When you need a strong pain killer, how do you choose what’s best for you? And what are the side effects?
Michael Vagg, Clinical Senior Lecturer at Deakin University School of Medicine & Pain Specialist at Barwon Health, Victoria, Australia, describes the common ingredients of strong pain killers, how they work in our bodies (it varies by individual) as well as some of the more common risks associated with these drugs including some tips on addiction risk.
Of particular interest:
"Codeine is a naturally occurring opioid with a very long track record of relatively safe use. It constitutes around 3% of the alkaloids found in opium juice, but is synthetically derived for medical use.
Codeine has relatively poor analgesic ability by itself. Most of the painkilling effect of codeine is produced when metabolised by the liver. An average person will produce around 1mg of morphine from the 10 to 15mg of codeine in many of these over-the-counter analgesics.
But there is major variability in our ability to metabolise codeine. As many as 25% of the people in the community are unable to produce morphine from codeine and therefore will get very little pain relief. But they will endure the same side effects.
A much smaller percentage will be very active metabolisers who will produce a far higher percentage of morphine from the same dose.'"