Talk:Analgesic

Lack of references

Needs

Needs one or more references for the content, added tag.--FloNight 21:26, 25 November 2005 (UTC)

• Returning tag to top of talk page. Category:Articles lacking sources states that talk page is an appropriate place for the tag. This is the place tags are placed on medical articles that are undergoing work by various projects related to medicine]]--FloNight 18:26, 30 November 2005 (UTC)

Unreferenced

Needs one or more references for the content, added tag.--FloNight 21:26, 25 November 2005 (UTC)

The tag belongs on the article, not here. As a general rule, talk pages don't need to cite sources :-) (See Category:Articles lacking sources.)

chocolateboy 11:35, 30 November 2005 (UTC)

NSAIDs

There are a number of fact tags in the NSAID/Paracetamol section regarding potential side-effects. These should all be listed, per FDA regulations in the US, on the product inserts. How does one cite these, specifically? siafu 22:51, 7 September 2007 (UTC)

Psychological effects

Can anyone add information about the psychological effects of stimulation-induced analgesia, stress-induced analgesia, and belief-induced analgesia? These are natural effects that, I assume, are simulated by analgesic drugs. My psych prof is saying something about it, and I just missed it. Experts, can you help with this? - 137.122.55.72 17:35, 7 Feb 2005 (UTC)

Wikipedia does not answer questions. You'd better go to the reference desk. I wish there were more "experts" on Wikipedia :-) JFW | T@lk 17:49, 7 Feb 2005 (UTC)

A lot of the things you mention may be mediated by endorphins, which are the natural ligands for the opioid receptors in the brain. Stimulation, stress and belief may lead to a release of these substances. JFW | T@lk 17:51, 7 Feb 2005 (UTC)

I know this talk section is really old but I found some articles that can confirm that stimulants can cause analgesic effects in mice doi:10.1211/0022357001773580. I also found an article that found that "Infusions of 6-hydroxydopamine into the nucleus accumbens abolish the analgesic effect of amphetamine but not of morphine in the formalin test", this means that the analgesic effect is different from opoids. And as a side note Tricyclic antidepressants often have a stimulant effect. — Preceding unsigned comment added by Bonnom (talk • contribs) 21:50, 12 April 2017 (UTC)

Alcohol

Alcohol doesn't count as a painkiller, does it? —The preceding unsigned comment was added by 207.200.116.198 (talk • contribs) .

Technically alcohol is an "outdated" painkiller, but it certainly does numb the perception of pain. --Thoric 15:48, 14 June 2006 (UTC)

Over-prescription?

Doctors over-prescribing narcotics? There have been exceedingly few cases of such a thing. By far the problem is under-prescribing. Most doctors are afraid to prescribe anything stronger than Tylenol No. 3 (which contains codeine). Under-prescribing of narcotics to patients in severe pain (cancer, back/neck injury, major surgery) has become a far more serious problem than prescription narcotic addiction could ever be. It seems that the powers that be would far prefer a patient to suffer intense pain for the rest of their lives, and/or to suffer complications from over-use of NSAIDs (ulcers, internal bleeding, heart attacks, death) than to take a chance they might become addicted to a narcotic. In what sane world is suffering and death preferable to the chance of addiction? --Thoric 15:57, 14 June 2006 (UTC) Edit note -- pure narcotic formulations (namely Oxycontin) were the only narcotics that were specifically over-prescribed, and primarily to people who were already addicted to narcotics. I would go so far as to say that reduction in heroin use was proportional to increase in Oxycontin use. Most doctors under-prescribe narcotics, and instead over-prescribe NSAIDs. --Thoric 22:21, 14 June 2006 (UTC)

Thoric, I have no idea what you are basing your edits on. They contain value judgements (who says there is over- or underprescription?) At the moment they gloriously fail both WP:NPOV and WP:RS, and I have removed them until these policies can be satisfied.

