Prescription and non-prescription medications are the front-line tools in the treatment of pain. They include opioids (sometimes called narcotics), which are usually the most effective choice for serious pain; over-the-counter pain relievers like aspirin and ibuprofen (Motrin); and medications primarily intended for the treatment of other conditions but also useful in treating pain. Sometimes more than one class of medication will be prescribed at the same time in order to achieve relief; prescription medications like Vicodin and Percocet combine an opioid with acetaminophen (Tylenol) in a single pill. Medication may also be used alongside other therapies like nerve blocks and radiation.
Much more extensive information than the brief overview below can be found in Treatment Options: A Guide for People Living with Pain (PDF download) from the American Pain Foundation.
Opioids
Opioids are generally considered to be the top choice for providing relief in cases of moderate to severe pain. They alleviate pain by blocking delivery of the message of pain. Not only are they highly effective, but they can be used in increasing doses when pain gets worse; there is no limit on the amount that can be given safely. (A discussion of unfounded fears of overdosing and other concerns associated with the use of opioids can be found in the Breaking Barriers section.)
Opioids can be taken by mouth in pill or liquid form. They can also be delivered in the form of a rectal suppository, an injection, an infusion, or a skin patch when patients cannot swallow or digest normally.
Non-opioids/NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) include over-the-counter medications like aspirin, ibuprofen (Motrin), and naproxen (Naprosyn) as well as some available only by prescription. These medications reduce inflammation and pain sensitivity and are effective for mild to moderate pain.
Acetaminophen (Tylenol) is not an NSAID and does not reduce inflammation, but it can be helpful in relieving mild to moderate pain. Acetaminophen is often combined with an opioid in a single prescription pill, so patients who are taking a combination medicine should consult a health professional before taking non-prescription acetaminophen. Acetaminophen can do serious damage to the liver in high doses.
Adjuvant analgesics
Some medications that are used to treat other conditions have been shown to help relieve pain in specific situations. These include certain corticosteroids, antidepressants, anticonvulsants and local anesthetics. They are most often used in combination with opioids, although they may occasionally be used alone. Adjuvant analgesics are most useful in situations where pain is not fully relieved, or not relieved at all, by opioids.