Opioids are some of the most commonly prescribed medications for pain, but they are often misunderstood. In her TED video What you should know about opioids and painkillers, Dr. Jen Gunter breaks down how opioids work, why they aren’t always the best option, and the hidden risks they carry. Contrary to popular belief, opioids are frequently outperformed by anti-inflammatory drugs like ibuprofen when it comes to managing many types of pain, and their effectiveness comes with a serious trade-off: the potential for dependence and addiction, even after just a few doses.

Dr. Gunter explains that opioids not only block pain signals by binding to specific receptors in the body, but they also trigger a release of dopamine, which can create feelings of pleasure and euphoria. This dual effect can confuse patients into thinking the medication is more effective than it actually is, especially as the body quickly adapts and begins to expect the drug. Withdrawal symptoms can mimic pain, leading patients to believe they still need opioids for relief—when in fact, the medication may be prolonging or worsening their discomfort.

The key takeaway is that while opioids can be a valid option for certain kinds of pain, they must be used with caution and under careful medical supervision. Dr. Gunter encourages patients to ask about alternatives like NSAIDs, physical therapy, and muscle relaxants, and to always ensure there’s a clear tapering plan in place if opioids are prescribed. She also stresses the importance of having naloxone on hand to reverse potential overdoses. Understanding how opioids work—and their risks—is essential for making informed decisions about pain treatment.

Find more from TED (October 2022)