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Side Effects of Pain Medications: NSAIDs and Opioids

pain medications

The two main types of pain medications are NSAIDs and opiates. NSAIDs stand for nonsteroidal anti-inflammatory drugs and include drugs such as aspirin, ibuprofen, and naproxen. NSAIDs are used to treat mild to moderate pain. Opiates include prescription drugs such as morphine, oxycodone, hydromorphone and various illegal drugs such as heroin and opium. Opiates provide a more profound pain relief than NSAIDs and are used to treat moderate to severe pain. Pain medication side effects vary depending on which of these pain relievers are used.


Pain Medication Side Effects: Opiates


The three main side effects of opiates are gastrointestinal system problems, addiction, and overdose. Gastrointestinal system issues are one of the most common pain medication side effects, especially for opiates. Opiates bind to receptors in the gastrointestinal tract and slow down the action of the intestines. In essence, waste is unable to move towards the anus, causing severe constipation.


Long-term opiate use is associated with both physical and psychological dependence. People need higher doses of the drug to achieve the same effect and they may exhibit drug-seeking behavior, putting themselves and others at risk in order obtain more of the medication. Opiate addiction is uncommon in people who use opiates for a short period, but the risk increases with long-term use or the use of powerful, illegal narcotic opiates.


Opiate overdose can be fatal. When opiate levels become higher than the body can tolerate, the drug causes a lack of awareness, altered mental status, diminished consciousness or unconsciousness, and dangerously slow breathing. If opiate overdoses not treated, breathing may stop, causing death. Opiate overdose is the most feared and serious pain medication side effects. It is not simply a problem among illegal opiate users, but it can occur with high doses of prescribed opiates.


NSAID Side Effects


The main side effects of NSAIDs are those affecting the gastrointestinal system, the kidneys, and blood. NSAIDs directly irritate the stomach and interfere with substances that help protect the lining of the stomach, such as mucus production. Thus, NSAIDs commonly cause stomach upset, pain, and can contribute to ulcers and gastrointestinal bleeding.


Aspirin keeps lead platelets from sticking together. This is useful when blood clots are an issue, but can increase the risk of bleeding in other circumstances. NSAIDs other than aspirin, have been shown to increase the risk of stroke and heart attack. People with chronic liver or chronic kidney disease, should not take NSAIDs because of pain medication side effects that may worsen organ function.


Liver Enzymes Predict Pain Medication Side Effects


Three cytochrome P450 enzymes are particularly important for pain medication metabolism. Most NSAIDs are metabolized via CYP2C9. On the other hand, CYP2B6 or CYP3A4 breaks down virtually all forms of opiates. People who are poor metabolizers of any of these cytochrome P450 enzymes may experience toxic accumulations of the respective pain medication. Higher-than-expected doses are responsible for various pain medication side effects.








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