You also reintroduced a weird little misplaced paragraph that wants us to know certain NSAIDs may increase risk for coronary artery disease. This fact should me mentioned in the relevant articles, not here, and with an academic reference (as opposed to a poorly researched news article). JFW | T@lk 22:55, 14 June 2006 (UTC)

I didn't add the paragraph blaming doctors for over-prescription. I only toned it down and pointed out that under-prescription has been a growing problem. The reintroduction of the news article link was an oversight. --Thoric 13:48, 15 June 2006 (UTC)

Just a comment on the part of the article that talks about addiction to "pure" narcotics. It says that Lortab and Vicodin are hydrocodone only. I don't think thats true. I know at least those two are hydrocodone/acetaminophen(APAP). 161.45.236.217 17:42, 2 November 2006 (UTC)Matt

A response to the last comment: Lortab and Vicodin are both (traditionally) 5/500 (5mg Hydrocodone, the narcotic, 500mg Tylenol). Whatever "blend" (or whatever) they are, they're still Hydrocodone "blends"... Hope this helps a bit...  :-) --JeffF

Copyvio

Somebody dumped this from the "Harvard Magazine" site. I cannot disagree with some points raised in that material, though. For example, physiotherapy, behavioral/relaxation techniques and surgery may be used to achieve analgesia. Perhaps we should expand the article to reflect this. JFW | T@lk 14:31, 17 July 2006 (UTC)

Atypical and/or adjuvant analgesics

I did some minor copyedits, but this section needs more edits relying upon subject-matter knowledge that I lack. Here are some suggestions.

Section heading. The section heading is awkward (see WP:MOS#Slashes and its subordinate section on "and/or"), and might not even need to use both adjectives. If "atypical analgesics" and "adjuvant analgesics" are synonyms, as the body text seems to imply, then use one of those terms in the heading and explain the alternate name in the body text. Thus, the section heading could be, simply, Adjuvant analgesics, and the body text could begin with "Adjuvant analgesics, also called atypical analgesics, ...". If those terms are not synonyms, then the heading could be, Atypical and adjuvant analgesics; however, there is no explicit reference to atypical analgesics in that section now, so additional editing would be needed to identify those drugs that are already included from that category, or to add them to the section, or to drop that adjective from the heading.

Run-on sentence. The first sentence is overly complex and appears to be serving two purposes: a list of drugs in one or both categories; and a description of their usage. So, it should be split up. For example, the revised wording could be, Adjuvant analgesics, also called atypical analgesics, include orphenadrine, cyclobenzaprine, scopolamine, atropine, gabapentin, first-generation antidepressants and other drugs possessing anticholinergic and/or antispasmodic properties. These drugs are used in many cases along with analgesics to potentiate centrally acting analgesics such as opioids when used against pain--especially of neuropathic origin--and to modulate the effects of many other types of analgesics by action in the parasympathetic nervous system.

Inconsistency. The first sentence about THC ascribes to it an "indisputably true benefit" that "may be" its superior anti-nauseant action. If we can say only "may be", then we can hardly describe that benefit as indisputable. Also, "indisputably true benefit" is redundant; "indisputable benefit" is sufficient.

I think there may be a couple of problems in the logic of the sentence structure in the Addiction section, too, but I'll stop here for now.

My 2¢ worth. --rich<Rich Janis 02:04, 27 July 2007 (UTC)>

Adjuvant, Atypical, Potentiators

Perhaps this section can be copied and used as the core of a new separate article on the use of other drugs to help with analgesia. — Preceding unsigned comment added by 4.254.87.92 (talk) 04:41, 12 January 2012 (UTC)

BCAA has been chosen to relieve pain and increase effectiveness of other analgesics such as morphine. — Preceding unsigned comment added by 212.226.43.93 (talk) 11:51, 10 July 2012 (UTC)

The "Adjuvant, Atypical, Potentiators" section is a section with no references.

I do not know what BCAA is - perhaps Branched-chain amino acid? I see no indication that BCAA is a pain medication. This is not a request which I think can be addressed so I will mark it as closed unless someone re-opens the issue with more explanation.

