Dr. M.J. Bazos, Patient Handout
Chronic Pain Medicines

What drugs can treat chronic pain?

Many medicines can decrease pain, including the ones listed below. Each one may have side effects. Some side effects could be serious. It's important to listen to your family doctor carefully when he or she tells you how to use your pain medicine. If you have questions about side effects or about how much medicine to take, ask your doctor or your pharmacist.
Acetaminophen (one brand name: Tylenol) helps many kinds of chronic pain. Remember, many over-the-counter and prescription pain medicines have acetaminophen in them. If you're not careful, you could take more acetaminophen than is good for you. Taking too much acetaminophen could cause liver damage. If you often have to take more than 2 acetaminophen pills a day, tell your doctor.
Anti-inflammatory drugs (NSAIDs)
Other drugs that help with pain are called anti-inflammatory drugs. Examples include aspirin, ibuprofen (one brand name: Motrin) and naproxen (two brand names: Aleve, Naprosyn). These medicines can be taken just when you need them, or they can be taken every day. When these medicines are taken regularly they build up in the blood to levels that fight the pain of inflammation (swelling) and also give general pain relief. Many of these medicines are available in low-dose forms without a prescription. If your doctor wants you to take an anti-inflammatory drug, always take it with food or milk, since the most common side effects are related to the stomach. If you are taking other pain medicines, don't take over-the-counter anti-inflammatory drugs without first talking to your doctor.
Narcotics can be addicting, so your family doctor will be very careful about prescribing them. However, for many people with severe chronic pain, these drugs are an important part of their therapy. If your doctor prescribes narcotics for your pain, be sure to carefully follow his or her directions. Tell your doctor if you are uncomfortable with the changes that may go along with taking these medicines, such as inability to concentrate or think clearly. Do not drive when taking these medicines. When you're taking narcotics, it's important to remember that there is a difference between "physical dependence" and "psychological addiction." Physical dependence on a medicine means that your body gets used to that medicine and needs it to work right. When you don't have to take the pain medicine any longer, your doctor can help you slowly and safely decrease the amount of medicine until your body no longer "needs" it. Psychological addiction is the desire to use a drug whether or not it's needed to relieve pain. Using a narcotic this way can be dangerous and may not help your pain. If you have a psychological addiction to a narcotic, your doctor may give you another drug to help with your psychological problems. Or your doctor might recommend that you talk to a counselor. Your doctor might also change the medicine that you are addicted to by lowering the dose, changing to another drug or stopping the medicine altogether.Narcotic drugs often cause constipation (difficulty having bowel movements). If you are taking a narcotic medicine, it's important to drink at least 6 to 8 glasses of water every day. Try to eat 2 to 4 servings of fresh fruits and 3 to 5 servings of vegetables every day, too. Be sure to tell your doctor if constipation becomes a problem for you. Your doctor may suggest taking laxatives to treat or prevent it.

Other medicines
Many drugs that are used to treat other illnesses can also treat pain. For example, carbamazepine ( one brand name: Tegretol) is a seizure medication that can treat some kinds of pain. Amitriptyline (brand name: Elavil) is an antidepressant that can also help with chronic pain in many people. Your doctor may want you to try one of these medicines to help control your pain. It can take several weeks before these medicines begin to work well. Remember--if you are taking any pain medicine, be sure to ask your doctor or pharmacist before you take any other medicine, either prescription or over-the-counter.

Are drugs the only way to treat chronic pain?
No. Many other treatments can also decrease pain. They can actually change the body's chemicals that produce pain. Almost anything we do to relax or get our minds off our problems can help control pain. It's important to add relaxing activities to your daily life, even if you are already taking medicine for pain. You might have to use stress reduction methods for several weeks before you notice a decrease in pain. Your doctor can give you tips about stress reduction and relaxation methods.