Are We Using Painkillers Correctly?

Pain, defined as an unpleasant sensory and emotional condition accompanying or identifiable by existing or potential tissue damage, is considered the fifth vital sign after respiration, pulse, blood pressure, and temperature. Unlike the others, pain can affect all vital signs. Due to its physiological and psychological effects, pain directly reduces the patient's body resistance. Reduced food and water intake, disrupted sleep and rest, and hormonal and neurological changes due to restricted social activities are among the significant reasons for decreased body resistance. Additionally, forgetfulness, attention deficit, chronic fatigue, depression, lack of motivation, and unhappiness frequently coexist with pain, naturally impairing the patient's quality of life and negatively impacting the healing process. Pain is an individual experience, but it directly and negatively affects the quality of life of the patient, their relatives, and healthcare providers. The same intensity of pain can be perceived differently by different people, and even within the same person at different times. This difference stems from the fact that multiple factors (ethnic characteristics, age, gender, religion, sociocultural environment, secondary acquired traits, psychological state, physiological state, etc.) underlie pain. The influence of certain secondary factors can also create variations in the perceived intensity and tolerance of pain. Examples include the belief that childbirth pain or experiencing pain during religious ceremonies is sacred, leading to a reluctance to use painkillers.

The indiscriminate use of pain relievers is unfortunately quite common. The main reason for this is that treatments for short-term, acute pain are often mistakenly applied to and used to alleviate long-term and chronic pain. While this approach may seem acceptable initially, over time it gives way to unnecessary and/or inappropriate drug use. Therefore, it should be understood that random and uncontrolled drug use, under the pretext of "it's just a simple pain," will not alleviate the patient's symptoms; on the contrary, it can worsen symptoms and lead to significant organ damage.

While pain was previously considered merely a symptom of an illness, this understanding has completely changed today. Regardless of whether an underlying cause is identified, treating a patient's pain is considered a human right, as long as it does not mask the symptoms of the underlying disease or delay diagnosis. Therefore, the pain of individuals who seek medical attention should be evaluated and treated regardless of their individual characteristics.

While it is important for pain treatment to be carried out in healthcare facilities, it is equally crucial to ensure effective treatment and symptom control for patients in their daily lives when managing chronic pain.

Therefore, patients need to be adequately evaluated in terms of the effectiveness of the treatment and potential side effects, and the treatment should be adjusted accordingly. Unlike hospital settings, there are many challenges in using pain relievers at home. Adjusting the dosages and intervals of medications, eliminating side effects, changing medications if they are ineffective, or adding additional medications or methods are generally not easy outside of a hospital environment.

Therefore, using analgesics outside of healthcare facilities can be somewhat uncontrolled and inappropriate. Every step that hinders patients from reaching their own doctors can lead to errors in medication use.

The use of painkillers should be done under the supervision of a doctor. In addition to the patient's own responsibilities during treatment for pain, the doctor also has important duties. These include making an accurate diagnosis, explaining this diagnosis clearly and accurately to the patient, defining and communicating treatment goals, promptly initiating effective treatment, monitoring results to evaluate treatment effectiveness, and replanning medication when necessary. If doctors do not perform these duties correctly and adequately, the misuse and unnecessary use of painkillers will continue to increase.

However, it is also important for patients to attend follow-up appointments and pay attention to recommendations that will allow physicians to fulfill their responsibilities. Careful monitoring and recording of feedback and any effects or side effects will enable the most effective treatment to be provided.

While not using painkillers under a doctor's supervision is the biggest mistake, it's unfortunately not the only one. Other significant mistakes include using expired medications, believing that increasing the number of medications will lead to greater effectiveness, taking medications with drinks other than water, especially alcoholic beverages, ignoring drug interactions, timing medication intake to coincide with meals, and only taking medication when pain intensifies.

In addition to reduced effectiveness, expired medications can also interact with other drugs, leading to unwanted side effects. Therefore, the expiration dates of all medications should always be checked before use. Experiencing relief from pain with a medication does not mean that higher doses will provide a stronger effect. A key characteristic of commonly used pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs), is their "ceiling effect," meaning that analgesic effects cease after a certain dose. While other effects may increase and the duration of action may lengthen above this dose, the analgesic effects unfortunately remain unchanged. However, the most significant disadvantage of this high-dose use is the potential for serious side effects on organs and systems. Medications should not be taken with beverages other than water, and other medications taken should be reported to the doctor to avoid drug interactions as much as possible.

Pain relievers should be carefully selected after evaluating the patient's pain, and the patient should be given detailed instructions on how to use the treatment. The doctor determines the nature of the pain, the tissues from which it originates, and the type of pain, and then initiates medication. It is crucial for the patient to be aware of the side effects of the medication and how to respond if they occur. A patient informed by their doctor will feel safer during medication and will be able to quickly manage any potential side effects.

One common misconception is that medications administered by injection are more effective than those taken orally. This belief stems from the idea that injectable medications have a faster onset of action. In reality, apart from the dosage and the time it takes for the medication to enter the bloodstream, there is no difference between the two methods. Therefore, oral medications are often preferred in patients with chronic pain. This reduces the discomfort associated with injections and minimizes the risk of sterile abscesses and hardening at the injection sites. Pain relievers, when taken regularly before pain begins, can provide sufficient pain relief even with lower doses. It is known that pain relievers taken after pain intensifies take longer to work and require higher doses. Therefore, it is important to use medications regularly and for the specified duration as directed by your doctor. Information obtained from your doctor is crucial when using pain relievers. During this period, medication instructions should be carefully read, and if any of the conditions described in these instructions are suspected, you should contact your doctor again to discuss what precautions should be taken. However, it should be kept in mind that medication instructions generally contain general information about all the components of the drug, and not everything written may occur; unlisted side effects may also occur. Necessary notes should be taken in writing and discussed with the doctor. Painkillers, commonly used in society, are readily available and easily accessible. However, while this may seem beneficial, excessive and prolonged use by individuals without sufficient knowledge can lead to significant organ damage. Examples include gastrointestinal disorders, impaired kidney and liver function, cardiovascular diseases, changes in bone marrow function, and reactive changes in respiratory tract activity. Therefore, it is recommended that individuals with such conditions contact their doctor before using these medications.

In conclusion, the use of pain relievers is a matter of considerable importance and requires careful attention.

• Pain is a condition that must be treated, but not all pain is treated the same way for everyone.
• Pain relievers must be used under the supervision of a doctor.
• The belief that using more than one of the same medication will relieve pain more is incorrect.
• Pain treatment is a dynamically adjusted treatment method according to the patient's pain condition; medication doses can be increased or decreased, or new medications can be added as needed.
• When using pain relievers, medication times should not be adjusted according to meal times; the time intervals should be regular.
• All existing illnesses and medications being used should be fully disclosed to the doctor prescribing the medication.
• If there is a suspicious situation as written in the drug's short product information, the use of the medication should be stopped and a doctor should be contacted immediately.
• The expiration dates of the medications to be used should be noted. should be checked.
• Medications should not be taken with drinks other than water.
• Painkillers should be obtained from pharmacies and used after consulting a doctor.