Resolved

Blue Rasberry (talk) 20:29, 27 July 2016 (UTC)

Review of opioids

doi:10.7326/M14-2559 JFW | T@lk 13:23, 13 January 2015 (UTC)

Bot maintenance

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Social issues

No history of analgesics?

I came here looking for the history of analgesics and didn't find what I was looking for after a quick glance at the article. Why is there not a section on it? —Preceding unsigned comment added by 173.53.180.137 (talk) 15:00, 18 November 2010 (UTC)

No section on why people are addicted to painkillers

124.254.78.121 (talk) 05:33, 2 November 2011 (UTC)

Clarification needed

Difference between analgesic and anesthetic?

What is the difference between an analgesic, and an anesthetic (especially a local anesthetic where consciousness is not impaired)? Would drugs such as the well known -caines (lidocaine, novacaine) count as anesthetics, alagesics, or both?

FT2 ^{(Talk | email)} 00:54, 20 November 2008 (UTC)

Pain-reliever versus Pain-killer

Isn't there enough usage to putatively show a perfunctory fiat upon the current idiom where Pain relievers are NSAIDs (prodrugs to cannabinoid receptor agonists and cannabinoids as direct agonists too) and such, whereas Pain killers are opiate or opioid narcotics a la mu-receptor agonists? 67.171.248.22 (talk) 04:57, 9 September 2010 (UTC)

No Section on Radio-Based Painkillers

There is nothing on shortwave diathermy or RF analgesics in general. Could someone correct this? — Preceding unsigned comment added by 2.100.65.56 (talk) 08:03, 5 August 2012 (UTC)

Analgesic vs Anesthetic

SO I came to this article fro another Wiki article to find what out what an "analgesic" is. From the article: "Analgesic drugs act in various ways on the peripheral and central nervous systems. They are distinct from anesthetics, which reversibly eliminate sensation,". From this sentence it seems to me that analgesics and anesthetics do the exact same thing unless anesthetics act *only* locally. Even if that is the case, aren't pain nerves part of the peripheral nervous system? I know absolutely nothing about biology and I am not getting a clear definition from the article so if someone could clear that up, I think it would help out the article (and the ignorant like me) a lot. Thank you.173.180.7.3 (talk) 10:54, 25 July 2013 (UTC)BeeCier

Rename proposal

Currently this article is titled "analgesic". "Analgesia" also redirects here. I think that "analgesic" is a name used by health care professions and not layman consumers. Because of this, I think this article's title should be changed to the WP:COMMONNAME. Here are some alternatives:

• Pain medication
• Pain reliever
• Painkiller
• Does anyone know others?

About 2000 Wikipedia articles have links to this article, so the name should be thoughtfully chosen.

Here are some examples of names that some other organizations use. I do not think these uses reflect any choice for an organization manual of style, but rather, these examples are just what the organizations used in these articles. Elsewhere they might use another name for the same concept.

• Pain relievers - MedlinePlus
• Painkiller - NHS Choices
• pain medication - Mayo Clinic
• painkiller - Centers for Disease Control and Prevention

Looking in Wikidata, the equivalent Wikipedia article in other languages is often called "analgesic".

I just did searches in Google Scholar. The following searches got the following numbers of hits.

• analgesic - 813,000
• "pain medication" - 69,200
• "pain reliever" - 13,000
• painkiller - 18,300
• "pain killer" - 11,700

I just did searches in general Google search. The following searches got the following numbers of hits.

• analgesic - 11,500,000
• "pain medication" - 870,000
• "pain reliever" - 452,000
• painkiller - 13,100,000 (top hits are unrelated to drugs for pain relief)
• "pain killer" - 433,000

Most instances of use overall favor "analgesic". However, from what I see, publications for consumers favor using terms other than analgesic.

