Painkillers are medicine that reduce or relieve pain when taken. They can be taken for headaches, muscle pain, back pain, toothache, arthritis, etc. Some people take pain relievers temporarily to handle acute pain, while others can be prescribed the drugs long-term for chronic pain management. There are many different types of painkillers.
Overview of the main types of painkillers
There are two ways to legally get painkillers: over the counter (OTC) or with a prescription. All of them carry a risk of abuse and eventual addiction if not used exactly as indicated. Here is a brief overview of the prominent pain relievers available.
Aspirin is an OTC medicine used to relieve pain, reduce fever, and reduce inflammation. It is also sometimes used preventively for chest pains, strokes, and heart attacks. When used in this manner, it should be under the supervision of a healthcare professional.
Acetaminophen (the active ingredient found in Tylenol), also known as paracetamol, is a drug used to treat mild to moderate pain such as headaches, toothaches, back pains, etc. It can also be used to reduce a person's fever or treat severe pain. This medicine can be bought over the counter. It is also found in combination with other compounds in some prescription drugs.
Ibuprofen is a painkiller and anti-inflammatory drug used to reduce fever or treat pain/inflammation due to headaches, back pain, menstrual cramps, or minor injuries. This drug is the main ingredient found in Advil and Motrin medication.
Naproxen is an anti-inflammatory drug that works by reducing the hormones that cause inflammation and pain. It is used for conditions such as arthritis, tendinitis, bursitis, and menstrual cramps to reduce pain, swelling, or joint stiffness.
Opioids are a type of painkillers derived from the opium plant. There are natural, synthetic, or semi-synthetic opioid pain relievers. They all interact with opioid receptors on nerve cells in the body and brain and reduce the intensity of pain signals and feelings of pain. All of the drugs listed below are Schedule II drugs, meaning there is a high risk of abuse and subsequent physical and psychological dependence. Here is a brief overview of the most common opioid painkillers. For more detailed information regarding opioids or opiates, please visit our Opioid information page.
Oxycodone is a semi-synthetic opioid used to treat moderate to severe pain. It is only available through prescription and should be used only as directed. Popular brand names include OxyContin, Endodan, and Percocet. For more detailed information on OxyContin or Percocet, please visit our pages for OxyContin information or Percocet information.
Hydrocodone is a synthetic opioid derived from codeine. This drug is used to help patients with severe pain, especially long-duration pain. It is also used as an antitussive medication (a drug that prevents or relieves a cough).
Meperidine is a synthetic opioid that is similar to morphine. It is used to treat moderate to severe pain. It can be used before or during surgery as an analgesic. However, it should not be used to treat long-term pain. It is used to treat sudden episodes of acute pain.
Morphine is an opioid painkiller that is taken directly from the opium plant. It is the most abundant opiate found in the plant. It is used to treat moderate to severe pain. Some extended-release tablets exist but are usually only used to treat pain that cannot be controlled with other medications.
Fentanyl is a synthetic opioid painkiller that is exceptionally potent. It is 50 to 100 times more potent than morphine. It is used to treat severe pain and is often given to patients when they have become physically tolerant to other painkillers. Because of its potency, fentanyl should only be used precisely as prescribed. If not, the risks of overdosing are higher than other drugs. For more detailed information of fentanyl, please visit our Fentanyl information page.
Hydromorphone is a semi-synthetic opioid painkiller used to treat severe pain. Some extended-release tablets exist but are usually only used to treat pain that cannot be controlled with other medications. This form of hydromorphone should not be used to treat short-term pain or pain that can be relieved using other medications.
Main brands of painkillers
|Brand Name||Availability||Main Active Ingredient(s)||Class|
|Advil||Over the counter||Ibuprofen||Non-steroidal anti-inflammatory drug|
|Aleve||Over the counter||Naproxen||Non-steroidal anti-inflammatory drug|
|Bayer||Over the counter||Aspirin||Non-steroidal anti-inflammatory drug|
|Motrin||Over the counter||Ibuprofen||Non-steroidal anti-inflammatory drug|
|Tylenol||Over the counter||Acetaminophen||Analgesic|
What do Painkillers Look Like?
