What is painkilling all about?

There are two main classes of medications used to treat pain: the so-called narcotics and the non-steroidal anti-inflammatory drugs (NSAIDs). The use of the word "narcotic" has been hijacked. In its medical sense, it originally referred to drugs derived from plants that would stupefy or knock you out. However, it is now linked to the opiates - those drugs derived from the opium plant which is recognized as having a good painkilling effect, i.e. it numbs the senses. In the legal sense, it refers to more or less any prohibited drug that has an addictive effect. NSAIDs painkillers are not addictive and are particularly effective to treat pain caused by inflammation.

To understand how the opiates and their derivatives work, think in practical terms. People who are unconscious feel no pain. So the more severe the pain, the greater the need to produce unconsciousness. For less severe pain, you need to block the pain signals and prevent them from reaching the brain. There may still be an active source of pain in the body, but the drug prevents us from becoming aware of it. It is rather the way you distract someone by changing the subject. If pain was the original subject, you produce a different sensation that takes your mind off it. But therein lies the rub (as Hamlet did not quite say). Quite often, the distracting sensation is so pleasant that people prefer that state to any other. They come to crave that level of pleasure all the time.

This should emphasize the seriousness of any decision to take pain medication. Physical and psychological dependence is a major danger if you take most of the opiates. It is a less serious problem if you take one of the atypical opioids like ultram or the NSAIDs, because they are not addictive. However, the advice of a doctor who knows your medical history is always a good idea to make sure that you will not be at risk from side effects. Some people do react adversely to medications, particularly when different medications are combined.

It is also a good idea to talk to your doctor about how to manage the pain. Ultram does not "cure" the source of the pain. All it does is to change the way you "feel" it. That leaves the doctor with the job of curing whatever the problem is causing the pain, assuming it can be cured. Unfortunately, some illnesses and diseases cannot be cured and will cause you chronic pain, i.e. the pain will last over time. In such cases, the knee-jerk reaction is to take more ultram for longer periods of time.

This may not be such a good idea. The more you take, the more likely it is that you will experience one or more of the side effects. Secondly, your body builds up a tolerance for the medication so you are continually forced to increase the dose to get the same painkilling effect. This drives up the cost both physically and in cash terms. So the decisions about how much ultram to take and over what period of time are always a balancing act. You need to weigh up the benefits against the risks.

This makes the management of pain a very personal problem. Your family and friends can help keep you positive. Your financial situation may be strong. People have different levels of tolerance for pain. The management of your pain is something only you can do. Talking to doctors can give you guidance and advice but, at the end of the day, you are the one who should stay in control, making the decisions about what is best for you. If you must up the strength of the medication to one of the opiates, you will have to deal with the risk of addiction. Some of the NSAIDs also have worrying side effects over time. Make sure you take an informed decision.

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