Pain is an epidemic in the United States, according the American Academy of Pain Management. Over 50 million Americans live with chronic pain, while millions of others are affected by acute pain due to surgery or accidents. With so much pain, it is no wonder there are so many different types of prescription pain medications available including opioids, corticosteroids, NSAIDs, antidepressants and anticonvulsants.
Opioids
Opioids, or narcotics, are the most commonly prescribed pain medication. They are often prescribed for pain following surgery or for long term use to treat chronic pain. Opioids effectively treat pain by mimicking endorphins, naturally occurring substances in the body that attach to nerve cells to decrease their activity. The opioids attach to the nerve cells and block them from sending pain signals to the brain.
There are many types of opioid medications including codeine, hydrocodone, oxycodone, fentanyl, methadone, meperidine and morphine. Patients can develop a tolerance to opioid medications; they may have to increase their dosage to attain the same relief, and long term abuse (defined as using the medication differently than prescribed) can lead to addiction.
Corticosteroids
Corticosteroids, such as Solumedrol or Deltasone, provide relief from pain by reducing swelling, redness or itching. Corticosteroids are often used to treat the chronic pain caused by diseases like osteoarthritis. This medication reduces the inflammation in the joints, relieving the pain, but does not alter the underlying disease according to a study performed by Bjorn Kullenberg and published in the "Journal of Rheumatology."
Non-steroidal Anti-inflammatory (NSAIDs)
Because steroids have so many side effects, the most complained about being weight gain, doctors often prescribe non-steroidal anti-inflammatory drugs, referred to as NSAIDs. Doctors originally believed that NSAIDs relieved pain by reducing the inflammation; however, the current research according to "The Pharmacology of Chronic Pain: A Review," published in the Spring 2006 issue of "Pain Management and Research" reveals that there are multiple factors involved in the mechanism by which NSAIDs relieve pain.
Long term use of NSAIDs, such as nabumetone, naproxen and meloxicam can cause gastrointestinal problems such as bleeding and liver toxicity.
Antidepressants
Antidepressants, medications typically prescribed to treat emotional conditions, alter the level of neurotransmitters in the brain leading to feelings of well-being and relaxation. These effects of antidepressants make them useful for treating chronic pain such as headaches and severe menstrual pains.
Peroxetine and sertraline affect serotonin levels in the brain and are often prescribed to treat pain caused by severe premenstrual syndrome. Escitalopram and venlafaxine also effect serotonin levels in the brain. Other antidepressants prescribed to treat pain include duloxetine, citalopram and lorazepam.
Anticonvulsants
Medications used to treat seizures, known as anticonvulsants, are often used to treat neuropathic pain because of their ability to reduce neuron excitability. Anticonvulsant medications used to treat chronic pain conditions include gabapentin, carbamazepine, lamotrigine and topiramate.
