Painkillers - Ginad.org

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MAIN TYPE

Painkillers are commonly used for a variety of illnesses and to relieve many everyday conditions, such as headaches, muscle aches, toothache, fever and sore throat. These conditions are usually treated with “over-the-counter” painkillers, which can be purchased in stores or pharmacies without a prescription. These include paracetamol, aspirin and ibuprofen. These over-the-counter pain medications are classified as non-steroidal anti-inflammatory drugs (NSAIDs).

For severe and recurrent pain, stronger painkillers may be available by prescription. Many of these medications are opiates, such as morphine and codeine. Because of the high risk of addiction, opioid painkillers are usually only prescribed when other painkillers have proven ineffective and in cases of particularly severe and debilitating conditions that cause chronic pain. However, some opioids are also combined in small doses with NSAIDs and marketed as over-the-counter medications. This is particularly true of co-codamol, which contains a small amount of codeine and a large dose of paracetamol.

While prescription painkillers are more often associated with addiction and abuse, those that are over-the-counter also carry the risk of addiction if instructions are not followed.

Prostaglandins are normally produced by the body to defend itself from injury and other disruptions and trigger a series of reactions, including the physical sensation of pain, inflammation of the affected area and fever. By blocking the production of prostaglandins, painkillers can reduce or eliminate these painful sensations.

Some types of over-the-counter painkillers are physically addictive, especially those that contain codeine or another opiate. This means that the body can become addicted to these medications and trigger significant withdrawal effects when not taken.

Others, such as paracetamol and ibuprofen, are not physically addictive but can be psychologically addictive. Even if, in the common opinion, these drugs are considered harmless, a consumption in large quantities can seriously damage the liver and even lead to liver failure.

OTHER TYPES

The most common over-the-counter painkillers in the world are paracetamol, ibuprofen and aspirin. They are manufactured by many pharmaceutical companies and sold under different names.

Paracetamol brands include Panadol, Tylenol, Vitamol, Doliprane, Calpol and Benuron. This medication is also sold as a generic.

Ibuprofen is sold under the brand names Anadin, Advil, Nurofen, Rimafen, Brufen and many others.

Aspirin is known under the brand names Anacin, Excedrin, Disprin and Aspro Clear. Ibuprofen and aspirin are also sold as generics.

Some of the stronger over-the-counter painkillers also contain a small amount of an opioid, usually codeine. Co-codamol, for example, is a mixture of codeine and paracetamol sold under the brand names Soldapine and Panadeine. Nurofen Plus contains ibuprofen and codeine.

The most common prescription painkillers are morphine, codeine, oxycodone and fentanyl. They come in different brand names.

The medical name for a painkiller is “analgesic” or “painkiller”.

MAIN EFFECTS

The most common over-the-counter painkillers in the world are paracetamol, ibuprofen and aspirin. They are manufactured by many pharmaceutical companies and sold under different names.

Paracetamol brands include Panadol, Tylenol, Vitamol, Doliprane, Calpol and Benuron. This medication is also sold as a generic.

Ibuprofen is sold under the brand names Anadin, Advil, Nurofen, Rimafen, Brufen and many others.

Aspirin is known under the brand names Anacin, Excedrin, Disprin and Aspro Clear. Ibuprofen and aspirin are also sold as generics.

The most common prescription painkillers are morphine, codeine, oxycodone and fentanyl. They come in different brand names.

The medical name for a painkiller is “analgesic” or “painkiller”.

PRODUCING COUNTRIES

Currently, different types of painkillers are available and almost all of them are legally manufactured by several pharmaceutical companies around the world.

Some of these drugs are sold freely, without any restrictions, in convenience stores, while those that are slightly stronger can only be sold by licensed pharmacies. Prescription painkillers, on the other hand, can only be legally sold through a licensed pharmacy and only to people with a prescription from a doctor or other qualified practitioner.

If a person taking prescription painkillers is suspected of being addicted, his or her doctor may withdraw the prescription and, if necessary, prescribe another medication. In this case, the person may seek out the same or a similar painkiller on the black market to continue using it and avoid withdrawal.

