eli5: If all pain medication does the same thing (trick the body into thinking everything is okay and it’s not in pain), then why does some pain require stronger medication like opioids?

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eli5: If all pain medication does the same thing (trick the body into thinking everything is okay and it’s not in pain), then why does some pain require stronger medication like opioids?

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Sometimes non-opioid pain medication isn’t enough to make the pain go away. Also, the mechanism of action of the non-opioid pain medication might not work for some causes of pain.

Weaker pain killers like ibuprofen or tylenol are anti-Inflammatory so they can only kill pain caused by inflammation, Which is most pain.

opioids hijack the endogenous opioid system straight up blocking the pain stimulus each opioid binds to the system in different ways making some better and some worse at killing certain types of pain.

They also use nmda antagonists as pain killer to like ketamine. This blocks pain in a completely different way than opioid or NSAIDs.

Different pain killers work differently in the brain. They affect different parts of the brain in different ways but all achieve pain relief.

The strongest pain meds work on all pain but knock you out. The over the counter meds are safe for the home because they don’t cause addiction and don’t require a doctor to properly calculate the right dosage.

I don’t know the mechanisms each uses, but it’s going to be something like the weak ones slow pain neurons, while the strong ones turn them off.

Opioids work through something called GABA, a signal transmitter in the brain. In comparison, paracetamol (a mild painkiller) affects an enzyme called COX-2. It is much more complex than this, but these are the main differences. One «strong» effect, and one slightly «weaker». Opioids sedates the nervous system, and overdosing can stop breathing. Stuff like paracetamol don’t have those dramatic effects.