What do they do?
Analgesics are drugs designed specifically to relieve pain. There are several types of analgesics: acetaminophen (Tylenol), which is available without a prescription, and a variety of opioid analgesics, which are available only with a prescription. Some products combine acetaminophen with an opioid analgesic for added relief.

How do they work?
Opioid (also called narcotic) analgesics work by binding to receptors on cells mainly in the brain, spinal cord and gastrointestinal system. Opioids are often very effective against pain, but they also carry a greater risk of side effects than acetaminophen.

Who are they for?

Analgesics are for anyone with pain, and that includes almost everyone with arthritis or a related condition.  Doctors once reserved opioids (also called narcotics) for treating severe acute pain, such as that from surgery or a broken bone but in more recent years, opioids have been increasingly prescribed for chronic pain, such as pain from arthritis. Unlike NSAIDS, opioids don’t cause gastrointestinal bleeding; they may be a better alternative for people who cannot take NSAIDs due to allergies or kidney or liver issues.

But opioid use for chronic (non-cancer) pain is controversial because they’re associated with a high risk of abuse, addiction and accidental overdose.  Certain factors predict the suitability of long-term opioid use for individuals with chronic pain. A tool called DIRE (Diagnosis, Intractability, Risk and Efficacy) helps doctors to assess those factors – including the patient’s cause of pain, psychological health, chemical health and social support. A high composite score suggests the person is likely to gain the greatest benefits from opioid analgesics with the least risk of adverse effects. Opioid analgesics are not appropriate for people at risk of addiction.

What’s important to know about the drug class?
While some analgesics are taken as needed, others must be taken at regular intervals to keep down pain. If your doctor prescribes an opioid analgesic, be sure you know how to take it – and when. And never stop taking it abruptly because doing so can cause withdrawal symptoms such as anxiety, sweating, nausea and insomnia.

Although some people may benefit from taking acetaminophen in addition to an NSAID for added pain relief, you should always speak with your doctor before combining any medications, even those without a prescription.  Also, it is important to speak with your doctor before combining an opioid analgesic and acetaminophen. Because many analgesic products already combine an opioid with acetaminophen, taking over-the-counter acetaminophen along with your medication could cause you to get a dangerously high dose.

When first starting an opioid analgesic avoid driving a car or other tasks that require concentration until you know how you react to the drug. Some people experience drowsiness or dizziness with analgesics.

If you don’t like taking pills, speak to your doctor about a patch that delivers a continuous does of an opioid medication through the skin.

The Arthritis Today Drug Guide is meant for education – not self-medicating. Arthritis Today, the Arthritis Foundation and the Drug Guide Medical Review Panel do not endorse any products mentioned in this guide. While we endeavor to keep the information up to date, we make no representations or warranties about the completeness of the information provided.

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