Pain medicine can be taken in a number of ways.
There is always a reasonably convenient and effective way to take pain medications.
- Most of the time, you will take pain medicine orally, by mouth, as pills or liquids. Over-the-counter medicines are usually taken regularly every four to eight hours, depending on the medication. Opioids are usually taken regularly by mouth every four to twelve hours. Morphine, hydromorphone, and oxycodone are available in long-acting forms that may be taken every eight to twenty-four hours. Doses of opioids for breakthrough pain may be taken as often as every thirty minutes, depending on the dose and the specific medicine. Be sure you know your schedule for taking medications. Write it down and review it with your doctor.
- For pain that is difficult to control, or for patients who are having trouble swallowing, various options are available. Pain medicine can be given subcutaneously, through a thin catheter attached to a very small needle placed just under the skin. A small battery-operated pump (PCA pump or CADD pump) can deliver injections continuously or on a regular schedule and allow patients to take extra doses for breakthrough pain.
- Patients having trouble swallowing for a short period of time may be given rectal medications. This is especially useful if swallowing becomes difficult or a pump malfunctions and it is the middle of the night. Most oral medications, but not all, can be given rectally with good results. However, many people would not want rectal medications for a long period of time. Rectal medications are not very useful for patients having diarrhea.
- Some people treat their pain with a transdermal ("across the skin") patch. The opioid fentanyl is the only one you can get in a patch right now [as of 2001]. The patch is placed on the chest or back and changed every three days. The patch is an effective method of controlling pain because it keeps the dosage at a fairly constant level. But, because it takes medicine in the patch twelve to eighteen hours to reach a useful level in the bloodstream, a quicker acting (oral, sublingual, rectal, or injectable) medication must be used during the first few days of wearing a patch and should be available to treat breakthrough pain.
- Many medications can be administered intravenously (IV), through a catheter in a vein. While this works in a hospital setting when an IV may be placed for other reasons, it may also be used at home. Some people will have had "permanent" catheters placed in order to give other medications. These are easy to use for pain medications, but patient and family have to learn some routines to use in caring for the catheter.
- Pain medications can also be given by injections into muscle or into the space around the spinal cord.
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