What is different? Why does some need stronger pain killers?
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Pain, at least the kind we give medication for in a medical setting, is ultimately an imflammatory response. That is to say, your immune system is responsible. When we hurt ourselves, say by twisting an ankle, the cells at injury site release “chemokines,” chemical messengers. These messengers sensitize our pain nerves (there are several types of pain nerves, we won’t get into them). We call this sort of response *inflammation*. We can takes things like NSAIDS (non-steroidal anti inflammatories. e.g. ibuprofen) to dampen the inflammation and lessen the pain. Importantly, these kinds of drugs don’t stop the nerves from firing, they just help to desensitize them.
Sometimes, that’s not good enough. Sometimes, for really nasty pain, we need to stop the brain from even receiving the signals. In steps opioids. Opioids change the way our pain nerves fire, and how our brains interpret the pain. They do **nothing** the fix the source of the pain, they just stop the pain signal from arriving.
It’s also important to consider pain tolerance. Some folks can get a hip replaced and get by with Tylenol. Some folks get the same surgery and need an opioid. Why? It’s complicated and has to do with genetics and past experiences.
So, why do different pains need different drugs and dosages? It depends on how bad our body decides the damage is. Sleep on your neck wrong? Meh, take an advil. Twist an ankle, you’re gonna need more ibuprofen and Tylenol. Get stabbed? That’s a lot of damage. You’ll need an opioid.
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