Types of Painkillers: Opioids, NSAIDs, Non-narcotic

Last Updated: April 15, 2024

Roger Weiss Authored by Roger Weiss, MD
David Levin Reviewed by David Levin
0 sources cited

Painkillers or analgesic drugs offer relief from different types of pain and aches. They are regulated by the FDA and have been categorized into different types of painkillers according to the physiological mechanisms from which they manage to reduce pain and provide relief. There are also different effects of painkillers depending on class and dosages taken.

The main types of pain medications are non-steroidal anti-inflammatory drugs (NSAIDs); opioids, that are narcotic painkillers; other non-narcotic pain meds, which are OTC pain meds. Some NSAIDs are also over-the-counter, and some, like Daypro and Nalfon, are available with a prescription only. Pain medications from the opioid class are sold with a prescription only.

Opioid Painkillers

The prescription painkillers from the opioid class perform similar effects on the body because they are chemically related. This type of analgesics impact the opioid receptors on the nerve cells in the central nervous system. This mechanism blocks the signals of ache that are sent to the brain, giving intense and immediate pain-relieving and relaxing effects for the user. These drugs are made from an analgesic alkaloid morphine obtained from the opium poppy seeds. Most of the opioid analgesics come in a pill form, but they can also be administered through intravenous therapy method, as injectable pain meds or even as a transdermal patch. For instance, Fentanyl transdermal patches are a widely used type of hospital painkillers, because it’s easier to control their use for chronic and severe pain than the injections.

Opiate-based painkillers (like Morphine) are widely abused recreationally in order to achieve the euphoric sensation. Due to their highly addictive and damaging properties, opioid painkillers are given only as prescription pain medications and the use of these drugs is regulated closely. Center for Disease Control and Prevention advises physicians to prescribe the lowest effective dose of opiates to take it for the shortest period of time. This is due to the possibility of developing a long term dependence to opioids in a period as short as five days.

A common opioid painkillers list includes such drugs:.

Apart from these legal pain meds, there are also illegal opioid drugs such as Heroin and synthetic Fentanyl, that have no allowed medical uses in the U.S.

Learn and differentiate Hydromorphone vs Morphine: both medications fall under the opioid category, leading to numerous shared characteristics.

opioid pain medications

Anti-inflammatory Painkillers (NSAIDs)

Non-steroidal anti-inflammatory drugs or NSAIDs work on a chemical level to block the effects of natural enzymes produced by the body that cause inflammation and pain. NSAIDs work as more than just analgesics. This type of pain medications relieves inflammation and also reduces blood clotting that creates a protective effect for those who suffer from heart diseases. The use of painkillers of this type is effective in conditions that cause both ache and inflammation such as arthritis or sciatica nerve pain.
The most popular over-the-counter anti-inflammatory painkillers:

  • Aspirin (Ectorin, Aspir, Bayer, Durlaza, and Lo-Dose). This non-opioid pain medication may also prevent blood clots due to its blood-thinning capabilities.
  • Ibuprofen (Advil). The active ingredient of this over the counter painkiller is propionic acid, which blocks certain natural substances produced by the body that cause inflammation.
  • Ketoprofen. It reduces the hormones in the body that cause inflammation and pain.
  • Naproxen. It blocks the production of certain natural substances in the body that cause inflammation and has a longer effect than other anti-inflammatory drugs.

Anti-inflammatory analgesics available by prescription:

  • Voltaren
  • Fenoprofen
  • Relafen
  • Diflunisal
  • Daypro
  • Lodine
  • Vimovo
  • Naprosyn
  • Ponstel
  • Motrin

There are people who are particularly allergic or show severe sensitivity towards anti-inflammatory painkillers. This type of analgesics also has a tendency to interfere with certain other medications when used simultaneously. The symptoms of an allergy or a negative reaction to NSAIDs can range from having a mild skin rash to severe vomiting and anaphylactic attacks.

Non-opioid Painkillers

Non-opioid painkillers do not pose many risks associated with opioid pain meds. They are available as both prescription drugs and over the counter pain medications.  A non-narcotic pain meds list includes next medications:

  • Acetaminophen (Tylenol). The active ingredient in this non-narcotic pain medication is Paracetamol, which increases the pain threshold of the body.
  • Steroids. The Canadian study described the beneficial effects of corticosteroids in relieving chronic ache among cancer patients.
  • Medical Marijuana and CBD oil. These substances often help to reduce inflammation and relieve chronic pain, however it is strongly regulated by the law in the U.S.
  • Natural painkillers for severe pain, moderate pain, and inflammation. Essential oils, herbal tinctures, magnesium, and other natural alternatives may effectively cope with different types of ache if they are correctly selected by the appropriate medical specialist.

Compound Medications

A compounding pain management system includes customized prescription analgesic combinations of  opiate painkillers, NSAIDs, and OTC painkillers. These individualized medications are highly regulated under the FDA to ensure their safety standards, the uniformity of the products used, and also the overall efficacy of the compound analgesic medication. This is because pain meds from the opioid class are included. However, there is still a lack of scientific research evidence when it comes to compounding analgesic medications.

A compound prescription painkillers list include:

  • Co-codamol
  • Co-codaprin
  • Co-dydramol

compound pain medications

Precautions For Taking Different Types Of Pain Medications

While analgesic medication can effectively give relief from pain, they also carry many risks and should be taken with proper awareness about precautions and safety measures.

  • Ask a doctor about the possible effects of any medication interactions with painkillers. It’s also essential to be honest with a doctor about any drugs, or other substances that are being taken to avoid severe health complications.
  • A general precaution for the safe use of analgesic is not to mix alcohol and pain medication from any type. Mixing even non-opioid pain medication such as Ibuprofen and Aspirin with alcohol in a large amount can cause irritations and internal bleeding in the stomach. Opioid pain medications and alcohol can cause severe damage to the liver, which can even lead to fatal outcome or coma. Always ask a doctor about the possibility to mix the specific type of pain medication with alcohol.
  • Acetaminophen is considered as the only safe painkiller for pregnant women; however, the use of this or any other pain medication during pregnancy should always be done under the supervision of a physician.

Addiction Treatment For Different Types Of Pain Meds

The main risk when it comes to taking analgesic drugs is building dependence and eventually developing an addiction. This risk is particularly high when it comes to taking narcotic pain meds as a part of a long term pain management medication program for chronic and severe pain. A patient who is under opioid analgesic to manage chronic ache is normally kept under close watch for any warning signs of addiction to painkillers. These include physical symptoms such as over-arousal, decreased appetite, increased heart rate, and behavioral symptoms such as frequent use of higher dosages of the drug and abandoning their important, regular activities.

Page Sources

  1. Prescription Opioids. National Institute Of Drug Abuse Publication. 2019. https://www.drugabuse.gov/publications/drugfacts/prescription-opioids
  2. CDC Guideline for Prescribing Opioids for Chronic Pain. Centers for Desease Control and Prevention. 2019. https://www.cdc.gov/drugoverdose/prescribing/guideline.html
  3. Arizona Opioid Epidemic Act. Office Of The Governor Doug Ducey. 2018. https://azgovernor.gov/sites/default/files/related-docs/arizona_opioid_epidemic_act_policy_primer.pdf

Published on: September 25th, 2019

Updated on: April 15th, 2024


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