What are the basic differences between narcotic and non-narcotic painkillers?
When should one use a narcotic analgesic or a non-narcotic analgesic? Are there any serious side-effects of using a narcotic painkiller except drowsiness?
It depends how bad it is. I know that at the pharmacy I work in, we always give people the non-narcotics to try first before sending them to the doc to get a perscription for a true narcotic. Besides often being expensive, they can be very addicting.
If you don’t yet know, there are different classes of drugs, with the heavy stuff like narcotics falling in Class II. With the exception of Class I drugs (illegal in the U.S.), Class II drugs make you become emotionally and mentally attatched to them, and for some users it’s hard to get off them.
Now for the heart of your question. If you’ve tried the weaker OTC (over the counter) analgesics, then be careful with the narcotics. You mentioned drowsiness as a side effect.
It appears when you wrote this question that the only side effect you were aware of is drowsiness.
The longer you take narcotics, the more side effects we’ve noticed in people taking Class II’s as a general rule of thumb.
On the other hand, there are some people who take them from extended periods of time with no problems whatsoever, but not many.
As you continue taking them, for many people it goes from just drowsiness to nausea and constipation, followed in rare cases to violent throwing up.
To conclude a bit here, try the weaker stuff, and if you do try the narcotics, just use some wisdom and discretion.
July 27th, 2009 at 4:11 pm
narcs are always quite addictive. Demerol, morophine, oxycontin.
oops sorry guess I should actually answer your question. Using a narc should only be for chronic pain. Pain management is important. If you are instructed to take every 6hrs don’t skip if you’re not in pain. Any pain killer with codeine can cause constipation. A stool softener should be used as well.
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July 27th, 2009 at 4:41 pm
narcotics induce a sleep that can kill. Thats called an overdose. Non narcotics don’t induce sleep. Research the word Narcosis
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July 27th, 2009 at 5:14 pm
Naarcotic analgesis relieve the pain but their use entail the risk of producing physical and sometimes psychological dependance. They in additon to relieve pain produces drowsiness, changes in mood and mental clouding.Sometimes there is addiction and abuse liabilty also. Whereas Analgesics are plain relievers.
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July 27th, 2009 at 5:53 pm
I aggree with the opinion given about narcotic pain killers and I would like to add that the non narcotic ones belong to the class of NSAID, that is non steroid antiinflamatory drugs. They don’t just relieve pain but they have also antiinflamatory properties. Usually, when an inflammation occurs there is also pain.
Not all of them induce sleep ; we can refer as an example Lonarid-N that is a quite frequently used medicine for this purpose.
Lonarid-N, according to the legislation of my country, is classified as a narcotic painkiller and it is included in the list of medicines that require a specific medical prescription.
Therefore, it is the phycisian’s decision when he will recommend them considering the origin and perception of pain.
Non narcotic painkillers can be sold also as OTC products, for internal or external use to treat conditions such as muscular pain, dental pain, burn or sunburn, haemorrhoids ecc.
There is a distinction between ORGANIC PAIN and PSYCHOGENIC PAIN.
For further information(as this is a long discourse) you can refer to the FDA site.
UPDATE
I’ve seen all the answers given and I have to say that they are excellent. Can be found also the distinction between organic pain (treated with this category of medicines) and psychogenic pain(requires another category of medicines).
I wanted just to say this.
I noticed that the term narcotic pain killers and narcotics is treated in the same way regarding addiction. Let me say that quite frequently, a person who is prescribed these medicines is not getting addicted because he is in an advanced stage of cancer or another life-threatening disease. So, he is not going to use them for a long time, he has not the time.
At this point, if we want to talk about side effects,we have to consider also the interactions of the narcotic pain killer(as you nominate it) with the other medicines that he is taking.
Anyway, science is advanced at this point and new medicines (in a more confortable form, they are patches)came out, in the effort to diminish the dependency.
Katerina
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July 27th, 2009 at 6:11 pm
I am not really sure but you can read this article about painkillers. It is quite long.
An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain and to achieve analgesia. This derives from Greek an-, "without", and -algia, "pain". Analgesic drugs act in various ways on the peripheral and central nervous system; they include paracetamol (acetaminophen), the nonsteroidal anti-inflammatory drugs (NSAIDs) such as the salicylates, narcotic drugs such as morphine, synthetic drugs with narcotic properties such as tramadol, and various others. Some other classes of drugs not normally considered analgesics are used to treat neuropathic pain syndromes; these include tricyclic antidepressants and anticonvulsants.
Stepwise use
In 1990, the World Health Organisation (WHO) approved an "analgesic ladder" which recommends the stepwise introduction of stronger painkillers if the more basic ones are ineffective. While originally introduced for managing pain in cancer, these guidelines have found application in all fields of medicine, such as surgery and anaesthetics.
The first step is paracetamol (500 mg to 1 g every 4–6 hours).
The second step involves the addition of an NSAID (e.g. ibuprofen) or a weak opioid (such as codeine).
The third step comprises the addition of a strong opioid (such as morphine, oxycodone or a fentanyl preparation); if codeine is being taken the strong opioid replaces codeine.
The major classes
Paracetamol and NSAIDs
The exact mechanism of action of paracetamol is uncertain, but it appears to be acting centrally. Aspirin and the NSAIDs inhibit cyclooxygenase, leading to a decrease in prostaglandin production; this improves pain and also inflammation (in contrast to paracetamol and the opioids).
Paracetamol has few side effects, but dosing is limited by possible hepatotoxicity (potential for liver damage). NSAIDs may predispose to peptic ulcers, renal failure, allergic reactions, and hearing loss. They may also increase the risk of hemorrhage.