Thoughts from others? Who prefers which name? Blue Rasberry (talk) 18:52, 27 July 2016 (UTC)

• I'm not sure our preferences matter much, though I do think "pain reliever" is clearest (even though I'm a health care provider). Your summary of usage indications is helpful, and "pain reliever" doesn't fare very well. I find "pain medication" ambiguous (does it relieve or cause pain?). It seems to me that retaining "analgesic" is sensible (and globally aligned). — soupvector (talk) 20:48, 27 July 2016 (UTC)
  • "Painkiller" seems to be the common name, but this article falls under WP:PHARM and WP:MED, which have their own naming conventions, so FYI I'm about to notify those projects of this thread. As far as I can tell, WP:PHARMMOS doesn't say anything applicable here, but WP:MEDMOS says: "The article title should be the scientific or recognised medical name that is most commonly used in recent, high-quality, English-language medical sources, rather than a lay term (unscientific or slang name)...For example, heart attack redirects to myocardial infarction." I work at a university hospital and when I search the medical library for peer-reviewed sources using "analgesic" vs "painkiller", "analgesic" wins 187,342 to 23,599, so based on that and the google scholar results, I'm guessing consensus will be to leave it how it is. I'm more or less indifferent between those two options. —PermStrump(talk) 02:33, 28 July 2016 (UTC)

    Nevermind, you already notified the projects. :) —PermStrump(talk) 02:35, 28 July 2016 (UTC)

• I would support pain medication Doc James (talk · contribs · email) 11:09, 28 July 2016 (UTC)
• I support keeping it the same in line with WP:MEDMOS. While lay terms may provide short-term benefit in the form of making the article initially more accessible, in the long-term they act as a persistent source of ambiguity and confusion. A reader might wonder why lidocaine, something they've been given many times for the purpose of reducing pain, is not present in the "Pain Medication" article. Worse even the article could give someone the mistaken impression that the lay term is an official one, they might try and correct someone in a situation like this: "How was getting your wisdom teeth removed?", "Good, I thought it would be really painful, but the pain meds they gave me made it so that I didn't feel a thing", "They didn't give you pain meds they gave you anesthetics, look it up on Wikipedia they are different things".M. A. Bruhn (talk) 23:46, 30 July 2016 (UTC)

"Comparison of available agents"

In April 2014 Fuse809 added a massive, brilliant table to this article called "Comparison of Available agents". See it live at Analgesic#Comparison_of_available_agents. I like the table a lot but I am unsure if the best place for it is here. It might be.

Here are some options I am considering -

1. Leave it here

   If it is left here, it needs an introduction somehow. I do not think that it attracts enough attention to itself without having 2-3 sentences introducing it. Also, if it does stay here, it should get a categorized redirect so that it can appear in in category lists including Category:Medical comparisons. I think this could be a model for other drug comparisons. It would be worthwhile to link several articles to this list, like for example, every drug class in the list should link here.

2. Spin it off into its own single article

   This is a tremendous amount of content and it could be managed in its own article. This much content usually is placed in a list article, just because of the style of Wikipedia. Additionally, if it were in its own article, it would not need to be collapsed and it would be easier to make other Wikipedia articles link to different sections of this list.

3. Do either of the above, but also duplicate parts of the list elsewhere

   This is a bad idea because Wikipedia should not WP:FORK content. It is better to have any list only in one place. However, some how in some way, portions of this list need to be made available for other articles. Like for example, Non-steroidal anti-inflammatory agents needs to link to its own section in this list.

4. Spin this off into multiple other lists

   I think this is a bad idea also, but there is so much content here that that this chart could be separate articles called "list of NSAIDS" and "list of COX-2 inhibitors" and the rest.

I think that I favor moving this into its own article. In addition to that, the drug classes listed here each need a section in their articles which describes the list and then links to it.

• Nonsteroidal anti-inflammatory drug
• COX-2 inhibitor
• Opioid
• I suppose there is no particular article which should link to the "Other analgesics" section

I am not in any hurry to do anything. Right now I am just thinking. It could just stay where it is, and I suppose since this is the high-traffic article this is a natural place for it. I just wonder if this content would be more prominent if presented in its own space and not collapsed. Thoughts from anyone? Blue Rasberry (talk) 19:36, 27 July 2016 (UTC)

believe #1 is best leave it here (and do the redirect)--Ozzie10aaaa (talk) 23:23, 27 July 2016 (UTC)

I'm fairly easy either way, though I do agree it should have its own space and not just be collapsed, thanks for the pats on the back though, at times it seems like all my edits do is cause people to get ticked off, it's nice to be reminded that people appreciate my work at times. Brenton (contribs · email · talk · uploads) 02:18, 28 July 2016 (UTC)

Classes of pain medications

Does anyone know of a basic reference source which lists and defines the classes of pain medications?

