Painkillers are medicines that are used to treat pain and they all come in various brand names. An opioid (sometimes called an opiate) is a strong painkiller such as morphine, oxycodone, fentanyl, buprenorphine, tramadol, codeine and dihydrocodeine.

There are three main types of painkillers

Non-steroidal anti-inflammatory drugs (NSAIDS), paracetamol, and opioids. Each works in a different way. Most people only need to take painkillers for a few days or weeks at most and some people may obtain good long-term pain relief with opioids if the dose can be kept low and they are only used occasionally.

NSAIDs work by blocking the effect of chemicals called cyclo-oxygenase (COX) enzymes. COX enzymes help to make other chemicals called prostaglandins. Some prostaglandins are involved in the production of pain and inflammation at sites of injury or damage. A reduction in prostaglandin production reduces both pain and inflammation. Not all NSAIDs are the same, and some work in slightly different ways from others.

Opioid Based Painkillers

PostScript360 mainly works with opioid based painkillers, which bind certain opioid receptors in your central nervous system, your gut, and other parts of your body. This leads to a decrease in the way you feel pain, your reaction to pain and it increases your tolerance for pain. Opioid medications are effective for treating pain. At lower doses they can make you feel very sleepy and higher doses can slow your breathing and heart rate which can be fatal.

Opiate painkillers can be addictive and produce ‘cravings’ and a psychological desire to keep using them.

It is important to taper if the medication is not providing useful pain relief, if the underlying painful condition is resolved, or if you are using the medication not for pain but for psychological reasons. Don’t try to go cold turkey on your own. Opioid withdrawal can be dangerous and symptoms can be severe.

Withdrawal symptoms

If you have taken opioid medications for more than a couple of weeks it is likely that you will need to stop. It is best to reduce slowly if you have been taking them for a month. If you have been taking opioid painkillers for longer than a month to avoid severe symptoms of withdrawal talk to your GP or a support service like us.

Withdrawal symptoms may vary depending on many factors such as which medication you are taking and the length of use. With the correct taper schedule you will be able to reduce withdrawal signs and symptoms.

Signs and symptoms of withdrawal may include:

  • Restlessness or anxiety
  • Irritability or mood disturbances
  • Increased pain
  • Feeling cold all the time, goose bumps, chills or sweating
  • Stomach cramps
  • Nausea, vomiting or diarrhoea
  • Muscle cramping or aches and joint pain
  • Tremors or muscle twitching
  • Rapid heart rate
  • Blood pressure changes
  • Trouble sleeping
  • Suicide ideation

It is important to drink plenty of water in order to avoid dehydration which can sometimes occur with opioid withdrawal resulting in feeling unwell. Mind-body therapies like yoga, relaxation, and meditation are useful strategies that many people find helpful when going through opioid withdrawal.

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