Besides these two types of analgesics there are also other medications (aspirin and particular non-steroidal anti-inflammatory drugs) known as painkillers. They provide some pain relieving effects but their primary purpose is elimination of inflammations, so including them to the class of analgesics is wrong.
Of all over-the-counter, non-narcotic painkillers the most popular is definitely acetaminophen. It is found in over 600 drugs, combined with other active elements for example in cold, flu or sinus infection medications. It is also available as a stand-alone drug. So when using it make sure you are not exceeding the dosage by combining it with drugs that contain acetaminophen, because an increased intake of this substance may damage your liver.
There are two main types of narcotic painkillers: opiates and opioids (substances derived from opiates). Opiates are the active chemicals that are contained in opium (the infamous liquid of white color that is extracted from the unripe seeds in poppies).
Opiates were previously widely used in medicine prior to the creation of effective opioids. But apart from analgesics effects the opiates provided, there were numerous side-effects that are very common for narcotics: delirium, hallucinations, loss of orientation, etc. This is why the use of painkillers in early days was quite limited and the effectiveness was traded for a certain price.
Opioids are considered any substance that affect the opioid receptors in the CNS (central nervous system) or gastointestinal tract. Opioids are usually divided into four main groups:
- Endogenous opioid peptides (substances produced within the human body such as endorphins, enkephalins, dynorphins)
- Opium alkaloids (thebaine, morphine, codeine)
- Partially-synthetic opioids (heroin, hydrocodone, hydromorphone, nicomorphine)
- Fully synthetic opioids (demerol, tramadol, methadone, propoxyphene, buprenorphine, butorphanol)
Opioids are applied as highly effective painkillers in cases of chronic or severe pain (for example, tramadol is known as the most effective medication is case of chronic pain). In contrast to opitates, opioids don't have the negative narcotic side-effects and also don't exhibit an upper limit in dosage. If increased gradually (especially in cases of chronic pain) the dosage of opioids used can be that high that it would be fatal for a person if taking any other medications with such concentration.
There are numerous discussions on the addictive nature of opioids, with many doctors claiming that they can form a habit over the long term. This is true, and as with any habit there may be withdrawal effects taking place in case the treatment is ceased immediately. However, when using opioids you have to weight all the pros and cons especially when you're dealing with chronic pain, like in the case of arthritis. Is addiction such a high price for a relief when you're constantly tortured by pain? It's up to you to decide.