Right now, this article lists these:

1. Paracetamol and NSAIDs
2. COX-2 inhibitors
3. Opioids
4. Flupirtine
5. Specific agents

I do not know how these were chosen. Paracetamol is not an NSAID, and they might have been listed separately. I am not sure why flupirtine is in its own category because it is not so significant as compared to other things that might have their own category. I do not know the origin of the term "specific agents", but this category seems like it is being used right now to mean "everything else".

Elsewhere in the article muscle relaxants, cannabis, and liniment are mentioned, but I think these should be considered classes of pain medication. There is no mention of ethanol or dietary supplements. Triptans might be mentioned because they are commonly used for migraine.

I wish that I could sort this article based on any established list of the sorts of pain medications in common use. The article on pain management would also be improved if this article could back up its coverage of pain medication.

Sources, anyone? Blue Rasberry (talk) 21:10, 27 July 2016 (UTC)

Non-chemical classifications

I have been browsing available literature.

It seems like there are a range of guides for choosing analgesics for specific populations. Here is one for children.

• World Health Organization (2012), WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses, retrieved 28 July 2016

There seem to be others for pregnant women, the elderly, and other groups. I am unable to identify any source which gives any grouping of which drugs are used for various populations, even though I can find example papers that there are different recommendations for different groups. Because of this, I am not sure if Wikipedia should say something like, "Drugs for pain can be classified for use by different populations." The manual of style already recommends a "special populations" section - maybe this should go there.

There are a range of guides for treating various diseases and medical conditions with different analgesics. For example, low back pain, migraines, and cancer pain are all treated with a range of analgesics, and often the same sorts of analgesics, so one might classify analgesics by the diseases they are used to treat. For any painful disease, one could look at a management guide and see that certain pain drugs are either more recommended or less so. However, I am unable to find any source which classifies analgesics in general by disease. Each disease just has its own treatment guidelines.

I know that lots of analgesics have legal restrictions on usage by country. Even in the European Union, some countries are more permissive with opioids and others are less. Definitely across the world there is a lot of variation in use of opioids, and lately, availability of cannabis has been changing a lot. I am not sure if cannabis is even traditionally called an "analgesic". Whatever the case, I think pain medications could be classified by legality by region. There actually are a lot of organizations which have written statements recommending that all countries provide access to drugs on the WHO essential medicine list. That includes opioids which many countries restrict. If anyone has ever tried classifying analgesics by legality, then I am unable to find such a thing.

For now, I think it is best to sort them in wiki by chemical class. There are other ways this could be done, but typically Wikipedia would copy someone else's classification system and not make a new one. I am unable to find other descriptions of classification systems, even though I do feel like it is easy to find examples of other classification systems being used as described above. Blue Rasberry (talk) 21:34, 28 July 2016 (UTC)

Paracetamol and NSAIDs were probably listed together because they are both nonopioids. The same grouping is shown in this WHO diagram which depicts three levels of analgesics: nonopioids to be used initially for pain, mild opioids for continuing mild to moderate pain, and then strong opioids for continuing moderate to severe pain. M. A. Bruhn (talk) 00:18, 31 July 2016 (UTC)

M. A. Bruhn That WHO classification actually has its own Wikipedia article at Pain ladder. I do not understand enough about the situation to know what is best. I separated the two because I had the idea that people with pain are sometimes advised to take an NSAID plus paracetamol, perhaps as described here.

• Ong, Cliff K. S.; Seymour, Robin A.; Lirk, Phillip; Merry, Alan F. (February 2010). "Combining Paracetamol (Acetaminophen) with Nonsteroidal Antiinflammatory Drugs: A Qualitative Systematic Review of Analgesic Efficacy for Acute Postoperative Pain". Anesthesia & Analgesia: 1. doi:10.1213/ANE.0b013e3181cf9281.

