Sustained Release Versus Immediate Release Medications: Which Works Best?
What is the right tool for 24/7 pain? Having the right tool for the job can mean the difference between being on a roller coaster of uncontrolled pain versus being on a merry-go-round of good pain control. Pain medications have two basic methods for delivering the active ingredient: immediate release or sustained release.
Immediate release medications are designed for occasional, temporary pain because they work fast but don’t last. This allows a person to use these short-acting medications like Vicodin, Lortab, and Percocet “as needed for pain” (this is a common instruction on prescription bottles). However, many people end up using quick-acting medications constantly, around-the-clock for 24/7 pain. That is like trying to use a hammer as if it were a nail. Immediate release medications are the wrong tools for the job of controlling constant pain. Because these medications wear-off so quickly, one never has a chance to stay ahead of the pain. Instead, this roller coaster is a never-ending game of catch-up.
In order to nail down 24/7 pain, the right tool is required. Sustained release medications are designed for constant pain because the active ingredient is released continuously to provide even, lasting pain control. Long-acting morphine, fentanyl patches, methadone, and buprenorphine are all good options when the pain becomes persistent and the immediate release medications cannot keep up with demand. People using these sustained release medications find that mornings are better, nights are better, and eventually life is better on a steady merry-go-round.
Long-acting and short-acting medications both have their place in the toolbox, but knowing the difference between the two can be critical for getting the job done. A hammer cannot be tricked into becoming a nail. The “as needed” immediate release drugs cannot reliably nail down 24/7 pain. Understand the options, communicate with your doctor, and use the right tool to manage your pain because eventually, the ups and downs of a medication rollercoaster will wear you down.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.