There are numerous different types of painkillers, as mentioned above, and they all look somewhat different. Here are a few examples of painkillers:
Effects of painkillers
Many different side effects come from using or abusing painkillers. Depending on the type of painkiller, some side effects may vary. Every body is different and may not react the same way to a specific drug. In this section, we will cover some of the effects related to specific kinds of painkillers, but to get a more detailed list of the risks and symptoms related to the specific medication you are taking, you should consult your healthcare professional.
- Cloudy urine
- Fever with or without chills
- Skin rash, hives, or itching
- Sore throat
- Unusual tiredness or weakness
- Abdominal or stomach pain, cramping, or burning
- Dark urine
- Decreased frequency or amount of urine
- General tiredness and weakness
- Irregular heartbeat
- Loss of appetite
- Numbness or tingling in the hands, feet, or lips
- Pain or discomfort in the upper abdomen
- Abdominal pain
- Cloudy urine
- Full feeling
- Itching skin
- Pain or discomfort in chest or throat
- Pale skin
- Shortness of breath
- Swelling of face, fingers, hands, feet, lower legs, or ankles
- Unusual tiredness or weakness
- Weight gain
- Chest pain
- Difficult or labored breathing
- Feeling of indigestion
- Itching skin
- Large, flat, blue, or purplish patches in the skin
- Skin eruptions
- Stomach pain
- Tightness in the chest
- Slowed breathing
Painkiller overdose can be a life-threatening situation and should be taken very seriously. As soon as a person suspects they or someone they know is overdosing on pain relievers, they should seek help immediately. Depending on the type of painkiller ingested, medical professionals can take the appropriate measures to help the person. An overdose can happen in different ways, such as taking too much of the drug at once, taking another dose too soon, or mixing drugs. When a person abuses the drug, the chances of this happening are greater. But even when a person is legitimately using painkillers, mistakes can happen.
A critical step is to identify the signs of an overdose so that an individual can get help as quickly as possible. In some cases, it is a matter of life or death.
Signs of an acetaminophen overdose
- Increased sweating
- Loss of appetite
- Nausea or vomiting
- Pain in the upper abdomen or stomach area
- Stomach cramps or pain
- Swelling in the upper abdomen or stomach area
- Tenderness in the upper abdomen or stomach area
Signs of an aspirin overdose
- Bizarre behavior
- Double vision
- Feeling faint
- Impaired hearing
- Low blood pressure
- Nausea and vomiting
- Rapid breathing
- Rapid heart rate
- Ringing in the ears
- Unsteady walking
Signs of an aspirin overdose
- Bluish lips or skin
- Difficulty sleeping
- Drowsiness to profound coma
- Mood or other mental changes
- Muscle tremors
- Not breathing
- Rapid, deep breathing
- Slow or irregular heartbeat
- Stomach cramps
- Sudden fainting
Signs of a Naproxen overdose
- Bleeding under the skin
- Confusion about identity, place, and time
- Muscle tremors
Signs of an opioid overdose
- Awake, but unable to talk
- Blue or purplish-black fingernails or lips
- Choking sounds, snore-like gurgling sound
- Erratic breathing
- Erratic pulse
- Loss of consciousness
- No pulse
- Not breathing
- Pale or clammy skin
- Skin tone turns bluish purple (lighter skin), for darker-skinned people, it turns grayish or ashen.
- Skin tone turns grayish or ashen (darker skin)
- Slow pulse
- Very limp body
- Very slow breathing
Even if not fatal, a painkiller overdose can lead to other health complications; some can even lead to permanent damage. For example, acetaminophen is known to cause liver damage, and opioid overdose can sometimes lead to brain or kidney damage. Therefore, although an overdose is not always fatal, it can negatively affect one's life permanently.
Painkiller use can lead to abuse and addiction. Different scenarios can lead to abuse and addiction. A person could develop a physical tolerance if they are on a painkiller for an extended period. Physical tolerance means that the body has begun to tolerate it, and the person will need a higher dosage or a more potent drug to feel the initial effects. Once this happens, a person will often feel withdrawal symptoms once they stop taking the medication. This can lead to painkiller abuse and eventual full-blown addiction. A person addicted to painkillers sometimes might never have intended for it to happen. Therefore, a prescription will often be for the lowest dose and the shortest time possible.
What Are the Signs of Painkiller Addiction?
There are many signs which can indicate that a person has developed a problem with painkillers. One of the first signs that one can notice on themselves is thinking a lot about the medication. This can include thinking a lot about the next time one will take their medication or how it makes them feel. A person struggling with a painkiller addiction will often have the drug has their sole focus.