Opiates and morphinomimetics
Tramadol and buprenorphine are thought to be partial agonists of the opioid receptors. Morphine, the archetypical opioid, and various other substances (e.g. pethidine, oxycodone, hydrocodone, diamorphine) all exert a similar influence on the cerebral opioid system. Dosing may be limited by opioid toxicity (confusion, myoclonic jerks and pinpoint pupils), but there is no dose ceiling in patients who tolerate this.
Opioids, while very effective analgesics, may have some unpleasant side-effects. Up to 1 in 3 patients starting morphine may experience nausea and vomiting (generally relieved by a short course of antiemetics). Pruritus (itching) may require switching to a different opioid. Constipation occurs in almost all patients on opioids, and laxatives (lactulose, macrogol-containing or co-danthramer) are typically co-prescribed.
When used appropriately, opioids and similar narcotic analgesics are safe and effective, carrying relatively little risk of addiction. Occasionally, gradual tapering of the dose is required to avoid withdrawal symptoms.
Specific agents
In patients with chronic or neuropathic pain, various other substances may have analgesic properties. Tricyclic antidepressants, especially amitriptyline, have been shown to improve pain in what appears to be a central manner. The exact mechanism of carbamazepine, gabapentin and pregabalin is similarly unclear, but these anticonvulsants are used to treat neuropathic pain with modest success.
Specific forms and uses
Combinations
Analgesics are frequently used in combination, such as the paracetamol and codeine preparations found in many non-prescription pain relievers. They can also be found in combination with vasoconstrictor drugs such as pseudoephedrine for sinus-related preparations, or with antihistamine drugs for allergy sufferers.
Topical or systemic
Topical analgesia is generally recommended to avoid systemic side-effects. Painful joints, for example, may be treated with an ibuprofen- or diclofenac-containing gel; capsaicin also is used topically. Lidocaine and steroids may be injected into painful joints for longer-term pain relief. Lidocaine is also used for painful mouth sores and to numb areas for dental work and minor medical procedures.
Psychotropic agents
Tetrahydrocannabinol and some other cannabinoids, either from the Cannabis sativa plant or synthetic, have analgesic properties, although the use of cannabis derivatives is illegal in many countries. Other analgesic agents include ketamine (an NMDA receptor antagonist), clonidine and other α2-adrenoreceptor agonists, and mexiletine and other local anaesthetic analogues.
Addiction
In the United States in recent years, however, there has been a wave of new addictions to prescription painkillers such as oxycodone (OxyContin, Percocet etc.) and hydrocodone (Vicodin, Lortab etc.). The U.S. Government is now taking steps to reverse this epidemic, which it has blamed on easy access to prescription drugs over the Internet. The bigger problem however is doctors overprescribing these drugs.
Reference
Cancer pain relief and palliative care. Report of a WHO expert committee [World Health Organization Technical Report Series, 804] . Geneva, Switzerland: World Health Organization; 1990. pp. 1-75.
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July 27th, 2009 at 6:24 pm
Ready? Narcotics affect each person in a differnt way but they can be put into two large categories. In easy terms.
Categorie #1. They killed my pain and now I am done.
Categorie #2 They killed my pain, my pain is gone and I love the pills.
#2 is the one that causes problems. If a person becomes addicted to them, through no fault of their own, (as I see it) they will do whatever it takes to get the pill. They will see several doctors, order online and hide the info (charges) they will steal and or borrow them from other people, they will snoop in cupboards and med cabinets in friends house to find them. They will take from their own family to get what they need. In worse cases they will hold up a pharmacy. One really makes you feel different, the nonnarcotic does not.
Narcotics make a person become a monster or slave to the relief. It is no longer pleasure, but relief. Then the lies affect their loved ones, no one trusts the narcotic user, he becomes less and less of a person, misses work, forgets things, thinks he is invisible, is a crappy love partner but thinks he is the greatest, has a false idea about what he/she looks like to other people.
The narc addict will lie when he needs it or needs to hide his use and will not back down even when all evidence presented tells he is using. He is in la la land about what others think of him, as he believe in his mind that while on the drug he is MR wonderful.
IS this what you were looking for?
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July 27th, 2009 at 6:48 pm
It depends how bad it is. I know that at the pharmacy I work in, we always give people the non-narcotics to try first before sending them to the doc to get a perscription for a true narcotic. Besides often being expensive, they can be very addicting.
If you don’t yet know, there are different classes of drugs, with the heavy stuff like narcotics falling in Class II. With the exception of Class I drugs (illegal in the U.S.), Class II drugs make you become emotionally and mentally attatched to them, and for some users it’s hard to get off them.
Now for the heart of your question. If you’ve tried the weaker OTC (over the counter) analgesics, then be careful with the narcotics. You mentioned drowsiness as a side effect.
It appears when you wrote this question that the only side effect you were aware of is drowsiness.
The longer you take narcotics, the more side effects we’ve noticed in people taking Class II’s as a general rule of thumb.
On the other hand, there are some people who take them from extended periods of time with no problems whatsoever, but not many.
As you continue taking them, for many people it goes from just drowsiness to nausea and constipation, followed in rare cases to violent throwing up.
To conclude a bit here, try the weaker stuff, and if you do try the narcotics, just use some wisdom and discretion.
References :
Five years working in the pharmacy, recently behind the counter as a technician.
July 27th, 2009 at 7:35 pm
you answered your own question, its in the molecular structure of narcotics and its binding properties with other molecules in your system that is the main difference.
as side effects go the narcotic because of its properties
can cause the most serious side effects, and depending on your own unique chemistry can cause side effects that were previously unknown but only in rare circumstances.
this is why some percentages of folks are allergic to what the general population may not be! Bat light is now off.
regards JuJu
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