Painkillers: What to Know and How to Stay Safe

Pain can be short-term (acute) or long-lasting (chronic). Some painkillers are strong and need a doctor's prescription. Others are available over-the-counter and can be safely chosen with the help of a pharmacist. Everyone's pain is different, so talking to a healthcare provider is the key to choosing the right pain relief.

Key takeaways:

There are many types of medicines that help take away pain. Opioids are the most commonly known, but others include medications that also treat seizures, depression, and inflammation. Let's take a brief look at the different kinds of medicines you can use to stop pain.


Opioids are the strongest painkillers available. They are best used for short-term pain relief for about 3–7 days after an injury, major burn, or surgery. Opioids for long-term use are typically reserved for cancer pain, severe long-term pain, or pain at the end of life.

If your doctor decides an opioid is needed for a longer time, they may send you to a pain medicine specialist. They can create a safe treatment plan for you.

Opioids work by attaching to nerve cells in the brain, spinal cord, or other parts of the body and block pain signals to the brain.

Taking opioid medicines for a long time can make your body get used to them. This means you might need to take more of them to feel better. Research has also found that using these medicines for a long time might even make your pain worse.

Some common prescription opioids include:

  • Codeine
  • Morphine
  • Hydrocodone
  • Oxycodone
  • Oxymorphone
  • Fentanyl

Using opioids for pain relief can cause problems like:

  • Nausea
  • Constipation
  • Low energy
  • Slowed breathing
  • Slowed heartbeat
  • Allergic reaction
  • Addiction
  • Overdose

Using alcohol or sedatives, such as diazepam or alprazolam, along with opioids can increase your risk of overdose. It's best to discuss any history of substance use disorder with your doctor before starting opioid treatment.

If, during opioid treatment, you start to think you need more medicine to treat your pain, this could be a red flag. Talk to your doctor about this symptom right away.

Seizure medications

Seizure medications work by blocking pain signals from damaged nerves. This class of drugs can be used for long periods of time under the care of a doctor. However, if you need to stop an anti-seizure medication, you will need to wean off slowly to prevent withdrawal seizures.

Some examples of seizure medicines used to treat nerve pain are:

  • Carbamazepine
  • Topiramate
  • Oxcarbazepine
  • Gabapentin
  • Pregabalin
  • Zonisamide

These drugs are typically used to treat pain from migraine headaches, damaged nerves, and overly sensitive nerves in trigeminal neuralgia and fibromyalgia.

The side effects of using anti-seizure drugs as painkillers are:

  • Low energy
  • Weight loss or gain
  • Inability to think clearly
  • Dizziness
  • Blurred vision

Some seizure medicines, such as gabapentin and pregabalin, carry the risk of addiction or overdose. Most doctors will prescribe other medications before prescribing those with a risk of addiction.

These drugs may also cause drug interactions and serious side effects such as blood disorders, blood chemistry problems, allergic reactions, and possible suicidal thoughts or actions.


Antidepressants work in the brain to raise your natural levels of feel-good substances called serotonin and noradrenaline. These brain chemicals can stop pain messages from going to our brain from our spine. So, when the brain gets fewer pain messages, long-lasting pain feels milder.

Antidepressants commonly used for pain caused by migraines, nerve damage, and fibromyalgia include:

  • Amitriptyline
  • Nortriptyline
  • Venlafaxine
  • Duloxetine
  • Milnacipran

The side effects of using antidepressants as painkillers are:

  • Increased suicidal thoughts and actions
  • Drowsiness
  • Dry mouth
  • Blurred vision
  • Increased blood pressure
  • Weight gain or loss
  • Anxiety
  • Constipation
  • Difficulty sleeping

These medicines can be used for the long term under a doctor's care. If you need to stop an antidepressant used for pain, your doctor will need to slowly decrease your medication to prevent sensitivity to pain and withdrawal symptoms.


