Things you need to know about painkillers (Analgesics)!

When we feel aches and pains somewhere, the first thing we do is run for a ' painkiller ', right? When we have a headache, a toothache, a stomachache during menstruation, when we fall and injure our limbs... we seek help from painkillers for all these. This is something that is definitely in every home's medicine cabinet. But, do we really know exactly about these painkillers, or 'Analgesics'? How do they work inside our bodies? Are there any types of them? What are the possible side effects of using them frequently? Today, we will talk about all this very simply, as if we were talking to a friend.

Simply put, what are these analgesics?

Painkillers, or as we call them , 'painkillers', are a type of medicine that relieves or reduces pain in our body. There is something important that we need to understand here. These painkillers are not like anesthesia drugs given during surgery. Anesthesia drugs temporarily stop nerve activity in a certain area, something like losing our consciousness.

But painkillers don't do that. They don't turn off our nerves, stop us from feeling things around us, or make us lose consciousness. They only reduce the sensation of pain in our brains or reduce the inflammation that causes pain.

In what situations do we use painkillers?

We've all used painkillers at one point in our lives. Imagine a situation like this...

• After surgery: Doctors recommend these to help manage pain after any minor or major surgery.
• In case of injury: Severe pain caused by accidents, such as a broken bone (fracture) or a sprained leg.
• Acute Pain: For things like a severe headache, toothache, or muscle strain.
• General body aches: For things like menstrual cramps and body aches after exercise.
• Chronic Pain: Manage long-term pain conditions such as arthritis, cancer, and back pain.

How do these painkillers work? There are two main types!

Painkillers can be divided into two main categories, each of which works in our bodies in two completely different ways.

1. Anti-inflammatory Analgesics

This type of painkiller works by reducing swelling, or inflammation, at the site of the pain. When something happens to our body, such as an injury or infection, the body's natural response is to cause the area to become red, swollen, hot, and painful. This is due to the release of chemicals called prostaglandins. These medications work by stopping the production of those chemicals. This reduces both swelling and pain.

We use the most common types of medications that belong to this category.

• Acetaminophen: This is the paracetamol we all know. It is most commonly used for fever and general aches.
• Aspirin: This is also a pain reliever and a medicine that reduces blood clotting.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): This name is a bit long, but we know these. For example, drugs like Ibuprofen , Naproxen , and Diclofenac belong to this group. These are very effective for things like muscle pain and joint pain.
• COX Inhibitors: These are a special class of drugs that are similar to NSAIDs, but have less effect on the stomach.

2. Opioid Analgesics

These are a group of drugs that are a bit stronger, and you need to be very careful with them. They are also called narcotics . These drugs don't work at the site of the pain; they directly affect our brain and nervous system.

Simply put, these drugs change the way the brain 'receives' pain signals. Even though the pain is in the body, it is reduced in the brain. That's why doctors prescribe them for very severe pain conditions, such as severe pain after surgery or cancer pain.

Some other drugs that belong to this group are:

• Codeine
• Tramadol
• Morphine
• Fentanyl
• Oxycodone

What are the ways to take painkillers?

Painkillers can be taken by our bodies in different ways. Your doctor will determine the most appropriate method based on the nature and severity of your pain, as well as your comfort level.

• Swallowed pills, tablets or capsules: This is the method we see and use most often.
• Liquid you swallow: This method is used for young children and those who have difficulty swallowing pills.
• Patches on the skin: When some powerful painkillers are applied to the skin as a patch, the medicine is gradually absorbed into the body.
• Injections: This method is used in emergencies and when quick pain relief is needed.
• Nasal spray: Some painkillers are also available in this form.
• Films under the tongue: These are quickly absorbed into the bloodstream.

What are the risks and side effects of using painkillers?

"Too much of anything is bad," they say. The same applies to painkillers. Using them, especially in high doses and for long periods of time without a doctor's advice, can cause serious side effects. Let's look at these two risk categories separately.

A little more about the risks of opioid addiction

Opioids are drugs that can save lives if used properly, but can kill lives if used incorrectly. Substance Abuse Disorder (SAD) develops slowly. There are several signs that someone may be developing this condition.

• Taking more medication than the doctor prescribed.
• Trying to reduce medication use but not being able to do so.
• Thinking about medication to the point of being unable to fulfill work, school, or family responsibilities.
• Continuing to use this medication despite knowing that it will cause problems.
• Withdrawing from social activities and friends.
• Using these even in risky situations like driving.
• Over time, the dose taken becomes insufficient before pain relief is felt (Tolerance).
• Withdrawal symptoms occur when the medication is stopped.

When should you seek immediate medical advice?

If you experience any of the following symptoms while taking a painkiller, see a doctor or go to the nearest hospital Emergency Department (ETU) without delay.

If you suspect that someone has overdosed on painkillers, take them to a hospital immediately. If necessary, you can also call the National Poisons Information Centre at the Colombo National Hospital for advice.