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The first non-opoid painkiller

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Re: The first non-opoid painkiller

#161

Post by Marazan »

Marazan wrote: post #136
theoreticalmal wrote: post #82

Earlier quoted context omitted.

My wife and I got colds while vacationing in Edinburgh and had a heck of a time before realizing to ask for paracetamol rather than acetaminophen. Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid.

As annoying as it is (and I agree it is fantastically annoying) much to my surprise admissions for paracetamol overdose to UK hospitals absolutely plummeted after purchasing restrictions were introduced. Score one for the nanny state.

For those interested having done a brief literature search I've found a review article that paints the picture as much less clear than my categorical statement

https://pubmed.ncbi.nlm.nih.gov/17536874/

Re: The first non-opoid painkiller

#162

Post by gbalint »

gorjusborg wrote: post #34
Snoozus wrote: post #5

This is clickbait, there are at least two classes of non opioid painkillers in use since a long time. https://en.wikipedia.org/wiki/Analgesic

I don't feel the title is misleading, but it may be a cultural language difference. The term 'painkiller' is reserved for strong pain relief, and wouldn't include things like ibuprofen. That made me think immediately of a non-opioid pain blocker not just a pain reliever.

How about metamizole? That is a painkiller (at least according to wikipedia), and it is definitely not an opioid or an NSAID.

Re: The first non-opoid painkiller

#163

Post by zdragnar »

pasc1878 wrote: post #141
zdragnar wrote: post #130

Earlier quoted context omitted.

Tylenol is slightly different in this case, as it is merely a brand name widely associated with their most commonly sold medicine. Tylenol does also make other medications, but the majority of it contains acetaminophen/paracetamol. Acetaminophen and paracetamol are two names for the same generic chemical composition drug, which is why it is especially confusing. You can ask for aspirin or ibuprofen in any English spe…

I don't think that is correct re football. Football is an English invention. It then split into Association Football and Rugby football. From Association Football we get soccer. So Football was first then soccer. e.g. The Football Association was formed in 1863 and the first international match in 1872 was billed as International Foot-ball Match and then in small writing (Association Rules) before the term soccer was…

Ah you're right, I may have gotten my memory slightly mixed up. Even so, the name soccer (at least as a nickname) was formed in the UK, along with association football, both referencing the same thing, and which became more popular over time diverged across country lines, so the analogy isn't too poorly fitting at least!

Re: The first non-opoid painkiller

#164

Post by DougN7 »

padjo wrote: post #124
theoreticalmal wrote: post #82

Earlier quoted context omitted.

My wife and I got colds while vacationing in Edinburgh and had a heck of a time before realizing to ask for paracetamol rather than acetaminophen. Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid.

Given how common accidental paracetamol overdose is I think it’s perfectly reasonable.

I’ve never heard of this particular overdose. In the US it’s completely unmonitored and I’ve never heard of an overdose. I’m genuinely surprised.

Re: The first non-opoid painkiller

#165

Post by giardini »

skerit wrote: post #27
bheadmaster wrote: post #21

Earlier quoted context omitted.

> even the "pain relief" provided by sticking a knife through your skin to the bone is addictive > the side effect of addiction isn't going to go away While I agree with your conclusion itself, I disagree that the premise implies the conclusion. The main difference between suzetrigine and opioids, as explained in the article: Crucially, opioids don’t just kill pain: they also incite pleasure. When the mu opioid recep…

What is this thread? Sticking a knife through your skin to the bone kills pain and is addictive?

Is this a useful first aid technique?

Like for Aron Ralston, who was trapped under a rock and had to cut off his own leg to escape: would it have reduced his pain if he had stabbed himself in the shoulder to the bone?

Would this best be done with, say possibly, acupuncture needles or an ice pick, so as to minimize the damage and to maximize the relief?

Gunsmoke TV episode:

Doc: Well, Billy, we'll have to amputate your lower left leg - it's shot plumb thru with gangrene.

Billy: Will it hurt, Doc?

