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As epidemic rages, ER study finds opioids no better than Advil and Tylenol

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Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#31

Post by astura »

Anechoic wrote: post #27

Of course while YMMV, I've found the same thing - I've been prescribed opioids for pain, and I found that Advil worked just as well, without the side effects. I do understand that opioids have their place - for example I was told that Advil was not safe to take before surgery so I was stuck with the prescription meds. On example that made an impression on me: a couple of years ago, I had arthroscopic surgery on a kne…

I agree the nurse absolutely should have answered your questions about the medication or gotten a doctor to answer them. It's just inexcusable behavior on her part.

Did the script say "P.R.N?" PRN means "as needed" in medical terms. It's an abbreviation for "pro re nata." Just for future reference.

I've also found that, for me, naproxen (Aleve) works much better than opioids. Opioids just make me feel very, very sick (from nausea). If they do help with the pain relief I can't tell over the nausea and vomiting.

But, yeah, YMMV.

Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#32

Post by astura »

ben_jones wrote: post #8
ams6110 wrote: post #2

an initial prescription of just a few days' worth of pills can trap patients into using the highly addictive, often deadly drugs for a year or more I call BS on this. Maybe if you have an unresolved underlying chronic pain, this could be true. But many people get a hydrocodone prescription after surgery or dental work and do not go on to become addicts. And no, Tylenol is not great for acute pain. It does very little…

I've met a few people who got addicted to pain killers at 15/16 years old. It started with a small prescription after dental surgery or similar, their parents left them to their own devices to take meds as needed. When the prescription was up they then went out and bought it on the street because they wanted the feeling to keep going. Some people are simply vulnerable, and even a little temptation is too much.

Yep, same.

My cousin got addicted in his late 20s after shoulder surgery.

My friend got addicted in his late teens after knee surgery.

Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#33

Post by ianai »

apendleton wrote: post #24
bryanlarsen wrote: post #14

Earlier quoted context omitted.

counter-anecdote: my doctor told me to use precisely that combination for severe pain. She said you cannot combine multiple NSAID's (ibuprofen, naproxen, ASA), but you can combine an NSAID with acetaminophen.

Agreed; I've been prescribed that combination more than once by different doctors. It's very common, and often the recommendation is to stagger them. NSAIDs are metabolized by the kidneys and acetaminophen is metabolized by the liver, so they can be safely combined. EDIT: also, this is pretty much what Excedrin is (aspirin instead of ibuprofen, but NSAID + acetaminophen, plus also caffeine)

As a migrainer, excedrin really only works part of the time. Though, opioids really only succeed in making me not care about the pain. I’m still in pain with them.

The best treatments, for me, directly address whatever underlying issue.

Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#35

Post by ineedasername »

Would like to have seen an opioid-ibuprofen combo in the mix. Or ibuprofen and acacetamenophine each alone. For the class of injury described, swelling and inflamation will be very common, and ibuprofen is better suited than acetamenophine for this.

Class of injury is very important too: limb injuries producing acute pain are more likely to be a type where time, even just 2 hours, will have a leveling effect on pain, while one class or combination of drugs might provide better instant relief.

Finally, we have these short term acute pain examples and long term chronic pain, but medium term acute pain in the range of days to weeks might be a primary area of risk for new addictions where a patient requires more than a few doses but doesn't ask the patient to shift their outlook on how they deal with pain and adjust to it that chronic pain patient may have to do, with or without opiods. If the pain is short term in this way, the potent opioid pills can be seen as a quick fix that doesn't take as much effort as rethinking "acceptable" levels of pain.

Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#36

Post by ythn »

Anechoic wrote: post #27

Of course while YMMV, I've found the same thing - I've been prescribed opioids for pain, and I found that Advil worked just as well, without the side effects. I do understand that opioids have their place - for example I was told that Advil was not safe to take before surgery so I was stuck with the prescription meds. On example that made an impression on me: a couple of years ago, I had arthroscopic surgery on a kne…

> Her response was "just take the pills."

