Popping Painkillers Regularly? Here's What Could Happen!

Each one of us has consumed a painkiller at least once in our lives. Painkillers help in relieving different types of acute (short-term) and chronic (long-term) pains. While acute pain arises suddenly, it resolves once the underlying cause is treated. On the other hand, chronic pain can continue for months, extending the dependency on painkillers for prolonged periods. Though painkillers are generally considered safe, prolonged or excessive use can result in adverse health consequences.

How do painkillers work? 

There are hundreds of nerves in the human body, which help in transporting messages from one body part to another. While nerves are spread across the body, the endings of these nerves (nerve endings) are found in the skin, gastrointestinal tract, and connective tissues. When the cells of the body are injured, they release chemicals called prostaglandins that sensitize the nerve endings, which in turn send a signal to the brain describing the injury and pain.  

Painkillers, medically called analgesics, can work in two different ways:

• Prevent the release of prostaglandins, so that the brain receives no pain signals.
• Prevent the transmission of messages between two nerves, so that the pain signals fail to reach the brain. 

With the help of these mechanisms, painkillers help in reducing or relieving the pain temporarily.

What are the common types of painkiller medications?

Painkillers are broadly divided into two categories—non-prescription (over-the-counter) and prescription painkillers. 

• Non-prescription painkillers: As the name suggests, non-prescription painkillers such as paracetamol (acetaminophen) can be bought without any prescription and are considered safe for use. These are commonly used painkillers for headaches and body aches. 
• Prescription painkillers: On the other hand, prescription painkillers such as opioids and steroids are strong analgesics that are prescribed to those experiencing severe or continuous pain. Prescription painkillers are usually given to people suffering from long-term conditions such as cancer, or after surgery.

Depending on their ability to relieve pain, the most common types of painkillers include: 

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These drugs alleviate pain by reducing the inflammation in the body. Some of the common examples of NSAIDs are ibuprofen, aspirin and naproxen. You may need a doctor’s prescription to order these medications.
• Non-opioid analgesics: These painkillers reduce the pain receptors in the brain and are considered effective in relieving moderate-to-severe acute pain. Some of the common examples of non-opioid painkillers include paracetamol, antidepressants (such as amitriptyline), antiseizure drugs (such as pregabalin and gabapentin), aspirin, and some NSAIDs. Topical non-opioid medicines such as lidocaine and capsaicin are applied to the skin to reduce superficial pain temporarily. 
• Opioid analgesics: Opioid painkillers such as tramadol, fentanyl, dextromethorphan, and codeine help in reducing pain by preventing the transmission of pain signals to the brain. These painkillers must not be consumed without consulting a doctor. 
• Combination painkillers: This type of painkiller contains a combination of two different types of analgesics. For instance, for treating severe pain, patients have often been prescribed a combination of tramadol and paracetamol. 

What are the side effects of painkillers?

If consumed responsibly or as prescribed by the doctor, painkillers can be a boon for many. However, excessive use of painkillers can result in side effects such as nausea, vomiting, sleep disturbances, mood changes (increased irritation and aggression), and weight changes.

Other serious side effects of using painkillers regularly include:

• Analgesic tolerance: The body gets tolerant to a painkiller if consumed in excessive quantities, thus reducing its effectiveness.
• Addiction: Prolonged use of opioids can create tolerance against the medicine in the body, increasing the need for high doses. This can even result in drug addiction.
• Gastric issues: Prolonged use of NSAIDs and opioids can result in gastrointestinal issues such as constipation, indigestion, stomach pain, internal bleeding, and stomach ulcers.  
• Skin issues: Excessive use of NSAIDs can increase the risk of rashes, blisters, bruising, and bleeding.  
• Liver diseases: Consuming more than 3000 mg of paracetamol or combining it with alcohol can result in liver damage. 
• Heart attack and stroke: Other than aspirin (a blood-thinning medicine), overuse of NSAIDs increases the risk of heart attack and stroke. 

When to contact a doctor?

One should contact a doctor immediately if they experience certain symptoms following the intake of painkillers. These may include: 

• Shortness of breath
• Blurring of vision 
• Drooping of eyelid or side of the mouth along with numbness
• Slurred speech 
• Difficulty in swallowing
• Diarrhoea with severe abdominal pain
• Blood in the urine (haematuria)

How to use painkillers efficiently?

• If possible, consult a doctor before consuming any painkiller. 
• Do not consume painkillers for more than a few days in a row.
• While trying a new medication, start with the lowest dose possible as this reduces the risk of complications and side effects. 
• Do not exceed the maximum daily dose of the medication. You can either check the maximum dose on the medicine information leaflet or consult a doctor for the same. 
• Do not share your pain-relief medication with other people.
• If the pain increases or worsens even after consuming the painkiller, instead of increasing the dose, consult your doctor.

Takeaway

Most painkillers available over-the-counter are considered safe to treat mild to moderate pain. However, like all medicines, these can also have side effects, some of which could be life-threatening. Those who consume painkillers regularly should consult their doctor to ensure the right course of treatment and to prevent any adverse effects. 

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