What is a Painkiller?

Analgesic, commonly known as Pain killers, is one of the oldest forms of medication recorded in history. Historians report that the Sumerians in Mesopotamia were among the first people to have cultivated the poppy plant, an opioid, around 3400 BC. These painkillers belong to a group of stoffer used to treat a variety of pains and other symptoms such as fever and inflammation.

Der er forskellige typer smertestillende midler, hver ordineret til bestemte tilfælde og hver fungerer på en bestemt måde. De tre typer smertestillende er:

  1. Ikke-opioide smertestillende midler, såsom paracetamol
  2. Opioide smertestillende midler - såsom kodein
  3. Antiinflammatoriske lægemidler eller NSAID'er 

Ikke-opioide smertestillende midler såsom paracetamol menes at virke ved at blokere kemiske budbringere, der udløser smertereaktioner. Paracetamol reducerer også feber ved at ændre de kemiske budbringere i et område af hjernen, der er ansvarlig for kropstemperaturen.

Opioide smertestillende midler including Morphine, codeine, oxycodone, hydrocodone, dihydromorphine, pethidine, and work by attaching to proteins called opioid receptors on nerve cells in the brain, spinal cord, gut, and other parts of the body. This blocks pain messages, reducing pain sensations and increasing pain tolerance.

Antiinflammatoriske lægemidler eller NSAID'er such as aspirin, ibuprofen and naproxen, work by inhibiting an enzyme called cyclooxygenase (or COX) which decreases the prostaglandins, hormones responsible for processes such as inflammation, blood flow, the formation of blood clots, and the induction of labor. By doing so, they relieve fever and reduce inflammations and associated pain.

 

Can one develop Painkiller Addiction?

These drugs vary in effect and are prescribed for different situations depending on the intensity of pain, general health, and consideration for side effects. In cases of low and short-term pains, Non-opioid painkillers are normally prescribed. In cases of pain accompanied by some sort of inflammation, NSAIDs are generally prescribed. NSAIDs are often prescribed to relieve symptoms of headaches, periods, muscle injuries such as strains, colds and flu, arthritis, and other causes of long-term pain. When these two drugs do not relieve pain, weak opioids such as codeine are prescribed. These drugs are generally riskier and should be ordineret with the lowest suitable doses and for short periods. In cases of broken bones and surgeries, stronger opioids such as morphine are used.

Ikke-steroide antiinflammatoriske lægemidler (NSAID'er) og ikke-opioide smertestillende midler sælges over-the-counter (OTC). Dette betyder, at du kan købe dem uden en recept fra din læge. De er generelt sikre at bruge uden potentiale for misbrug. Opioider er på den anden side klassificeret mellem skema I og skema V, afhængigt af om de er godkendt til medicinsk brug, deres risiko for misbrug og afhængighedspotentiale. Godkendte opioider har brug for recept. Dette skyldes, at opioider har langt flere bivirkninger end NSAID'er.

Non-opioid medications are generally safe and have few side effects. Nonetheless, medicines like paracetamol can cause damage to the liver when taken excessively.

Paracetamol er en meget almindelig medicin, der ofte findes som en sekundær ingrediens i flere medikamenter. Det er svært at justere og holde trit med paracetamolindtagelsen. Når paracetamol tages ofte over en lang periode, kan det føre til leverforgiftning. De tidlige symptomer inkluderer følelse af træthed, mavesmerter eller kvalme. Efter et par dage udvikler symptomerne sig til gullig hud, blodpropper og forvirring som følge af leversvigt. En overdosis af Paracetamol kan forårsage permanent skade på leveren og kræver levertransplantation.

NSAID'er er også sikre, når de tages i moderation, men alligevel forårsager de bivirkninger i tilfælde af overdreven brug eller usunde individer og ældre. Brug af NSAID øger risikoen for en række gastrointestinale (GI) problems, kidney disease, and adverse cardiovascular events. Around 10–20% of people taking NSAIDs experience digestion issues.

Opioider er de mest risikable af de tre, da de kan have alvorlige til fatale bivirkninger, især når de tages sammen med anden medicin. Bivirkninger forbundet med opioidbrug inkluderer: 

  • sedation
  • kvalme
  • svimmelhed
  • opkast
  • forstoppelse
  • fysisk afhængighed
  • tolerance
  • respirationsdepression

These medications also have the potential for abuse, dependency, tilbagetrækning, and even overdose. They can cause cognitive and psychological issues and even increase the risk of suicidal behavior.

Opioidforgiftninger resulterer i gennemsnit på 16 indlæggelser om dagen i Canada, såvel som 11 akutafdelingsbesøg om dagen i Alberta og 13 akutafdelingsbesøg om dagen i Ontario. Opioid-involverede overdosisdødsfald steg fra 21.088 i 2010 til 47.600 i 2017 og forblev stabile i 2018 med 46.802 dødsfald. Dette blev efterfulgt af en betydelig stigning i 2019 til 49.860 overdosisdødsfald.

 

Painkiller Withdrawal and Treatment

Painkillers are intended to relieve pains that humans cannot tolerate. Paradoxically, they sometimes lead to more pain and suffering, especially when misused. People often believe that medications have no side effects. They think that medicine can cause no harm and overlook the warnings and side effects. This is especially true with Non-opioids and NSAIDs which people often in a careless manner. As for opioids, illicit use is seen to be on the rise. The use of medications such as Benzos and Codeine for recreational purposes has increased over the past years making regulations to the rules surrounding analgesics crucial. If you need help with health or medication dependency and recovery, take a look at our internet side.

 

Referencer

Rosenblum, A., Marsch, LA, Joseph, H., & Portenoy, RK (2008). Opioider og behandling af kronisk smerte: kontroverser, nuværende status og fremtidige retninger. Eksperimentel og klinisk psykofarmakologi16(5), 405-416. https://doi.org/10.1037/a0013628

Mallinson, Tom (2017). “En gennemgang af ketorolac som smertestillende præhospital”Journal of Paramedic Practice9 (12): 522-526. doi:10.12968 / jpar.2017.9.12.522. Hentet 2. juni 2018

“Acetaminophen”. The American Society of Health-System Pharmacists. Arkiveret fra originalen den 06-06-2016.

https://www.nhs.uk/live-well/healthy-body/which-painkiller-to-use/

Lee A, Cooper MG, Craig JC, Knight JF, Keneally JP (april 2007). “Virkninger af ikke-steroide antiinflammatoriske lægemidler på postoperativ nyrefunktion hos voksne med normal nyrefunktion”Cochrane-databasen over systematiske anmeldelser (2): CD002765. doi:10.1002 / 14651858.CD002765.pub3PMC 6516878PMID 17443518.

Simone Rossi, red. (2006). Australsk medicinhåndbog 2006. Adelaide: Australian Medicines Handbook Pty Ltd. ISBN 978-0-9757919-2-9.[nødvendig side]

Rostom A, Dube C, Wells G, Tugwell P, Welch V, Jolicoeur E, McGowan J (2002). “Forebyggelse af NSAID-induceret gastroduodenalsår”. Cochrane-databasen over systematiske anmeldelser (4): CD002296. doi:10.1002 / 14651858.CD002296PMID 12519573

https://www.drugabuse.gov/sites/default/files/National%20Drug%20Involved%20Overdose%20Deaths%201999-2019.pptx