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

arstechnica.com

91–100 of 161 posts

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

#91
post #52

Earlier quoted context omitted.

> or a shot of whiskey would suffice Not sure if you said it in jest or not but alcohol is also highly addictive, prone to abuse, and harmful to your health and IMO would really not be a step in the right direction. edit: I almost added to my comment "It's almost taboo in our society to mention this fact" but didn't. I was almost immediately down voted so I guess maybe I'm not wrong...

I'd say it's extremely taboo to mention anything negative or even the possibility that alcohol is one of the most abused and disruptive drugs in our society.

People don't even like to call it a drug, which severely bothers me to be honest. I've tried some things and alcohol, from my perspective, is one of the more dangerous drugs around

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

#92
post #48

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.

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 for the weekend when I can just sleep it off or my only tasks are to go for a hike and get groceries though. Better than alcohol at least.

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

#93
post #89
post #77

Earlier quoted context omitted.

Drifting off-topic, but have you tried sumatriptan ("Imitrex")? It seems to have a near-total effectiveness on my ~monthly migraines. Neither acetaminophen nor NSAIDs ever did anything for my migraines. I agree that directly addressing underlying causes like stress, noise, sleep, and diet are better than a pill.

I was about to say the same thing - sumatriptan works amazingly well for my migraines. I'm in the UK though, and I seem to recall someone on HN saying it was very expensive in the US.

It might have once been expensive ("Imitrex" (R)(TM)) but there is a generic now. I understand there are also non-pill delivery systems, like nasal or patches, and other permutations that may still be under patent. The pills seem to work for me.

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

#94
post #19

All the commenters thus far seem to think they know more than a randomized clinical trial that was double blinded looking at oral (not IV morphine) combination doses of opioids like codeine, hydrocodone, and oxycodone with tylenol vs ibuprofen+acetaminophen (tylenol). Here's the actual study if you would like to read more... https://jamanetwork.com/journals/jama/article-abstract/26615... I'd like to note that their p…

Ok. I just think it’s important to remember that different people handle pain differently, and we shouldn’t end up refusing people something that helps them because an average in a study said it wouldn’t help. That does need to be weighed against the danger of addiction/dependence, though.

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

#95
post #66

The title of this link is frustrating and misleading. The article clarifies a bit, but I take issue with Ars linking to the specific study with text stating the methodology is the gold standard. That doesn’t mean the conclusion will hold up to scrutiny, or that “extremity pain” is a meaningful dimension. The type of injury (eg. compound fractures, sprains, etc.) could be more meaningful than where the injury is. Ther…

I was about ready to chime in the same thing. I've been on opiods for six years (not by simple choice). I'm also on a literal 15 other medicines. I take around 30+ pills a day I've had multiple back surguries. I've got on average 3 doctor visits a month (those co-pays add up fast!)... for six years. And this all started in my prime... at 25 years old where I went from starting a Ph.D program... to fighting with every ounce of my strength and mental fortitude to keep from being homeless.

I'm not sitting around, popping pills to get high. And, you can't magically get addicted to opoids if you never take increasing doses (read: follow the prescription). The longer you take them, the high rapidly goes away (drug addicts "chase" it by increasing doses) while the pain relief stays usable for a _much much_ longer period.

After six years, I've gone down on dosages slowly. The relief works fine. And I get zero high. It's like taking a Tylenol for me except it actually helps my pain.

Meanwhile, for 6 to 9 months when I lost my insurance I was stuck with over the counter medicine. I destroyed my gastrointestinal tract and almost my kidneys, just trying to take enough medicine to not commit suicide from the pain.

Are opoids being over perscribed? Yes. duh.

Does treating anyone who takes opoids into an addict, help anyone? NO.

People need to get off their high horses (ha, pun.) and realize pills are pills. You can argue for reduced perscriptions but the second you start villifing actual patients by telling them "you're pain isn't real. just take some Tylenol" you're now apart of the problem. You're not stopping a single person from getting high. You're just helping oppress people who are already so !@$!@ed up that they barely have the energy to keep going, let alone defend themselves from the public's armchair warrior researched lynching.

I've moved plenty of times. I've seen literally dozens of doctors. And almost every single one of them agreed with my diagnosis that I should be on this medicine. What makes you think reading a bloody internet magazine article about a single study makes you think you know better than the doctors who are trying to save my life?

So while yes, I think most people here are more reluctant to be as judgey--and I thank you for it--there are still plenty of people abusing sources to make their soap box point. They think opiods are automatically evil. They're not. They're the "right tool for the right job." end of story. And just because one research study says they're not useful for specific scenario, doesn't mean all scenarios are some secret conspiracy to get healthy people high.

