Painkillers are mostly taken orally as pills or capsules. Most oral non-opioids are available over the counter, but a patient can also get the opioid pain medication online by a doctor’s prescription. The liquid pain meds can be taken by children or adults who cannot swallow pills or capsules. Painkillers may also be taken in different ways such as injections, topical gels, suppositories, dermal patches, nasal sprays, and as a pump. Sublingual and nasal pain meds are used only for treating breakthrough pain of cancer. The stronger painkillers are taken in the form of a pump to release the medication over a period of time slowly.
It’s important to take the medication regularly, even if there is no feeling of pain (unless other conditions have been prescribed by a doctor). Taking painkillers on a regular basis helps in maintaining a steady level of the medicine in the blood to make sure that it works as well as possible and to keep the pain under control.
Learn About Ways Of Taking Pain Medications:
Injections And Infusions
There are some painkillers that can be taken by injection, either intramuscularly (IM) or intravenously (IV). These drugs can also be taken by infusion over a period of time. The pain medication injection list may contain non-opioid OTC painkillers or prescribed opioids. Some patients are advised to take intravenous pain medications, such as acetaminophen and non-steroidal anti-inflammatory drugs for immediately relieving severe pain after an accident. On the other hand, IM pain meds are taken for relieving mild and moderate pain. Some injectable pain meds, such as opioids, are taken intravenously at regular intervals for relieving pain after surgery, as the patient may still be under the influence of anesthesia and cannot take painkiller pills or capsules orally. Also, taking IV painkillers after labor is common, but should be used as prescribed.
The main advantage of taking IV medication is that it gives its effect rapidly after a few minutes of administration.
However, the use of injectable pain medications can cause many side effects for pregnant women such as drowsiness, nausea, vomiting, and lack of concentration.
There are serious side effects of pain meds, such as increased heart rate and respiratory depression may affect fetus while taking it intramuscularly after labor. According to a study published in the Journal of International Medical Research, IV pain meds have greater pain relief than IM pain medications without breath depression.
Oral Pain Meds
The popular painkillers are available orally in the form of pills and capsules. It is recommended to use liquid pain medications for a patient who cannot swallow the tablets or capsules as in infants and the elderly. The liquid painkillers for adults can be used after oral surgery or oropharyngeal cancer via enteral feeding. Liquid pain medications are completely absorbed in about 15 to 30 minutes after taking it. So, it gives its effect more rapidly than tablets and capsules. The oral pain meds cannot be taken after surgery as the patient cannot take any medication orally and also not taken while the patient is vomiting. Oral pain medication is not completely absorbed into the blood as it is subject to the first-pass metabolism of the liver.
Painkillers Pills And Capsules
The pain medication pills are used for adults to relieve acute and chronic episodes of pain. The painkillers pills list includes acetaminophen, NSAIDs, and opioids. Pills and capsules are not completely absorbed as it is metabolized by the liver before entering the blood. The pain medication pills are absorbed after about 1 to 2 hours after taking it. So, it takes more time to start their effect more than liquid form. Non-steroidal anti-inflammatory drugs such as ibuprofen and ketoprofen pills are effective teeth pain medication. It is not recommended to take painkillers during pregnancy except taking acetaminophen pills as it is the safest medication. The pills can be taken after minor surgery for relieving mild and moderate pain. Most painkiller pills cannot be used while there is an inflammation in the stomach as it may increase gastric bleeding.
Buccal And Sublingual Pain Medications
Sublingual pain meds are taken under the tongue without swallowing to dissolve and diffuse the medication into the blood, while buccal painkillers are taken between the gums and cheek and also absorbed directly into the blood. One of the major advantages of taking sublingual pain medication is that it is absorbed rapidly and gives its effect faster than oral painkiller pills. Sublingual pain meds are not subject to the hepatic first-pass metabolism, so it is completely absorbed into the blood. The effect is achieved after 15 minutes of taking sublingual painkillers. Therefore, using short-acting sublingual painkillers such as fentanyl sublingual pills is preferred for rapid relief of severe pain. However, using these types may irritate the mouth while taking it with a patient has mouth sores or lesions.
Only a medical specialist can determine the type of pain correctly and prescribe the right medication, which won’t cause the side effects. Don’t self-medicate as it may cause significant harm for the body.
Pain Medication Patches
The pain medication patches are applied onto the skin to release the medication over about 3 to 7 days slowly. It may take 24 hours before the effect appears. This type of painkillers is completely absorbed into the blood over a long period of time. Transdermal pain medications usually contain opioids such as fentanyl and buprenorphine. This type of medication is used for relieving chronic pain.
It is not recommended to expose the pain medication patch to any source of heat such hot water as the extreme heat could increase its blood absorption and may cause severe adverse reactions. Some patients cannot tolerate the patch because it may cause skin irritation.
The patient shouldn’t take alcohol when using patches, as using painkillers with alcohol may increase the risk of side effects such as nausea and drowsiness. Mild withdrawal symptoms may appear in the newborn baby whose mother takes painkiller patches during pregnancy.
How to ask doctor for stronger pain meds patches, if the previously prescribed ones no longer work as expected? Before prescribing strong pain patch medication, the doctor should implement a pain medication contract with patients to ensure that the patient takes the medication correctly.
The painkillers may be administered directly to the site of pain using an implanted pump. This pump is inserted under the skin in the abdomen to continuously deliver small quantities of the medication at a constant rate for a long period of time. The pump can be periodically refilled with the medication every 1 to 3 months. It is used to treat chronic pain that cannot be relieved by oral meds or surgery. Moreover, pain pump medication is used when the patient cannot swallow. The pump works more efficiently than oral pills or capsules because it delivers the drug directly into the spinal fluid, and not a subject for the first-pass metabolism of the liver. On the other hand, the pump may cause serious complications such as infection, leakage of spinal fluid, and moving the pump within the body. The painkiller overdose symptoms may occur as a result of these complications.
