# Is there a fourth class of painkiller? **URL:** \ **Category:** Factual Questions\ **Created:** [July 22, 2012, 4:32pm UTC](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049 "2012-07-22T16:32:08Z")\ **Posts on this page:** 7\ **Page:** 2
**Author:** ![yohan\_go](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/yohan_go/32/3620_2.png) [@yohan\_go](https://boards.straightdope.com/u/yohan_go)\ **Post date:** [July 24, 2012, 10:52am UTC](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049/21 "2012-07-24T10:52:49Z")
Well, I do take a benzodiazepine medicine (Xanax generic, to be precise), about an hour before I visit my dentist for drilling session. It does nothing about the pain, that I would notice. But at least I don’t care about it so much (not to mention that completely removes anxiety, what it is designed for). BTW, nobody mentioned alcohol, I believe it is one of the oldest painkillers used, although, not very efficient in quantities that would not cause some funky side effects. ---
**Author:** ![Monty](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/monty/32/47_2.png) [@Monty](https://boards.straightdope.com/u/Monty)\ **Post date:** [July 24, 2012, 3:18pm UTC](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049/22 "2012-07-24T15:18:42Z")
> [@yohan\_go](#): > > BTW, nobody mentioned alcohol, I believe it is one of the oldest painkillers used, although, not very efficient in quantities that would not cause some funky side effects. I believe that would the sixth class of painkiller. ---
**Author:** ![drewtwo99](https://avatars.discourse-cdn.com/v4/letter/d/d07c76/32.png) [@drewtwo99](https://boards.straightdope.com/u/drewtwo99)\ **Post date:** [July 24, 2012, 6:45pm UTC](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049/23 "2012-07-24T18:45:57Z")
What about adrenaline or methamphetamines? I’ve heard stories that people high on these things are almost impervious to pain. But they were just stories. ---
**Author:** ![Hirka\_T\_Bawa](https://avatars.discourse-cdn.com/v4/letter/h/db5fbb/32.png) [@Hirka\_T\_Bawa](https://boards.straightdope.com/u/Hirka_T_Bawa)\ **Post date:** [July 25, 2012, 4:00am UTC](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049/24 "2012-07-25T04:00:10Z")
One thing no one has mentioned so far, there are two things here to look at, treating the pain itself, or treating the cause of the pain… And this totally depends on what the actually problem is. > [@Qadgop\_the\_Mercotan](#): > > 1. NSAIDs (aspirin, motrin, naproxen, indocin, etc. etc. etc.) > > 2. Acetaminophen (aka tylenol, APAP, paracetimol) > > 3. opioids (morphine, oxycodone, vicodin, codeine, dilaudid, fentanyl, heroin, tramadol, and a few dozen others) > > 4. neuropathic pain meds, particularly tricyclics and gabapentin. As expected, **Qadgop** lists the major treatments of pain. Theses are the major treatments an MD would prescribe for pain. I see scripts for these all the time. These are the drugs that will treat pain. > [@Sudden\_Kestrel](#): > > There are also anesthetics such as lidocaine patches (or IcyHot, etc., for OTC remedies) and compound medications like Excedrin. Lidocaine is an effective topical anesthetic that will help treat pain if it is one area that has problems. It is used commonly with dental pain, and also as a patch to treat pain in a particular area. As with all the cains’ it just numbs the area, so is good for some things but not others. Excedrin on the other hand is just a combination of an NSAID (Asprin), APAP (Acetaminophen, Tylenol), and Caffeine. The NSAID and APAP was mentioned in **Qadgop** post. The Caffeine is there for two reasons, one, caffeine is a vasoconstrictor so will shrink the blood vessels, including the ones in the brain, and that can help lessen a headache and will make the other meds work better, and two, one of the major symptoms of caffeine withdrawal is headache, and effects people mainly on weekends when they don’t have their coffee or other caffeinated beverage of choice. > [@eldowan](#): > > What about capsaicin? > I want to remember reading about it being used as a nonaddictive alternative to opiates. Capsaicin however would be counted as another class of pain medication. What it does is deplete the amount of nerve transmitters that are available to feel pain. This is the reason that someone who first uses capsaicin will feel a “burn” when it is applied, though after regular use the “burn” goes away. When the burn is gone, it means all the nerve transmitters are used up, and the drug is working 100%. The problem is… Capsaicin will only work if it is a particular area that is topical. It is not something that can be taken internally (pill form), or will work for pain that is deeply inside the body. > [@drewtwo99](#): > > What about adrenaline or methamphetamines? I’ve heard stories that people high on these things are almost impervious to pain. But they were just stories. These type of products do nothing at all to help with pain… What they do is keep the person exposed from caring about the pain. The pain is still felt, but the people just don’t care about it. As I mentioned before, there is also treating the cause of the pain. Depending on what the problem is, Flexeril (cyclobenzaprine) and Robaxin (methocarbamol) are also treatments. If the problem is caused by muscle spasms, or muscles pulling unevenly (mainly back pains, or from injury) that would be the treatment. There is also Gas-X (simethicone) that will help with gas pains. and of course there is always surgery to help with other problems. So there are a bunch of ways to treat pain; even treat the pain itself, or treat the cause of pain so there isn’t any to begin with. Depending on the problem, there are a lot of possible treatments. ---
**Author:** ![bouv](https://avatars.discourse-cdn.com/v4/letter/b/bc8723/32.png) [@bouv](https://boards.straightdope.com/u/bouv)\ **Post date:** [July 26, 2012, 1:44am UTC](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049/25 "2012-07-26T01:44:45Z")
What would the inhaled anesthetics (like halothane, isoflurane, sevoflurane, desflurane, etc…) count as? Or nitrous oxide? ---
**Author:** ![Simple\_Linctus](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Simple\_Linctus](https://boards.straightdope.com/u/Simple_Linctus)\ **Post date:** [July 26, 2012, 8:00pm UTC](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049/26 "2012-07-26T20:00:00Z")
So let’s suppose hypothetically someone has nasty lower back pain, and takes 16mg of buprenorphine and 150mg diclofenac daily, and also has access to as much aspirin and paracetamol as they like, and find none of that kills the pain - proabailstically speaking will any of the “odder” (that is to say not opioid, not NSAID) painkillers be likely to help? I am not speaking about a particular case, I am just coming up with a scenario! ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [July 26, 2012, 8:13pm UTC](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049/27 "2012-07-26T20:13:21Z")
> [@Confused dart cum](#): > > So let’s suppose hypothetically someone has nasty lower back pain, and takes 16mg of buprenorphine and 150mg diclofenac daily, and also has access to as much aspirin and paracetamol as they like, and find none of that kills the pain - proabailstically speaking will any of the “odder” (that is to say not opioid, not NSAID) painkillers be likely to help? I am not speaking about a particular case, I am just coming up with a scenario! Frankly, the literature tends to indicate that the best solutions for chronic non-malignant pain (both musculo-skeletal and neuropathic) is a combination of relaxation, meditation, stretching, distraction, meaningful work, weight loss where appropriate, and regular appropriate exercise regimen involving the affected muscle groups along with general aerobic exercise. Most people prefer a pill. [Previous page](https://boards.straightdope.com/t/is-there-a-fourth-class-of-painkiller/629049.md?page=1)