Corticosteroids are often administered as an injection at the site of musculoskeletal injuries. They exert powerful anti-inflammatory effects. They can also be taken orally to relieve pain from, for example, arthritis.
Acetaminophen increases the body’s pain threshold, but it has little effect on inflammation.
Opioids, also known as narcotic analgesics, modify pain messages in the brain.
One major difference between anti-inflammatories and opioid analgesics is that the former have a “ceiling effect” — that is, continuous dose escalation does not provide concomitant escalation in pain relief.
One reason opioids are so useful in the treatment of chronic pain is that as tolerance to a dose develops, the dose can be raised.
In fact, there is no limit to how high opioid dosing can go -– keeping in mind that higher doses can be associated with unpleasant and/or even dangerous side effects.
What are the strongest pain medications?
Opioid analgesics, in general, are the strongest pain relief medication.
The benchmark drug in this class is morphine — with other opioids falling above or below it in terms of pain-relieving potential.
Near the bottom of the list is codeine, usually prescribed in combination with acetaminophen to relieve, for example, pain resulting from dental work.
Codeine is only about 1/10th as powerful as morphine.
But the strongest opioid in community use is fentanyl which, in its intravenous form, is 70 to 100 times more potent than morphine. Fentanyl is also available as a long-release patch (Duragesic) and as a lozenge that dissolves in the mouth (Actiq).
Sufentanil is even more powerful than fentanyl, but its use, at present, is restricted to the intravenous route.