There's a fairly big camp of people both online and in real life that is strongly against questioning medical authority. I've encountered it before.

For example (and I know this is purely anecdotal), after doing a few hours of extensive research and photography comparisons online I came to the conclusion that my sister had shingles. I mentioned this to the doctor when I took her and he dismissed it and said that it is unlikely since she is so old. I mentioned this on a subreddit that I frequent and a bunch of people jumped on me and told me to stop doing my own research and to let medical authorities do their job without me pestering them. However, after taking her to a different doctor, he immediately recognized it as shingles and prescribed her the appropriate medicine.

On the one hand, I get why doctors don't want the "ignorant masses" doing their own research and coming op with cockamamie theories, but on the other hand, doctors can only hold so much information in their heads whereas the internet has vastly more information available and I can become an expert in one tiny little niche fairly quickly.

Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#37

Post by ceedan »

Some more anecdotal evidence

I was hospitalized with a huge abscess that was damaging my leg and hitting my sciatic nerve. The pain was as acute as I would imagine is possible. The morphine drip that I had did nothing. It was very frustrating. Sometimes the pain would re-occur before I was allowed to get more morphine, and the duration/severity of the pain was comparable.

At the time, I thought that the morphine only managed to make me tired after the pain had subsided, but maybe taking a nap after that kind of pain was normal anyways?

Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#38

Post by PaulHoule »

Anechoic wrote: post #27

Of course while YMMV, I've found the same thing - I've been prescribed opioids for pain, and I found that Advil worked just as well, without the side effects. I do understand that opioids have their place - for example I was told that Advil was not safe to take before surgery so I was stuck with the prescription meds. On example that made an impression on me: a couple of years ago, I had arthroscopic surgery on a kne…

NSAIDS are not benign.

Digestive problems are so common with long-term use that some doctors think that they should co-prescribed with omeprazole and other agents to head them off. (Long-term omepraloze will give you B-12 deficiency if you don't supplement; it is an unusual side effect, but I can't sleep if I take omeprazole.

Cardiovascular risk from Vioxx was enough to pull the drug from the market; risk is also seen with Celebrex and other COX-2 selective NSAIDS. The risk with non-selective NSAIDS is less understood but still present.

My doc does not want me taking acetaminophen because she thinks it causes me to get elevated liver enzymes.

Like opioids there are problems when people don't "use as directed". My grandmother used to take Bufferin by the handful and one day at the dinner table we saw her throwing up blood like something out of a horror movie and she was subsequently hospitalized..

Acetaminophen overdoses can easily destroy your liver and are one of the most common forms of fatal poisonings.

The verdict is that we don't have truly 'safe and effective' medicines for pain in 2017.

Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#39

Post by kbutler »

Anechoic wrote: post #27

Of course while YMMV, I've found the same thing - I've been prescribed opioids for pain, and I found that Advil worked just as well, without the side effects. I do understand that opioids have their place - for example I was told that Advil was not safe to take before surgery so I was stuck with the prescription meds. On example that made an impression on me: a couple of years ago, I had arthroscopic surgery on a kne…

I was going to post a similar opinion specifically of percocet: it was prescribed for me after a surgery, it gave me a weird sense of detachment, but didn't seem to do anything particularly significant for pain.

I stopped after the first one.

I have enough addictive behaviors, I don't need to add a chemical one.

Re: As epidemic rages, ER study finds opioids no better than Advil and Tylenol

#40

Post by shams93 »

Anechoic wrote: post #27

Of course while YMMV, I've found the same thing - I've been prescribed opioids for pain, and I found that Advil worked just as well, without the side effects. I do understand that opioids have their place - for example I was told that Advil was not safe to take before surgery so I was stuck with the prescription meds. On example that made an impression on me: a couple of years ago, I had arthroscopic surgery on a kne…

This is not the case when you suffer major 3rd degree burns. When you need morphine in the case of say regrowing nerve endings in a damanged limb advil will not cut it, not even medical cannabis will cut it, there are still cases where giving a patient morphine is appropriate.
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