eli5: If our own endogenous opioids are stronger than morphine then why do people need pain killers?

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For example beta-endorphin which is produced by our bodies during pain, stress, exercise, pleasure, is 18 to 33 stronger than morphine according to https://en.m.wikipedia.org/wiki/Beta-Endorphin under “Pain Management” so why would we even need pain killers?

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Anonymous 0 Comments

Vodka is about 8 times stronger than beer. And yet you’ll get a lot more drunk from drinking 10 beers than from drinking a single shot of vodka.

Beta-endorphins being stronger than morphine does you precisely zero good if your body refuses to release any more of those endorphins while you’re in pain. And that’s often the case. Our bodies didn’t evolve to suppress pain. That would defeat the purpose of having pain in the first place. It’s meant to be a warning signal, not to be ignored. When pain is severe or long-lasting, your body may suppress is somewhat, but never completely and often not enough for comfort.

And that’s why we use pain-killers: since the body won’t shut off the pain of its own accord, we need to send an external signal to do the job instead. And that’s where things like morphine come in. Now, if we could somehow use or mimic the endogenous opioids and use them as a painkiller, perhaps that might be more effective than the painkillers we currently have. I’m not a pharmacologist but I imagine this is simply not currently possible with the knowledge and technology that we have. E.g. maybe we have no way of synthesizing beta-endorphins, or maybe we do but we have no way of administering them (e.g. because they won’t cross the blood-brain barrier or something), or maybe the problem is that they have more side effects when administered in the kind of doses required for adequate pain relief, and so forth.

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