I want to be straightforward in saying that I do not really know how to classify these. Also I have been unable to find the original WHO pain ladder paper. Some papers say it was published in 1986. I am not sure how to access the original or if it has been updated. You liked to a page which other people are linking, but that seems to be an incidental overview and not publication of the pain ladder itself. I might like to see the original. I do not suppose you know how to find the original paper or any update of it, do you? I checked Google Scholar, PubMed, and the WHO site itself. I found citations but no online version of the paper. Blue Rasberry (talk) 16:55, 1 August 2016 (UTC)

The original WHO publication that introduces the ladder is here on page 53 (World Health Organization. Cancer pain relief. Geneva: WHO, 1986). I don't think investing a lot of time will yield an optimum way to categorize them, however. The most practical approach may just be to determine a size threshold for giving something it's own section, and putting everything below that threshold into a miscellaneous section.M. A. Bruhn (talk) 02:47, 2 August 2016 (UTC)

M. A. Bruhn Thanks. I added a link to that publication at Pain_ladder#Further_reading. Do you have any suggestions for finding a "size threshold"? I might wish for a paper like, "Comparison of use of drugs for pain management" which then reports either what physicians prescribe or what people use. Whatever is not listed in the report could go into the "other" section. Blue Rasberry (talk) 20:03, 4 August 2016 (UTC)

Spam for my employer

Wikipedia is sensitive to WP:COI so I wanted to post notice that I added a link to one of my employer's publications to the external links section. There were no external links previously. Please discuss further if needed at Talk:Pain_management#spam_for_my_employer_-_added_external_link, where I discuss adding the same link to the pain management external links section. Thanks. Blue Rasberry (talk) 21:07, 29 July 2016 (UTC)

Thanks for acknowledging the COI, but I would suggest using Suggested Edit in a case like this. Nice resource, but a lot of ads. Mixed feelings about whether it adds value. — soupvector (talk) 22:25, 29 July 2016 (UTC)

I removed the link and made a request for the "suggested edit" coi process at Talk:Pain_management#spam_for_my_employer_-_added_external_link. Thanks for the feedback. I went further on that talk page and linked some comparable resources provided by other organizations. I hope that gives context to what resources are available to people who search for such information. Blue Rasberry (talk) 16:42, 1 August 2016 (UTC)

Alternative medicine as an analgesic

At talk:Pain management Ronz mentioned that there should be more coverage of alternative medicine. It is true there, but also here. I just added an alternative medicine section.

This is not solid content, but I think it is better than nothing. Alternative medicine can mean any of thousands of drugs, so it is difficult to talk about it collectively. The academic literature does treat it collectively. I cited three Cochrane reviews of herbal medicine for pain. In all the papers, they are considering many drugs for a different type of pain in each review. These were the only such Cochrane reviews I could find where any drug from alternative medicine is used to treat pain.

• Oltean, Hanna; Robbins, Chris; van Tulder, Maurits W; Berman, Brian M; Bombardier, Claire; Gagnier, Joel J; Gagnier, Joel J (2014). "Herbal medicine for low-back pain". doi:10.1002/14651858.CD004504.pub4. {{cite journal}}: Cite journal requires |journal= (help)
• Cameron, Melainie; Gagnier, Joel J; Chrubasik, Sigrun; Cameron, Melainie (2011). "Herbal therapy for treating rheumatoid arthritis". doi:10.1002/14651858.CD002948.pub2. {{cite journal}}: Cite journal requires |journal= (help)
• Cui, Xuejun; Trinh, Kien; Wang, Yong-Jun; Cui, Xuejun (2010). "Chinese herbal medicine for chronic neck pain due to cervical degenerative disc disease". doi:10.1002/14651858.CD006556.pub2. {{cite journal}}: Cite journal requires |journal= (help)