Black market painkillers come from a number of sources. Unscrupulous pharmacy workers have been known to sell prescription painkillers to addicts or “under the table” dealers. Doctors may also be paid to write prescriptions for painkillers.

In other cases, drugs are stolen or diverted from hospitals and pharmacies with stockpiles, suppliers or delivery depots.

Because of their chemical similarities to illegal narcotics such as heroin, opiate painkillers are often used for recreational and addictive purposes, either as a substitute or to enhance the effects of other drugs. Finally, they are sometimes used to counteract the harmful effects of the “high” following the use of stimulants, which only increases the demand on the black market.

FACTS AND STATISTICS

Facts

There are different types and brands of painkillers. Some, such as paracetamol, aspirin and ibuprofen, are available over the counter at any store. Others are only available by prescription.
Many painkillers work by inhibiting the production of chemicals that signal pain and injury to the brain.
Some are also used to prevent or reduce inflammation.
Even over-the-counter painkillers can be addictive. Although they generally do not contain physically addictive substances, they can be psychologically addictive.
Prescription painkillers that contain opiates are highly addictive, both physically and psychologically. Tolerance can quickly develop and withdrawal effects can be severe.
Some over-the-counter painkillers contain low doses of opiates such as codeine.
Although the dose is much lower than in prescription painkillers, addiction can develop if used for longer periods of time and at higher doses than recommended on the package.
Abuse of paracetamol can severely damage the liver and even lead to liver failure. An overdose can be fatal.
An overdose of ibuprofen can cause abdominal bleeding, breathing difficulties, seizures and, at very high doses, coma or death. Massive, long-term use of aspirin and ibuprofen can cause severe kidney damage.
People often take painkillers for legitimate reasons, but then continue to take them after the pain subsides, creating an addiction.
Strong prescription painkillers can also provide a sense of euphoria and detachment, just like illegal drugs.

5. Facts and Statistics

Statistics

A U.S. study on drug abuse found that after marijuana, over-the-counter and prescription drugs were the most abused substances. Statistics show that 5.1 million people abused painkillers in 2010.
About 1 in 12 American high school seniors admitted to abusing Vicodin (a mixture of paracetamol and hydrocodone) and 5% of them abused oxycodone, a narcotic painkiller.
According to the same study, 70% of high school seniors (17-18 years old) who abused prescription opioid painkillers reported getting them from someone they knew.
Another U.S. study in 2002 showed that 3.2% of youth had abused prescription painkillers in the previous month.
An estimated 20% of Americans use painkillers too often.
A 2009 government report estimates that 30,000 Britons have been addicted to over-the-counter painkillers containing codeine. The report also states that these drugs can be addictive after only three days of use.
In Scotland, there were 644 deaths from paracetamol poisoning between 1994 and 2000
In the United Kingdom, in 1998, the number of tablets allowed per box of over-the-counter painkillers was reduced from 100 to 32 in pharmacies and from 24 to 16 in stores. The number of boxes that can be sold to one person was also limited.
According to a study by Oxford University researchers, these changes led to a 22% drop in paracetamol-related suicides over the next year. In four years, the number of paracetamol-induced liver injuries and failures dropped by 30%. Massive paracetamol overdoses decreased by 20% in the second year and aspirin overdoses by 39% in the third year following these changes.

SIGNS OF ADDICTION

addiction

The exact nature and signs of painkiller addiction and abuse vary depending on the medication (over-the-counter or prescription), but there are some common visible signs.

In some cases, addiction begins with legitimate painkiller use and progresses to abuse and dependence. In particular, tolerance can develop with opioid painkillers, forcing the individual to take larger and larger doses to get the desired effect. The individual may then experience withdrawal symptoms when not taking painkillers, such as mood swings and other emotional disturbances, anxiety and irritation.

If the pain has subsided but the person has become addicted, he or she may continue to claim that he or she is in pain and needs the drug, even if the opposite is obvious. When confronted about their use of the drug, they may become defensive and angry.

People who are addicted to painkillers (over-the-counter or prescription) may lose interest in any method of pain relief that does not involve medication. They may also resort to fraudulent means or turn to the black market to obtain the product, even if it is not like them.