Topical Pain Relievers
Topical painkillers are applied directly to the skin for temporarily relieving chronic pain. They can be available as creams, gels, and rubs. Most topical forms are available over the counter such as a natural painkillers and some require a doctor’s prescription. The topical pain relievers are suitable for patients who have difficulty swallowing or who cannot tolerate the injectable route. The topical form rarely produces side effects as oral pills and liquids. Topical creams and gels have several advantages over oral pills; it has less systemic side effects, not undergoing first pass-metabolism, and target pain site only with low doses of the drug. However, these forms may increase the risk of skin swelling and irritation.
Suppository Pain Medications
Non-opioids and prescription painkillers are available in that form. The effect of rectal suppositories is achieved after about 1 hour of administration. The rectal pain medication suppository is absorbed directly into the blood without hepatic metabolism. The suppository pain medications are prescribed for patients who cannot swallow oral liquids and capsules or the one who has severe vomiting and nausea. It is also prescribed for unconscious patients. The frequent use of this form may cause mucosal irritation of rectum and may change the bowel function and movement. Stopping opioids suppositories without the doctor’s advice may experience pain medication withdrawal symptoms like nausea, depression, muscle cramping anxiety, and agitation.
There are some NSAIDs and opioids that can be taken intranasally. The nasal pain medication is rapidly absorbed through the nasal capillary network and delivered to the blood. It can be used in patients with a history of chronic pain in lower doses. The intranasal route is painless, noninvasive, with a rapid onset of action. It bypasses the first-pass metabolism with higher bioavailability. It has mild side effects with a lower risk of overdose. The nasal spray pain medications may cause local side effects with short term use such as nasal irritation and irreversible damage of nasal cilia. Some intranasal opioids such as fentanyl may cause systemic side effects. However, respiratory depression does not occur with nasal painkillers.
The long term use of intranasal opioids may cause epistaxis, sinus congestion, and pharyngitis.
Gas And Air
Gas and air is a colorless, odorless mixture of oxygen and nitrous oxide gas available in hospitals only. It is a mild painkiller used for young people and children during short procedures. It is the common method for relieving labor pain without side effects on the baby. Gas and air do not completely relieve pain, but it can rapidly reduce it. It is used efficiently, and its effects wear off once stop gas breathing. Drowsiness, nausea, and mild headache are the expected side effects of gas painkiller. Dry mouth may occur with the long term use of gas and air painkiller.
How Painkillers Are Abused
Many people use pain medications for non-medical purposes. Except abusing the common pills by extending the prescribed dosage, recreational users smoke and snort opioid pain medications. Ways of taking analgesics listed below are dangerous and may cause lung and mucosal damage, and many other adverse effects, as well as lead to addiction development and overdose.
Some abusers smoke painkillers to get high, by heating the substance. The effect of opioids starts after about 10 to 15 minutes of inhaling it. This route of taking painkillers has no therapeutic indication. Smoking painkillers can be as dangerous as the injectable route. The chronic use of smoking opioids can cause respiratory depression and chronic coughing.
The repeated use of painkillers in such way causes the addiction, dependence, and tolerance very soon. The risk of opioids overdose is also too high.
There is another route of taking painkillers is by snorting it. The abusers crush the tablet into a powder to snort it. While snorting painkillers, the medication is rapidly absorbed through the nasal membrane and then goes directly into the blood circulation without undergoing hepatic metabolism.
Snorting pain meds not only has side effects but also increases the chance of addiction. The repeated snorting of these drugs may cause damage to nasal passages, nasal mucosa irritation and sinusitis.
Snorting opioids can cause a sudden decrease in blood pressure, respiratory depression, and cardiac arrest. Some opioids, such as hydrocodone can lead to hypersensitivity pneumonitis when snorting it.
Choose The Safe Way Of Taking Pain Medications
There are different ways of taking painkillers. Topical painkillers are the safest way of taking the medication with fewer side effects without the painful sensation of injections. It is also suitable for those who cannot swallow pills or capsules.
Only a doctor should decide what way of taking painkillers is the most suitable for each patient. Seek medical advice immediately if any side effects appear or if the prescribed way of taking pain medications causes the discomfort.
It’s also essential to notify the doctor about any other medications taken, as the dangerous interactions may occur. For example, mixing sleeping pills with painkillers of opioid class may cause an overdose.
Snorting and smoking painkillers are the most dangerous ways of taking medication. In these ways, the drug abusers may take high doses of painkillers, leading to dangerous side effects and may cause addiction. A person who smokes analgesics may experience more intense withdrawal symptoms.
Always take painkillers as prescribed by the healthcare provider to avoid the occurrences of tolerance and addiction development.
- Jo Noble-Gresty. Recent and Upcoming Approaches in the Management of Cancer Breakthrough Pain. 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590051/
- Jing-fen Jin, Ling-ling Zhu, Meng Chen, Hui-min Xu, Hua-fen Wang, Xiu-qin Feng, Xiu-ping Zhu, Quan Zhou. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4494621/
- Malaika Babb, Gideon Koren, Adrienne Einarson. Treating pain during pregnancy. 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2809170/
- Lakshmi Kant Pathak, Vimala Vijayaraghavan. Hydrocodone snorting leading to hypersensitivity pneumonitis. 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4900771/