Common Painkillers in Medicine

Painkillers, also known as analgesics, take a variety of forms. Odds are, you’ve seen them as pills or tablets: the bottles of Tylenol lining any pharmacy shelf are great examples.

However useful painkillers are in relieving pain caused by surgery or other types of bodily damage, many of them are addictive. In North America, particularly, misuse of opioid analgesics has caused an epidemic of drug abuse, afflicting thousands of people and costing an estimated one trillion dollars (that’s a 1 followed by twelve zeroes) from 2001 to 2017 alone. That number is only projected to rise as time goes on.

When used with proper discretion, however, analgesic drugs can provide much-needed relief for those afflicted with chronic pain. Below, I list five commonly-prescribed pain medications and explore their potential side effects.

The first thing to know about Vicodin is that it isn’t a single molecule, but a combination of two distinct drugs: acetaminophen and the opioid agonist hydrocodone. Although acetaminophen prevails in the average dose of Vicodin — the standard ratio is 300 mg acetaminophen to 5 mg hydrocodone — the Drug Enforcement Agency (DEA) classifies Vicodin as a Schedule II, and therefore highly-addictive, drug.

As with any medicine, Vicodin has the potential to cause side effects in the body while in use. The most commonly-reported of these effects are light-headedness, dizziness, sleepiness, nausea, and vomiting. Less frequently, mental clouding may occur, accompanied by feelings of lethargy and impaired mental performance. Anxiety, fear, and dysphoria have also been reported.

Vicodin’s minor ingredient, hydrocodone, is an opioid agonist, which means it mimics the behavior of opioids closely. In performing this mimicry, hydrocodone produces feelings of relaxation and analgesia comparable to those achieved through administration of morphine, fentanyl, or any other opioid.

Like Vicodin, Percocet comprises not one but two molecules: Acetaminophen and oxycodone. You’ll see it most commonly in tablet form — different colors indicate the amount of oxycodone present in each dose — but liquid administrations exist as well. Whatever form it takes, however, Percocet acts to relieve mild to moderate pain; it’s prescribed frequently after surgeries to patients who need reliable, but temporary, pain relief.

Percocet’s side effects include sleepiness, mental disclarity, and difficulty breathing deeply enough to support adequate oxygen intake. As with any opioid medication, it is best taken under the strict supervision of a physician, lest side effects accrue or addiction develop.

Methadone is an opioid analgesic with effects similar to morphine. It’s sold under the brand name Dolophine, and comes most commonly in tablet form. Although methadone is often used to stabilize patients dealing with the negative effects of opioid withdrawal, it can be an effective painkiller as well. Because it targets a special type of receptor found in nerve cells — the N-methyl-D-aspartate receptor, to be specific — methadone has been speculated to enact its greatest effect in patients suffering from neuropathic pain, which results when nerve cells sustain damage and begin firing when they’re not supposed to.

Methadone has several potential side effects, the most commonly-reported of which are restlessness, nausea, and a reduced breathing rate.

Fentanyl is an opioid known for its strength. It’s 80-100 times as powerful as morphine, and is prescribed in most cases as a drug of last resort for patients struggling with severe pain that resists alternative treatments.

Because it’s so potent, fentanyl has become a keystone in the illegal drug trade, being mixed into heroin to create a cheaper, “cut” product. While it makes sense from an economic standpoint to substitute a pinch of fentanyl (which costs about $6,000 a kilo) for a larger amount of heroin ($6,000 as well), poor measurement practices can result in product with a frightening — and unhealthy — concentration of fentanyl per unit dose.

Fentanyl’s side effects include fever, drowsiness, dizziness, and appetite loss.

Last but not least, there’s ibuprofen. This non-prescription painkiller belongs to a class of pharmaceuticals known as non-steroidal anti-inflammatory drugs, or NSAIDs.

NSAIDs originated in 1897, when Felix Hoffman, a chemist working for the German pharmaceutical company Bayer, synthesized acetylsalicylic acid — or aspirin — in the lab. After this momentous discovery, there was a period of entrepreneurial silence that lasted until the 1950s, when more NSAIDs started to be developed. Ibuprofen was discovered in 1961.

Because it’s an “over-the-counter” drug, ibuprofen can be purchased without a prescription. This wasn’t always the case, but the medication’s good performance in phase-IV trials following its release to the public prompted public health officials to revoke the prescription requirement.