Prescription Pain Relievers

• Controlled pain medications
• Non-Controlled pain medications
• Buying prescription pain meds online

The purpose of this overview is to help people stay within the rules when they are considering purchase of pain medications online. All prescription drugs are regulated under federal law, but some are regulated more strictly than the others.

Narcotic pain relievers

Many pain medications belong to the opioid class of drugs. In the United States narcotic (opioid) pain meds are classified as controlled substances. Narcotic pain medications can produce physical and psychological dependence and have well-recognized abuse liability. This has led to their scheduling under international, national, and state controlled-substances laws. That is why they are controlled.

Controlled medications can not be purchased without a valid prescription from a doctor, and are placed under additional controls beyond the need for a prescription. Prescribing opioids for pain is lawful when there is a physician-patient relationship established by an examination, a treatment plan, and medical records.

Non-Controlled pain medications

The lowest level of federal scrutiny applies to medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and tramadol. These pain medications are not classified as controlled substances, but a prescription is required for most of them. Prescriptions for non-controlled medications are not subject to some of the restrictions applied to controlled substance prescriptions.

Tramadol (Ultram)

Legally buying pain meds without a prescription

Some consumers prefer to purchase prescription drugs without visiting their doctor's office to receive a prescription.

There are online pharmacies that work with physicians who review a patient’s self-reported medical history and then write a prescription if deemed appropriate. Online prescribing is usually realized for "lifestyle" medications, that are non-addictive, safe, effective, with clear contraindications, and less likely to require physician monitoring.

State regulations for internet prescription services vary considerably from state to state. The Federation of State Medical Boards established a National Clearinghouse on Internet Prescribing, which includes a state-by-state regulations and actions related to the regulation of internet prescribing.

Tramadol was first introduced in 1977 and is available in over 100 countries. It is a powerful analgesic with weak µ-opioid and non-opioid effects. Tramadol’s dual mechanism of action differentiates it from opioid pain relievers.

Butalbital APAP Caffeine is a combination strong pain reliever. This medication have been approved by the U.S. FDA for treatment of tension headache.

Diclofenac is a relatively potent NSAID. Diclofenac is used to treat a wide range of painful conditions, including arthritis pain (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis), pain caused by kidney stones and gallstones, migraine attacks, menstrual pain.

Ibuprofen (Motrin) is used to reduce fever and relieve pain or inflammation, including headaches, toothache, back pain, menstrual cramps, minor injury, arthritis. The World Health Organization includes ibuprofen in its "Essential Drugs List", which is a list of minimal medical needs for a basic health care system.

Ketorolac (Toradol) is non-steroidal drug with potent analgesic and anti-inflammatory properties. It is indicated for short-term management (up to 5 days) of moderately severe pain that otherwise would require narcotic pain meds.

Meloxicam (Mobic) is a NSAID drug and its tolerability is believed to be due to the preferential inhibition of COX-2 over COX-1. Meloxicam is effective treatment for people suffering from inflammatory joint diseases, such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, and other conditions involving acute pain, such as back pain and sciatica.

Piroxicam is a NSAID used to relieve pain and swelling. The principal advantage of piroxicam is its long-lasting effect, which allows a once daily dosage.

Some suggestions

• Talk to your doctor or other health care professional if the medication is not working.
• Talk to the doctor if there are problems with side effects. Medication side effects can be controlled and subside over time.
• Look for another doctor, or request referral to a specialist, if the pain is not taken seriously. Not every physician is qualified to deal with all types of pain.
• Medication is not the only way to relieve pain. Other therapies and adjunctive measures, used alone or in addition to medication, are often effective in treating pain.