DR. SAPNA PARIKH: Prescription painkillers work really well.
In fact, drugs like oxycodone and hydrocodone
are actually the best when it comes to medications for pain.
But here's the problem.
They make people feel great, so naturally they want more.
And also, they don't just block pain signals.
They impact other parts of your body, too.
The best painkilling drugs are called opioids.
Kind of a funny-sounding word, but they
come from the opium in plants.
Morphine and codeine, for example,
are naturally-occurring opiates, but there are synthetics,
as well.
Opium comes from poppies.
Think of The Wizard of Oz.
Remember that scene where they have
to run through a field of bright red poppies
to get to Emerald City?
But Toto passes out, and Dorothy's all,
like, I'm sleepy!
All these opioids work directly on neurons in your brain.
They latch on to what are called opioid receptors--
makes sense-- and there are four types--
the mu, kappa, delta, and the OFQ/N receptor.
The mu receptor is the one that most opioid prescription
painkillers work on.
It's that mu-receptor activation that
blocks the perception of pain and also causes
the feelings of euphoria.
Honestly, the mechanism of action isn't fully understood.
But when it comes to pain, it's believed that opioids bind
to the receptor and block an enzyme called adenylyl cyclase.
That makes the neuron less likely to fire
and also affects the release of neurotransmitters
like dopamine and GABA, which impact how you perceive pain.
But here's the catch--
the mu receptors aren't just in the brain.
These opioid receptors are also on nerves
throughout the central and peripheral nervous system.
And that's why these opioid drugs
cause a range of effects, things like nausea, dry mouth,
pinpoint pupils, itching, even cough suppression.
That's why there's codeine in really strong cough syrup.
Because these painkillers, they don't kill pain.
They activate receptors everywhere.
For example, the mu receptors are also
on nerves in the digestive tract.
Opioids slow things down, but when
it comes to the digestive tract, you want to keep things moving.
Opioids cause opioid-induced constipation, or OIC,
and it's a huge problem.
In fact, after surgery, doctors usually
prescribe painkillers and stool softeners at the same time,
because you're going to need them.
But you don't want to take these painkillers for too long--
not just because of constipation,
but because opioids may literally
change the brain itself.
Using opioids for a long period of time
causes neuroplastic changes, or changes
in the brain connections and pathways, in animals.
And a couple of small studies in humans found that taking
morphine every day for a month reduces the amount of grey
matter in multiple parts of the brain.
Grey matter contains the main bodies of neurons.
And physically changing the brain is one thing,
but these painkillers can also affect brain behavior.
Another example-- normally your body makes its own painkilling
compounds to soothe itself.
You might know them as endorphins.
Well, endorphins bind to those same opioid receptors.
Over time prescription painkillers
may stop the body from making endorphins,
because they keep these opioid receptors constantly activated.
So the body downregulates the production
of its own endorphins and you may end up needing opioid drugs
just to be, well, "normal."
And these are just a few examples of the ways
that opioids affect not just the brain, but also the body.
These painkillers are pretty fascinating drugs that really
work when it comes to pain.
But now scientists are trying to create more targeted drugs that
don't hit receptors all over the body, that
don't have all the side effects, and that don't cause addiction.
We're not quite there yet, but wouldn't that be great?
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Did you know that some people never feel pain, ever?
Find out why and how in this video.
And what do you think of these so-called wonder
drug painkillers that are now the cause of an addiction
epidemic?
Tell us in the comments section down below.
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