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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

#141

Post by gwbas1c »

PaulHoule wrote: post #38
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 see…

But there's a clear difference between addictive opioids and non-addictive alternatives sold over the counter. The risk is just not comparable.

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

#142

Post by temporallobe »

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…

> just take the pills

God do I hate medical professionals like that. It's as if they don't want you to steal any of their elite knowledge or that you as a patient are beneath them. How dare one of us ask a semi-intelligent question!

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

#143

Post by xbzbanna »

tasty_freeze wrote: post #138
latencyloser wrote: post #92

Earlier quoted context omitted.

Anecdotal, but I can't imagine living a normal life while regularly using though--even if regular is just a couple days a week. It's legal where I live and the handful of times I have used during the week, I can't remember what I did the day before as well, or what my tasks for the day are. My performance at work noticeably degrades. I'm also more tired the day after, despite generally getting more sleep. It's great…

I'm curious what makes it great for the weekend for you. Not being able to remember what your goals for the day are or remember what you did the day before doesn't sound great, even if it is the weekend.

I'm not the person you are responding to, but I limit my cannabis use during the workweek for similar reasons. Most often my goals for the weekend are to relax and enjoy myself. Of course I'm not going to get high if I'm about to fill out paperwork to refinance my mortgage.

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

#144

Post by foobarian »

mholmes680 wrote: post #110
pasbesoin wrote: post #83

Earlier quoted context omitted.

Same here. After a LONGGG phone call cradling the receiver while trying to type, etc., I had my neck spasm severely -- so much so that the following day someone else had to drive me to urgent care (1). They prescribed a strong muscle relaxant in combination with either Percocet or Vicadin -- I forget which. I switched over to the default over the counter dose of ibuprofen, and it worked better than the combination of…

I've found through my experience that the choice of urgent care vs a non-urgent care doctor is more important than I have always thought: An urgent care center wants to focus on the shortest path to getting you relief (your story aside). They'll err towards slightly over-prescribing. The non-urgent care doc will take a more comprehensive treatment path. A slight distinction that might not matter sometimes, but i ofte…

For the ER in our town to take you seriously you would have to have visible bullet holes or severed limbs. Otherwise they dismiss you with a condescending sneer.

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

#145

Post by bayesian_horse »

The title is misleading, because opioids clearly are better at treating severe pain. I'm not familiar with the particular combination researched here, but Ibuprofene alone certainly doesn't cut it in many instances. On the other hand, I can't understand why doctors in the US are so happy to prescribe opioids.

In veterinary medicine it's slightly different, because we can't use ibuprofene for dogs and cats, but something similar. Still, opioids are a good idea perioperatively, and addiction is at worst a transient problem. The dog can't go out and score some heroin, for instance.

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

#146

Post by bayesian_horse »

ythn wrote: post #36
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…

It's a fine line. Most of the time, the patient is actually wrong, and that can make it pretty annoying, especially if the medical professional in question is having a stressful day (and aren't they all...).

I have a lot of medical knowledge and I try not to be a wise ass with my doctors. Sometimes though, it pays to pay attention.

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

#147

Post by SpikeDad »

Well lets take some of these folks and give them a herniated disk like I had. Advil? Tylenol? Sure - like Skittles. Even high doses of Hydrocodone only kept the debilitating pain away for a couple of hours.

I only slept 3 hours a night for 2 month. My neurosurgeon said - "When you've reached your pain limit call me and we'll schedule surgery". That was 2 months.

I'm very grateful for both the narcotics and the neurosurgeon. Surgery was the last resort and thankfully it reduced my pain 95% (micro discectomy).

Some years later I was umpiring and tripped and fell right on my ribs (I'm 230 lbs) - crackity crack. Breathing would not have been possible without a good dose of Percocet - a limited, appropriate amount.

So not sure exactly what's going on with this study (and I think the hysterical press has some factor) but I'd debate the results.

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

#148

Post by arcbyte »

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…

That is straight up malpractice.

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

#149

Post by cmrdporcupine »

testvox wrote: post #48
PaulHoule wrote: post #38

Earlier quoted context omitted.

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 see…

Cannabis works pretty well and has minimal side effects, at least compared to those you describe.

Cannabis makes my pain worse.

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

#150

Post by crx087 »

derefr wrote: post #9
dajohnson89 wrote: post #4

Agreed that opiods are overprescribed, but for acute pain there's no comparison. At least in my experience. I was rushed to the ER with an excruciating condition, and i popped quite a bit of ibuprofen at home before going to the hospital (i think 4-6?). Nothing. In the triage room or whatever, that morphine drip (plus saline IV to replace all fluid i vomited up due to pain) made the 8/10 pain reduce to a 2-3/10, allo…

They didn’t say opioids are no better than either acetaminophen or ibuprofen; they said that opioids are no better than the combination of ibuprofen with acetaminophen — something very rarely prescribed (and usually advised against on the labels of both drugs.)

They didn't say opioids are no better than acetaminophen+ibuprofen, but codeine, which is weak enough to be freely available OTC in many countries.

Anyone doubting the merits of opioids in pain control should take a look at https://en.wikipedia.org/wiki/Equianalgesic - many of the voices in this debate will sorely regret their remarks if they ever experience real pain, which most people will at some point.

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