NSAID and Narcotics

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withdrawn from the market as it has been linked to cardiovascular problems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.