What are the side effects of chronic pain relief medications?

Commonly used relief drugs for chronic pain have widely varying side effects. Commonly purchased over-the-counter painkillers can easily damage the gastrointestinal tract and affect liver and kidney function. Prescription opioids carry the risk of dependence, and auxiliary painkillers for neuralgia may cause transient dizziness and mood swings. Generally speaking, as long as they are used according to the doctor's instructions, most side effects can be controlled. There is no need to bear the pain and not take medicine because of fear of side effects.

I have been working as a nurse in the pain department for five or six years, and I have seen too many patients who had problems because they did not understand the side effects. The one who impressed me the most was 62-year-old Uncle Zhang. He had been suffering from lumbar disc herniation for almost ten years. He never came to the hospital. He bought ibuprofen at the drug store. When the pain was severe, he took four or five pills a day. Last winter, he suddenly fainted with black stools and was sent to the emergency room. It was found that he had gastric mucosal erosion and bleeding, which was caused by long-term fasting of non-steroidal analgesics. In fact, many people don’t know that if you take this kind of painkiller that can be bought everywhere for more than a week, it is best to consult a doctor, especially for people with gastric ulcers and chronic kidney disease. Even if they take a small dose, long-term accumulation may cause problems. There is still controversy in the academic community as to whether people without underlying diseases can take such medicines in small doses for a long time. Some studies believe that it will increase slight cardiovascular risks, while others believe that the risk can be ignored. The core still depends on the individual’s physical condition.

After talking about the common analgesics that everyone is most familiar with, let’s talk about the opioid analgesics that many people have heard of. A few months ago, a family member of a patient with advanced lung cancer came to me and refused to give the elderly morphine. He said that he was afraid that he would become addicted after using it. In the end, "the person died and became an addict." In fact, the general public's fear of opioids is very different from the actual clinical situation. This is also the most controversial point at present: many people think that as long as they touch opioids, they will become addicted. However, in fact, clinical data at home and abroad show that the addiction rate of opioids used for chronic pain treatment is less than 1% if the dosage is titrated according to the doctor's instructions. On the contrary, if the pain is so severe that you can't help but increase the dosage at will and do not take it according to the time, it is more likely to develop tolerance and even dependence problems.

There are also many patients with chronic neuralgia, such as those who have had pain for several months after herpes zoster, or who have constant throbbing pain from trigeminal neuralgia. Doctors sometimes prescribe drugs originally used to treat epilepsy or antidepressants. Many people’s first reaction after receiving the drugs is that the doctor prescribed the wrong one. In fact, these drugs are used to regulate nerve signal conduction and are specifically designed to deal with nerves that are like pinpricks or discharges. Pain, most of the side effects appear in the first week of taking the medicine, such as feeling dizzy when you wake up in the morning, walking like walking on cotton, and you need to pay special attention when driving long distances or climbing high. These reactions will basically disappear after the body tolerates it. A few people may have some fluctuations in appetite, either not wanting to eat or always feeling hungry. This can be relieved by asking a doctor to adjust the dosage, and there will be no long-term effects.

In fact, the side effects of drugs are like hitchhiking with strangers. You are mainly hitchhiking to your destination for pain relief. These strangers are just picking up along the way. As long as you know their habits in advance, for example, some will irritate the stomach, so take them after meals, and some will make people dizzy, so don’t drive after taking the medicine. Most of them will not cause you any big trouble. The biggest fear is that if you eat and increase the amount without reading the instructions or asking the doctor, the passengers who are passing by may also cause trouble for you.