Overview
The definition of pain is an uncomfortable sensory and emotional experience connected to actual or potential bodily damage, according to “Understanding Medical Surgical Nursing” by Linda Williams and Paula Hopper. Chronic pain is complex, has both physical and emotional components, and persists beyond the normal healing time frame. Examples of chronic pain diagnosis include low back pain, phantom limb pain, chronic cancer pain and arthritic pain. Treatment of chronic pain may require a variety of medications and non-drug treatments, says Williams and Hopper.
Non-Opioids
Non-opioids can be effective at treating chronic pain and are usually the first line pain medication given to treat pain, states Williams and Hopper. This drug class contains medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (Tylenol), used in the treatment of chronic pain, per “Core Concepts in Pharmacology” by Norman Holland and Michael Adams. Long-term use of NSAIDs is not widely practiced because there is a point when an increased dose of the medication cannot relieve pain without elevating the risk of side effects, according to Williams and Hopper.
Opioids
A morphine-like substance derived from the poppy plant that reduces pain is an opioid, according to Holland and Adams. Opioids can prevent the awareness of pain by attaching to opioid receptors throughout the body, per the National Institute on Drug Abuse (NIDA), which is why opioids are the drug of choice to treat severe, chronic pain, according to Holland and Adams. Opioid drugs include buprenorphine, propoxyphene, oxycodone, hydrocodone, fentanyl codeine, methadone, morphine, butorphanol, heroin, hydromorphone and meperidine.
Analgesic Adjuvants
Adjuvants are drugs intended for a different purpose but are also successful at relieving pain, per Williams and Hopper. These analgesic medications treat pain that is not covered thoroughly by non-opioids and opioids medications alone. Medications in this class include drugs such as benzodiazepines (for anxiety and muscle spasms) and steroids. Tricyclic antidepressants, such as imipramine, amitriptyline, doxepin and desipramine, treat neuropathic pain and other nerve-related conditions. Anticonvulsants, such as carbamazepine (Tegretol) and phenytoin (Dilantin), treat symptoms of peripheral nerve pain, states Williams and Hopper.
Side Effects
Opioids can cause drowsiness, nausea, respiratory depression,\ and constipation. Euphoric effects caused by opioids can lead to potential abuse and also increases the risk for opioid overdose, per NIDA. Physical dependence, caused by the body adapting to frequent use of a medication, can be a side effect, according to Holland and Adams, as well as psychological dependence on a drug. Other conditions, like withdrawal and tolerance, can occur as the body adapts to a drug and requires higher doses to maintain the same initial effect, states Holland and Adams.
Long-Term Use
Use of NSAIDs increases the risk of stomach problems, states the American Gastroenterological Association. Women using 500 mg or more of non-aspirin pain medications, like NSAIDs, are at greater risk for developing high blood pressure, according to the American Heart Association. Opioid users are at risk for developing physical dependence and addiction, reports NIDA. Pain medications containing acetaminophen, like Tylenol, can cause liver failure and possibly even death when not taken as prescribed, states the U.S. Food and Drug Administration. Acute kidney failure may be caused by over-the-counter painkillers used long term, according to the National Kidney and Urologic Diseases Information Clearinghouse.
About this Author
Annie McElfresh is a nurse by trade and an avid writer by night. Her background includes 10 years of experience in pain management, operating room, home health, and medical office management. She has completed two full-length novels, contributes to two blogs, and is a member of several writing forums.