Although addiction to over-the-counter painkillers is less common (since they are much easier to obtain than prescription ones), it can go undetected much more easily. Taking more than the recommended amount, having a large stockpile, or regularly refilling medications is evidence of a potentially harmful addiction.

The types of treatment appropriate for painkiller addiction depend very much on the substance involved, as well as the duration and extent of the use.

For paracetamol abuse, the first step should be a thorough examination by a physician. Even if few side effects are visible, taking the drug may have damaged the liver. Therefore, a quick and accurate diagnosis is necessary to determine whether liver damage or other internal problems need to be treated. Similarly, heavy use of ibuprofen and other over-the-counter painkillers can cause abdominal bleeding, which should be checked by a doctor.

In some cases, especially with over-the-counter painkillers, the addiction is more psychological than physical. Unlike prescription opioid painkillers, medications such as paracetamol produce few withdrawal effects.

Nevertheless, constant excessive use can lead to headaches (called “rebound headaches”), which creates a vicious circle as the individual will increase his consumption to relieve these pains. He or she may also begin to increase consumption in order to relieve these headaches. Combined with the tolerance effects of the drug, the amounts taken can increase exponentially and lead to a build-up of toxicity and a higher risk of harmful side effects.

Opiate painkillers, such as codeine (which can be found in small amounts in some over-the-counter medications), are physically addictive because they are chemically dependent.

TREATMENTS

7. Painkillers – Treatment

Over time, the body will gradually rely on the drug to perform the same function as the chemicals it normally produces, while reducing its own production of these chemicals. This leads to significant withdrawal effects when the medication is stopped, including depression, anxiety, palpitations and insomnia. Substances such as morphine and codeine can also be psychologically addictive in the same way as illegal opiates such as heroin.

In some cases, addiction to opiate painkillers is best treated in a detox center or hospital. In addition to prescribing medications to ease the effects of withdrawal and closely monitoring the progress of detoxification, these clinics can offer psychological and emotional support for the addiction and its aftermath.

In the case of addiction to over-the-counter painkillers, hospitalization will probably not be necessary, but support may be helpful in helping the individual overcome the addiction. Therapies such as cognitive behavioral therapy (CBT) have proven to be very effective for many addictions. As such, CBT addresses the personal reasons and triggers for the addiction, while helping the individual to adopt healthier alternative behaviors.

Simple talk therapies such as counseling can also help the addicted person identify and overcome the reasons for their addiction. If they are still suffering from the pain for which they were legitimately taking the drug, alternative and safer methods of relief can be considered.

References

http://www.bupa.co.uk/individuals/health-information/directory/o/over-the-counter-painkillers

REFERENCES

http://www.bupa.co.uk/individuals/health-information/directory/o/over-the-counter-painkillers

http://www.nhs.uk/Livewell/Pain/Pages/Whichpainkiller.aspx

http://www.elmhurst.edu/~chm/vchembook/555prostagland.html

http://www.nps.org.au/consumers/publications/medicines_talk/mt22/whats_in_a_name

http://www.nhs.uk/Conditions/Painkillers-paracetamol/Pages/Introduction.aspx

http://www.webmd.com/pain-management/news/20030130/when-relieving-pain-raises-risk

http://www.bbc.co.uk/health/emotional_health/addictions/painkiller.shtml

http://www.bbc.co.uk/news/health-15837468

http://www.thenational.ae/news/uae-news/stolen-painkillers-sold-on-black-market

http://www.usatoday.com/NEWS/usaedition/2012-02-28-DEA-Cardinal_CV_U.htm

http://news.bbc.co.uk/1/hi/8237626.stm

http://www.drugabuse.gov/publications/topics-in-brief/prescription-drug-abuse

http://www.keeprxsafe.com/drug-facts/otc-pain.html#_ftnref4

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1874442/

http://cebmh.warne.ox.ac.uk/csr/resparacet.html

http://www.medicinenet.com/script/main/art.asp?articlekey=24572

http://www.drugabuse.gov/publications/infofacts/treatment-approaches-drug-addiction