Corticosteroids, also called steroids, are synthetic hormones that reduce pain by reducing inflammation symptoms such as:

  • Tenderness
  • Swelling
  • Redness or darkened skin
  • Soreness

Corticosteroids are not like the steroids bodybuilders use but are similar to the hormones made in our adrenal gland that help regulate metabolism, physical stress, and immune system functions.

Common corticosteroids used to help with inflammation pain are:

  • Prednisone
  • Methylprednisolone
  • Dexamethasone

Doctors may give these as infusions, injections, or pills. They are helpful to treat swollen joints, injured muscles or tendons, or an over-active immune system.

Because corticosteroids can suppress your immune system, damage bones, and impede your body's ability to combat physical stress, they are best used only for short-term pain relief. Examples of short-term uses include pinched sciatic nerve, swollen joints, or a flare-up of lupus or rheumatoid arthritis.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) help to lessen swelling and soreness in the body, just like steroids do. However, they do not affect your adrenal gland.

NSAIDs work by stopping the action of an inflammation-causing enzyme called cyclooxygenase. This type of swelling is common in injured joints, muscle strains, backaches, and bruises. NSAIDS can also treat fever, headaches, menstrual pain, and toothaches.

NSAIDs have other benefits. They are available over the counter (OTC) in pills, oral liquids, and topical rubs or patches. Also, in certain conditions, such as gout or rheumatoid arthritis, doctors can safely prescribe them for long-term use.

NSAIDs available OTC include:

  • Ibuprofen
  • Naproxen
  • Topical salicylates
  • Topical diclofenac

Common prescription NSAIDs are:

  • Diclofenac
  • Celecoxib
  • Indomethacin
  • Meloxicam

Although NSAIDs do not cause problems with your adrenal gland, they can have side effects ranging from minor to serious:

  • Skin rash
  • Stomach upset
  • Heartburn
  • Increased blood pressure
  • Bleeding or bruising
  • Stomach ulcers
  • Kidney damage
  • Heart and circulation damage
  • Allergic reactions

Long-term use of NSAIDs is best under a doctor's care who will monitor blood work for bleeding or kidney damage. This class of drugs can also have serious drug interactions and cause problems in persons with heart problems, asthma, bleeding disorders, or low kidney function.

Aspirin is considered an NSAID, but aspirin has much more risk of side effects, and long-term use is not a safe option.


Acetaminophen, also known as paracetamol, Tylenol, or APAP, is a painkiller that blocks the effects of cyclooxygenase like NSAIDS do, but only in the brain and spinal cord. So, it works by blocking pain signals coming into the brain.

Acetaminophen is good for treating pain without inflammation or swelling, such as tension headaches, sore throat, minor cuts or burns, and joint pain from worn-out cartilage (osteoarthritis).

You can buy acetaminophen easily without a prescription, and it comes in different forms, such as pills, liquids, and suppositories. It is fine for most people to use acetaminophen occasionally according to label instructions.

However, just because acetaminophen is available OTC doesn't make it completely safe. If acetaminophen is used long term, it should be done under a doctor's care so they can monitor for side effects. These include:

  • Rash
  • Allergic reactions
  • Kidney damage
  • Liver damage

It is important to stay within the dose limits in the package directions. Always track how much acetaminophen you take in 24 hours and double-check directions. Taking too much acetaminophen can cause permanent liver damage and death.

The use of alcohol with acetaminophen can also lead to liver failure and death. Acetaminophen overdose is a medical emergency, and if this occurs, you should call 911 or your local medical emergency contact.

To sum it up

Remember, no one should have to endure pain without relief. You have so many options to choose from, one of those can be CBD oils for pain relief. It's always important to use these medicines wisely and safely. Before you or a family member takes any painkiller, always check with a doctor or pharmacist first. They can help you make the best choice and help everyone stay safe and pain-free.

If you need to use pain medication, talk to your doctor or pharmacist about safe alternatives to opioids, steroids, or certain seizure medicines. Seek alternative therapies such as chiropractic care, physical and massage therapy, or acupuncture. Pain has many sides and may require multiple different treatment methods.


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