
• Painkillers have become the cornerstone of the way the pain is treated and managed nowadays.

The last reason draws up more concerns from the part of professionals. It seems like it’s easier for an individual to take Tramadol pill for example and forget about the pain, rather than address a doctor to see whether there’s a health issue to be concerned with. Not speaking of exercises and improvements in lifestyle. Painkiller pills have become the fast solution for any trouble, but can they stand up with the array of public health issues that may arise in the future due to such tendencies. We’ll see.

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Chronic pain can be caused directly by an injury or disease, or it may be a side effect or complication following surgery, caused by drug interactions, etc. Always liking to produce lists, doctors have classified pain into the following categories:

Nociceptive where you feel a sensation in a specific location. This may be somatic and so felt in the joints, bones, muscles and ligaments, or visceral which is felt in the internal organs such as the heart, lungs, liver and kidneys. The latter can be more difficult to localize because the pain simply comes from inside the body.

Non-nociceptive may be neuropathic, i.e. pain generated by the nervous system and not tied to a specific location in the body. When the nervous system is damaged, the messages become more difficult to interpret and the brain is often confused by random effects. The result is unpredictable feelings of tingling, numbness, pins and needles and other unpleasant symptoms. Alternatively, there may be sympathetic pain where the skin and tissue around an injury become unusually sensitive and restrict movement.

No matter which variety of pain you may have, there are a range of analgesics or painkillers available to relieve any suffering. The less powerful drugs are the nonsteroidal anti-inflammatory drugs (NSAIDs) which reduce swelling and inflammation in the joints and elsewhere. The more powerful deal with moderate to severe pain with tramadol being the most commonly prescribed because it is less likely to cause dependence than the opiates. Tramadol works by changing the way in which the neurotransmitters carry messages in the nervous system. Because of this, it is equally effective no matter what the cause of the pain, i.e. localized or arising from the nervous system itself. The messages are not carried to the brain or not clearly interpreted as being pain messages. Thus, you can have a reasonably good quality of life even though the source of the pain remains active in your body.