In all three reviews, the treatment was found to relieve some pain better than placebo, and more research was advised. I tried to communicate this as a general research finding in alternative medicine. I think that I matched my cited sources, but sometimes, even Cochrane reviews are not as clear as what I hoped to find. Blue Rasberry (talk) 15:01, 2 August 2016 (UTC)

I'm not sure the comment by Ronz is referring to alternative medicine. I interpreted their comment about expecting external links "perhaps having alternative presentations" to mean a having a different way of structuring and reporting information. I don't believe an alternative medicine section is appropriate for this article. Analgesics are a specific type of medicine, so alternative medications would seem to me to be off topic. Additionally an apparent decrease in pain may be the result of a broader anesthetic effect, rather than specifically being an effect that targets pain. I would thus hesitate to place something in either this article or the anesthetic article without knowing more about the specific nature of how it is reducing pain. M. A. Bruhn (talk) 19:54, 2 August 2016 (UTC)

I was not referring to alternative medicine. Given that this article is about a class of drugs, I don't see how alt-med would fit, especially in light of WP:MEDRS. --Ronz (talk) 21:23, 2 August 2016 (UTC)

@Ronz and M. A. Bruhn: Right, I re-read the comment and it includes the word "alternative" but I misinterpreted it.

However, if either of you like, I would appreciate more comments about what should be here. In a section above I proposed renaming this article at Talk:Analgesic#Rename_proposal. The situation is that the article currently has a technical name, "analgesic". I do not know what this term means, but probably most physicians imagine that the term refers to some but not all drugs which relieve pain. I see that there is line that an analgesic is not an anesthetic, but overall I am not clear on the difference between an analgesic and a "pain medication" or "painkiller". Some of the odd members on this list are alternative medicines, cannabis, alcohol, antidepressants, and there is a section on some other miscellaneous drugs not usually imagined as analgesics. I am seeing supporting evidence that everything on this list is routinely used to relieve pain. If an analgesic relieves pain, and if this article is about "pain medications" or "pain killers", then I think the list is appropriate. If "analgesic" means "the subset of pain medications most commonly used in mainstream Western evidence-based medicine" then some of the items here are misplaced. I think there should be some article on painkillers, because a lot of people who read this are typical consumers seeking information on what people do to get pain relief.

Ronz, I do not see any conflict with MEDRS here, so if you like, tell me what you see. I think that sources establish that people use alt-med to treat pain. I just tried to add another review article to establish the idea that some people try alt-med. I tried to present information about the efficacy of this as reported in the best MEDRS sources I could find. At the same time, I recognize that many pain management publications would omit acknowledgement of all sorts of alt-med treatments. I am quite unsure of whether alt-med is an analgesic, but I am more sure that alt-med drugs are used in an attempt to treat pain. What do you think? Blue Rasberry (talk) 14:47, 3 August 2016 (UTC)

why did someone undo this edit?

https://en.wikipedia.org/w/index.php?title=Analgesic&oldid=760575810 "have been derived from" is clunky language. It seems that it is written by someone who knows english as a second language. 162.231.134.145 (talk) 02:00, 18 January 2017 (UTC)

Classification by mechanism of action?

The Classification section introduces itself with the sentence "Analgesics are typically classified based on their mechanism of action." Good idea. Do we have a taxonomy of mechanisms of action? Well, not in this article. How about reference 4, the BNF online link? It redirects to https://about.medicinescomplete.com/, which conveys that BNF is a very exclusive organization of some sort. OK, how about by example in the various subheadings? The first subheading is acetaminophen, that's a chemical not a mechanism of action. OK, as a last resort, let me take a stab at what the mechanisms of action might be. The first is to prevent pain from arising in the first place, e.g., by reducing inflammation. The last is to prevent the brain from finding out about it. An intermediary strategy might be to stop the central nervous system from finding out about it. Somewhere in all of this, we should see the term "antinociception," but we don't, I find that odd. The subheadings for this section suggest that the classification used is mainly historical. Perhaps the easy fix would be to replace the first sentence of this section with a more accurate overview of what is to follow. Page Notes (talk) 20:20, 26 February 2019 (UTC)