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Non-Opioid Pain Relievers

Non-opioid pain medicines are the most common medications used to treat pain. They are usually the first medications tried because they are generally considered safer than opioid (narcotic) medications. Non-opioid pain relievers include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, diclofenac, and meloxicam.
 
Acetaminophen is marketed under the brand name Tylenol®. It is available over-the-counter (without a prescription), and also combined with stronger pain drugs as a prescription product. Acetaminophen is effective for reducing pain and fever, but it does not affect inflammation.
 
Unlike acetaminophen, NSAIDs have anti-inflammatory properties. They are available as both prescription and nonprescription products, depending on the strength and the particular NSAID. Although NSAIDs can be used safely in many people, they can cause ulcers and kidney problems, especially with long-term use. Therefore, many healthcare providers only recommend these drugs for short-term treatment.
 

Opioid Pain Medicines

If non-opioid pain medicines do not effectively control your pain, your healthcare provider may recommend switching to or adding an opioid. Opioids, also sometimes called narcotics, include codeine, hydrocodone, oxycodone, and morphine.
 
The decision to use an opioid for chronic pain should not be taken lightly, as these medications are not without risk. Extended use of opioids can lead to tolerance, which causes a person to need higher doses of the medicine over time. These higher doses can increase the risk for side effects.
 
Opioids can also cause other adverse effects, such as drowsiness, constipation, and sleep problems. In addition, although many people are effectively treated with these drugs without becoming addicted to them, all opioids carry the risk for addiction and abuse. 
 
Because of these risks, opioid treatment is generally reserved for people with moderate-to-severe chronic pain and should only be continued when the benefits of treatment outweigh the side effects and risks. Many people derive benefits from opioid treatment, including reduced pain, increased function, and improved quality of life. However, if these benefits are outweighed by serious side effects or addiction, a healthcare provider may recommend a different medication.
 
Tramadol is a unique medication that has opioid-like properties. Much like morphine, the drug binds to certain opioid receptors in the body known as μ ("mu") receptors. Tramadol was originally marketed as having little potential for abuse, and was approved by the U.S. Food and Drug Administration (FDA) as a noncontrolled medication. Unlike controlled substances, noncontrolled medications do not have strict regulations controlling their use.
 
However, since its approval, there have been numerous reports of abuse and addiction with tramadol. In response, several states have reclassified it as a controlled substance. It is still uncontrolled on the federal level, however.
 
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