Another sign of pain reliever addiction is behavioral changes. Things such as mood swings or out of character behavior can be a sign that there is a problem. A person can also start seeing changes in their sleep patterns, having problems sleeping, or falling asleep during the day. When addiction takes hold, it can impair one's judgment, leading to impulsive or risky actions which can endanger their life or the lives of others. As the person becomes more focused on their medication, they can start to withdraw from their everyday life and drop social activities that they enjoyed in the past.
A big sign of abuse and addiction to painkillers is the mishandling of the medication itself. A person that starts taking their painkiller medication even when they do not feel actual pain but just in case has a problem. Once a person starts developing a problem with their painkiller, they can begin taking amounts different than those prescribed or taking it more often than needed. This abuse cycle can lead to other illegal behavior such as borrowing medication from other people or "losing" their medication to get another prescription. The person can start "doctor shopping." This means that the person will visit multiple doctors for the same ailment to get multiple prescriptions.
How to help a loved one addicted to painkillers
Once you have realized that someone you love is addicted to painkillers, something needs to be done, no matter how it came about. The first part is educating yourself on painkiller addiction to understand what is happening with the person. It is a thin line between helping a painkiller addict and enabling them. Enabling refers to actions that help the addiction go unaddressed and allows it to continue. One way to differentiate between helping and enabling is that you want to support the person but not support the addiction. There are some steps you can take to get them the help they need.
Once you are educated on the subject and understand it, you should look at treatment options. The treatment plan should be adapted to their specific painkiller addiction and meet your loved one's needs. It can be a good idea to decide on treatment plans and facilities before confronting your loved one because if the conversation goes well and they agree to get help, they should go get treated as soon as possible. We have referral specialists available 24/7 who can help narrow down the best treatment options in your area.
When having the conversation, you need to make it clear that you are aware that they have a problem and want to help them, but that the behaviors associated with their addiction are not okay. It's important to let them know that you want to help them get treatment. Beforehand, be mentally prepared for the reaction you might get. When confronted, the individual can become angry about the subject and not want to face the facts. This is a usual problem when dealing with addiction. One should not be surprised if they are faced with intense anger when confronting someone about their painkiller addiction. It is crucial not to get swayed by those reactions. The tough-love approach can seem counter-intuitive, but the alternative is letting the person keep using painkillers.
If a person is very resistant to getting help or is having trouble facing the fact that there is a problem and that help is needed, an intervention might be required. Before a person can start to get better, they need to realize that there are issues. An intervention can help the individual understand the hurt they are causing to themselves and those around them. The outside point of view of a professional interventionist can be helpful. An addict will often try to minimize the issue or brush it off, and it can be hard for family members and friends to follow through and get the person to realize that this cannot go on. Once the addict agrees to get treatment, do not waste a second. Get them into treatment as soon as possible.
Painkiller Abuse and Addiction Treatment
Once a person has decided to get help, the usual course of action is to get a person through a detoxification program. Detoxification is the process of stopping the use of the substance and waiting for the drug to be eliminated from the body while managing the withdrawal symptoms. The detox phase's intensity depends on the person's body, the painkiller taken, the quantity, and how long they have been taking it. The withdrawal symptoms experienced can include the following:
- Abdominal cramping
- Body aches
- Dilated pupils
- Excessive sweating
- High blood pressure
- Muscle aches
- Nausea and vomiting
- Rapid breathing
- Rapid heartbeat
- Runny nose
- Watery eyes
Depending on the severity of the symptoms, it can be challenging for a person to go through this phase without professional help. A medical detoxification program is often recommended, especially when someone has abused opioid pain medication. There are many advantages to medically supervised detox. First, it provides a safe space for the recovering addict to get through the withdrawal without any distractions, triggers, or chances to relapse. The individual will also have access to proper medical care if any emergency should happen during the process. The withdrawal symptoms can be adequately managed to keep the person safe and as comfortable as possible. A medical detox program will also be able to give the proper medication to manage specific symptoms, such as insomnia, high blood pressure, and diarrhea. Although some symptoms don't seem that problematic, they can lead to other complications if not handled properly. For example, if a person has diarrhea and vomits a lot during the withdrawal, this can lead to dehydration, and that can lead to other symptoms like exhaustion and dizziness. All of these can be appropriately handled in a professional setting.
