Hi, Dr. Yu again
So NSAIDS AND NARCOTICS ARE THE 2 MOST COMMON MEDICATION THAT WE ARE USING.
Nsaid is usually over the counter and Narcotic will always require a prescription.
What are NSAIDS?
You may have heard that some drugs, like Ibuprofen and Aspirin, are NSAIDS.
The term NSAID means non-steroidal anti-inflammatory drug. These medications
are not steroids, hence the term non-steroidal. They work, instead, by impacting
certain enzymes that are involved in the inflammation response. NSAIDs act to
block the action of enzymes called COX-1 and COX-2. You may not know what
enzymes are and what they do.
I will explain this quickly to you. An enzyme is basically a molecule that helps a
chemical reaction to take place in a cell and, in the case of inflammation
enzymes, help the reactions in which inflammatory chemicals are released. These
medicines also do not affect all the responses that occur in inflammation. This
means that they are only having a limited effect that is temporary.
SO…..NSAIDs help by blocking specific enzymes, but they only work on two of
these, COX1 and COX2. The NSAIDs thus only reduces the release of
prostaglandins, not other chemicals. The types of NSAIDs sold in the United
States include Ibuprofen, Naproxen and Aspirin. These are common over-the-
counter drugs that you can buy and use.
Why are NSAIDs not helpful?
You may think this is the solution, but there are several problems with NSAIDs.
For starters, they have been linked to cases of severe stomach bleeding1. This is
obviously something you should be worried about and, it is even worse for people
who happen to be taking blood-thinners.
The NSAIDs also often only work on one limited part of inflammation and you may
feel better but it is a short-lived effect. In the end, you have to keep taking the
medicine, and over time you may develop some tolerance, or really dangerously
hurt your stomach or other organs.
In fact, NSAIDs can have other dangerous side effects for the kidneys and the
heart. Long-term use of NSAIDs can causes kidney disease such as chronic
interstitial nephritis. NSAIDs can also, when used for a long time, increase the risk
of heart disease and stroke.
Some NSAIDs were even taken off the market because of the impact on the
heart. For instance, Rofecoxib, sold under the name Vioxx has since been
withdrawn from the market as it has been linked to cardiovascular problems
leading to death in some cases2.
The other issue is that the NSAIDs do not treat the underlying cause of your
problem, so you have to keep taking them. Inflammation is a sign that something
is wrong or it could be a sign you have an autoimmune disease or even simply
some type of neuralgia, especially when it is chronic inflammation.
Neuralgia is a condition in which your nerves are inflamed and hurt. There can be
many causes of this condition but the point is that a simple NSAID anti-
inflammatory will not cure your problem and neither will taking a narcotic
medication.
What are narcotic medications and do they help?
Narcotics are opioid medications that help with pain and they work by binding to
opioid receptors on nerve cells found in the brain and other parts of the body. You
are probably thinking “What exactly is a receptor?” Without getting too
complicated I will explain as simply as I can in the next paragraph.
A receptor is a protein found on the surface of a cell to which a particular type of
molecule can bind. The easiest way to think of this is to imagine how a lock and a
key works. Picture the receptor being like the lock of your door while the key is
the molecule. You know only one key fits and can work in a particular lock so you
can open your door. This is pretty much how molecules and receptors work on
cells.
Narcotic medications then can basically trick the receptor and attach to it, but of
course they are not really the correct “key”, so the next steps can’t take place and
they stop the proper molecule from attaching and thus stop the system from
working.
What are some types of narcotics and why are they problematic?
Narcotic medications include codeine, morphine, hydrocodone, fentanyl,
oxycodone, meperidine, norco, and methadone. Tramadol is not an opioid but it
works in a similar way and thus also has some similar issues that we find with
other true opioid narcotics.
At first it looked like narcotics were the solution to pain and inflammation, and
certainly many are very strong drugs that can help with severe pain, say the pain
you feel after surgery. The trouble is that narcotics do not treat inflammation or
nerve pain but they are simply masking it through blocking the sensation of pain
by binding to receptors. This means that the problem returns once you stop the
medicine.
This class of medications is carefully regulated. In fact, most of these medications
require a prescription and may only be prescribed for short time periods.
BUT….”Dr. Yu…..why is this the case?” you may ask. Actually, these are powerful
and dangerous medications.
Why are narcotics so dangerous?
Narcotic medications can easily lead to dependence and tolerance3 which means
you have to take higher doses to get the same effect. The result is that there is a
high risk that you can overdose on such drugs and certainly addiction is a big
concern. You see some of these drugs also make a person feel euphoric, which is
a pleasant sensation and increases the odds, even more, of you becoming
addicted.
There is currently an epidemic of opioid addiction in the United States. In fact,
there have been many cases of oxycodone addiction in recent years. The FDA
estimates that at least 1.9 million people in the United States are abusing opioid
prescription drugs, and in 2017 alone, there were 47,600 deaths due to opioids.
Besides the concerns about addiction and overdose, these drugs also have
adverse and harmful side effects4. They can upset your stomach, make you
drowsy and make you unable to function normally. The most dangerous effect of
narcotics is respiratory depression, in other words, it slows your breathing down.
This is the reason that an overdose can quickly lead to death, it stops you
breathing.
These analgesics are not really treating any of the inflammation, so it does not
help in the long-term. It is, at best, a very temporary way to alleviate pain, but as
studies have shown, the use of such drugs is very limited and can cause more
problems for you in the future.
Summing up and what can be done to avoid synthetic anti-inflammatory
and narcotic drugs?
NSAIDs are anti-inflammatories that only target one or two enzymes involved in
the inflammation response, and thus have only a limited impact. There are
dangerous side effects of these drugs including stomach bleeding, and heart and
kidney problems.
Narcotics work by blocking an opioid receptor in the brain, so they only mask the
pain and do not treat nerve pain or inflammation at all. The chances of addiction
are high with narcotics and they can cause death because they strongly depress
respiration.
Basically, NSAIDs and narcotic do not target chronic inflammation and thus are
not effective over the long term. These medications also have many severe side effects, and are easy to become addicted to.
I have given you all the reasons why I want to use herbal treatments to reduce
chronic inflammation. We want a way to help you without unpleasant side effects
or dangers of addiction and overdose. Herbs can offer an effective solution when
it comes to helping with chronic inflammation in the body.
My goal is to help you find natural and safe alternatives to synthetic chemicals.
Many of these natural herbs can treat the underlying problems causing you such
pain and inflammation. In general, Ayurvedic medicine uses herbs that are
adaptogens which help your body to cope with stressful conditions that can lead
to inflammation. Many adaptogens and plant extracts such as CBD oil offer good
remedies for inflammatory conditions. These are topics I will cover further in
other articles.
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