Doc: Hell yeah, it'll hurt! But thanks to Hacker News we have a new pain treatment: every time you yell. Chester here will stab your right leg to the bone with this h'yar ice pick. And Mary will hold a leather strap in your mouth so your teeth don't crack off! Don't forget to breathe.

Billy: I'm obliged and grateful to be part of your research program, Doc, but can't you instead just wait 10 minutes while I drink this here quart of whiskey and pass out? Then you can do as you wish.

Doc: Hell, no, time's a'wasting! Hold him down, fellas! Doctorin' progresses only a step at a time!

Re: The first non-opoid painkiller

#166

Post by refurb »

xnorswap wrote: post #122
dspillett wrote: post #108

Earlier quoted context omitted.

> the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid Worse than that: it is effectively per day per shop. In a very short space of time I can buy two packs in Boots, two in Tesco, two in Sainsbury, ooh look another small Tesco I'll get two there as well, two from Savers, two from SuperDrug, …

And yet the policy appears to have been effective in reducing overdoses.

Based on what?

The US went with the educational route - any product containing acetaminophen has “CONTAIN ACETAMINOPHEN - DO NOT COMBINE WITH OTHER PRODUCTS CONTAINING ACETAMINOPHEN”

Overdoses went down despite the fact I can buy $1,000 tablets for $5 at Costco.

Re: The first non-opoid painkiller

#167

Post by OJFord »

DougN7 wrote: post #164
padjo wrote: post #124

Earlier quoted context omitted.

Given how common accidental paracetamol overdose is I think it’s perfectly reasonable.

I’ve never heard of this particular overdose. In the US it’s completely unmonitored and I’ve never heard of an overdose. I’m genuinely surprised.

It's unfortunately quite easy to do even inadvertently (not following dosage instructions) - doesn't take a lot.

The reason for the rule though was to combat its use in suicide attempts. They also have to be sold in blister packs here for the same reason, not the big bottles of Tylenol/Advil etc. that you get there (and we used to here) - relatively difficult to take several, requires more preparation than just chugging a bottle.

Re: The first non-opoid painkiller

#168

Post by refurb »

bigfudge wrote: post #100
stavros wrote: post #87

Earlier quoted context omitted.

True, but paracetamol overdoses are not a fun death. Granted, you need to take a massive amount, but still.

You don't need to take that much. LD50 is surprisingly close to the normal dose, and possible to do if you don't realise that cold remedies contain it (or that aminocetophen and paracetamol are the same thing!)

The LD50 is 10x the standard dose (5 g vs 0.5 g)

And the people that have serious toxicity at 5 g are likely already sensitive due to alcohol intake, malnutrition, etc.

For a healthy, well fed human who isn’t consuming alcohol the dose that causes serious issues is closer to 20x

Re: The first non-opoid painkiller

#169

Post by refurb »

hallway_monitor wrote: post #102
bigfudge wrote: post #100

Earlier quoted context omitted.

You don't need to take that much. LD50 is surprisingly close to the normal dose, and possible to do if you don't realise that cold remedies contain it (or that aminocetophen and paracetamol are the same thing!)

I avoid it at all costs because of the possibility of liver damage. Ibuprofen seems to have the same effect without potentially serious side effects.

Ibuprofen and other NSAID result in a ton of hospitalizations each year due to gastric bleeding.

Re: The first non-opoid painkiller

#170

Post by OJFord »

refurb wrote: post #166
xnorswap wrote: post #122

Earlier quoted context omitted.

And yet the policy appears to have been effective in reducing overdoses.

Based on what? The US went with the educational route - any product containing acetaminophen has “CONTAIN ACETAMINOPHEN - DO NOT COMBINE WITH OTHER PRODUCTS CONTAINING ACETAMINOPHEN” Overdoses went down despite the fact I can buy $1,000 tablets for $5 at Costco.

Based on studies⁰ that examined it.

The fact that another country had success with a different technique too doesn't mean it wasn't successful.

[0]: E.g. https://pubmed.ncbi.nlm.nih.gov/23393081/

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