Detoxification is only the first step. A full rehabilitation treatment will help a person get to the root of the problem and address it. The purpose of rehabilitation is to address the underlying issues linked to addiction and give the person the tools needed to handle their life and be productive without painkillers. Over the decades, drug rehabilitation has evolved, and there now exists a variety of treatment models. This increasing number of treatment strategies is excellent since no single treatment is right for everyone. A person can have many other issues to address apart from just the substance abuse. Here are some of the services that can be found in different rehabilitation centers:
- Educational services
- Family services
- HIV/AIDS services
- Legal services
- Medical services
- Mental health services
- Vocational services
It is vital to find a rehabilitation treatment that addresses the specific needs of the individual. This will give them the best possible chance of long-term success.
Painkiller Abuse Statistics
According to the National Survey on Drug Use and Health of 2018, there were 1.9 million people that misused prescription painkillers in the United States for the first time within the past year. This means that, on average, 5,200 people misuse some type of painkiller for the first time. The only drug that had more initiates in the past year was marijuana. This shows just how much of a problem pain relievers are and how easy it is to misuse it. The following estimates also show that painkiller misuse is a problem in all age groups.
- For adolescents aged 12 to 17, 310,000 misused prescription pain relievers for the first time in the past year, an average of 850 teenagers each day.
- For young adults aged 18 to 25, 464,000 people misused prescription pain relievers for the first time in the past year, an average of 1,300 young adults each day.
- For adults aged 26 or older, 1.1 million misused prescription pain relievers for the first time in the past year, an average of 3,100 adults each day.
Painkiller misuse is often a problem that persists and does not stop at just once. This survey estimated that around 9.9 million people (3.6% of the population) misused prescription painkillers in the last year. When compared to the 1.9 million initiates mentioned above, one can see that around 8 million people had misused painkillers before 2018 and misused it at least once within the past year.
Of those 9.9 million people, around 695,000 were teenagers aged 12 to 17, representing 2.8% of the population of that age. Approximately 1.9 million adults aged 18 to 25 misused pain relievers, representing 5.5% of all young adults. And around 7.4 million adults aged 26 or older misused prescription painkillers in the past year, representing 3.4% of the population of this age group.
The survey also went over the reasons people had to misuse the drug. Here are the main reasons they had for their last misuse of pain relievers.
- Relieving pain: 63.6%
- Feeling good or getting high: 10.6%
- Relaxing or relieving tension: 9.2%
- Helping with sleep: 4.5%
- Helping with emotions or feelings: 4%
- Experimenting: 2.5%
- Being hooked or feeling like they need the drug: 3.2%
- Increasing or decreasing the effects of other drugs: 0.9%
No matter the reason for the misuse, it can lead to addiction, nowadays called pain reliever use disorder. It is estimated that 1.7 million people suffer from this disorder. And here is the breakdown of pain reliever use disorder by age group to show that this affects people of all ages.
- Age 12 to 17: 0.4 percent of that age group (104,000 people)
- Aged 18 to 25: 0.7% percent of that age group (248,000 people)
- Aged 26 or older: 0.6% percent of that age group (1.3 million people)
Definitions of common terms related to painkillers
|Non-Steroidal Anti-Inflammatory Drug (NSAID)||Non-steroidal anti-inflammatory drugs (NSAIDs) are part of a drug class used to reduce pain, decrease fever, prevent blood clots, and in higher doses, decrease inflammation. The term non-steroidal distinguishes these drugs from steroids, which have a similar anti-inflammatory action.|
|Opioid||A class of drugs derived from opium (poppy plant), it also includes drugs that produce similar physiological effects than opium (such as pain relief).|
|Pain reliever addiction (pain reliever use disorder)||A condition that occurs when attempts to control or stop use are unsuccessful or when use results in social problems and a failure to fulfill obligations at work, school, and home. Addiction often comes after the person has developed a tolerance and dependence, making it also physically challenging to stop.|
|Pain reliever dependence||A condition where the body adjusts to the painkiller medication and starts needing it to function normally. This condition is why withdrawal symptoms are experienced when the drug is stopped.|
|Painkiller tolerance||This is when a person using painkillers begins to experience a reduced response to the drug, requiring more medication to achieve the same effect.|