I don't "want" to be an ANY of these medicines. Every single one is a potential liability. I have to keep them with me when I go places. I have to keep them safe from thieves (!!!) at home. I have to monitor how many each I take a day. At 25 years old, I had two 7 day pill counters just a 85 year old man. We don't _want_ to be on these medicines and deal with their side-effects upon side-effects. We're taking them because we have to and the other option is to simply roll over and die.

So forgive me if I sound emotional, when literally one of the tools that keep me alive, is being threatened by both conservative and democrats looking to grandstand to their constituents while nobody actually does anything to stop the abuser.

You can't imagine what it's like when you see someones face (nurse, doctor, police officer) completely change and withdraw the second they find out you're on an opoid. It's unreal. The entire room "goes cold." I dare you to try telling someone that. They stop talking to you and talk _at_ you. I've literally had a cop lie on a police report when he found out I take a medicine that I'm 100% legally prescribed. I've had receptionists not forward my calls to the doctor. I've had people scout out and follow me home.

All because I chose to put a pill in my mouth that a doctor told me to.

I could write an entire book on this stuff by now. I've considered building a YouTube channel about it. As a scientist, I can tell you, it's like walking into another world.

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

#96
post #48

Earlier quoted context omitted.

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

Cannabis has pretty awful side-effects for me. It gives me absolutely incredible nausea, to the point where I've tried it ~10 times in varying doses, thinking my dosage was an issue, and out of those I was violently ill 4 of the times. The other 6 times were simply unenjoyable. It doesn't just go away like alcohol either. If I drink too much and throw up, I feel better within a few minutes. For cannabis I remain high…

I never touched the stuff, but I would end up having to take my friend to the ER. For some reason at different times it would cause an allergic reaction and he would act like he was in septic shock and have dementia.

Doctors and I were convinced he was not telling the truth or his stuff was laced. Ended up that he was telling the truth and was clean other than pot. Sad thing was he would keep using pot which ended up messing with his health.

I never see why people care to be sedated emotional. Worst thing about pot to me. They miss out on so much emotionally.

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

#97
post #62
post #55

Those opioid doses are all super low, roughly equivalent to a single Tylenol 3. The alternative is a super high dose of acetaminophen. 1/4 your daily recommended maximum. At roughly 3x the acetaminophen + the fairly high dose ibuprofen I don't think there is anything really surprising about this. You couldn't take that acetaminophen dosage for more than 8 hours with 2 hour dosing without hitting your daily maximum. I…

These are standard doses of all these medications. Its the dose of tylenol often used in the hospital and wasn't dosed every 2 hours it was dosed once. For the opiates we either give 1 or 2 pills, here they gave 1. Perfectly reasonable.

OTC standard dose for regular strength Tylenol is 1-2 capsules x 325mg. They are giving the patients 1000mg or the equivalent of two extra strength pills (500mg). While both are 'standard' doses, I think the poster's point is that they're comparing 'regular strength' opiates (5mg of oxy/hydrocodone) with extra strength acetaminophen (1000mg acetaminophen). If they wanted a proper comparison, they should compare 7.5 or 10mg of oxy/hydrocodone with 1000mg of acetaminophen. Also, because the oxy/hydrocodone pills they test also contain acetaminophen you'd think they'd test the efficacy of oxy/hydrocodone by themselves as well, but apparently that didn't cross their minds. It definitely looks to me like the combinations tested were chosen so as to get a predetermined result.

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

#98
post #15
post #10

Yeah, look, I staggered into the ER with a shattered collar-bone and a shitload of missing skin, and 10 mg of oxy had me feeling pretty much FINE while a nurse took a coarse sponge to scrub the asphalt out of my wounds. Overprescribed, yes. Comparable to OTC? Absolutely fucking not. Claiming that ibuprofen is as effective as diluadid or morphine is completely disingenuous.

Acute pain from injury? Give me opioids. Post-surgical pain while in hospital? Opioids. Released from hospital? Opioids probably shouldn't be prescribed.

[deleted]

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

#99

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…

Took morphine for a back injury, I just got sleepy but still had the pain.

Took Percocet after a shoulder surgery, I just slept through the pain. I also understand now why people get addicted.

I get raging migraines, Excedrine is the only thing that works for that.

True story, when my daughter was in the hospital (cancer) we overheard a nurse and doctor discussing what to give a child (also with cancer) for tooth pain... "morphine". The nurse was like "for a tooth? can't we tell the mother to give him Tylenol?"

Also, true story Tylenol is not "formulaic" (I may be saying that wrong) at many hospitals. Meaning THEY DON'T KEEP IT IN THE PHARMACY (the one that fills orders for internal use). I was very surprised to learn this.

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

#100

I don't get the US stance on opioids. In Germany they are heavily regulated and can't be obtained without special prescription giving them an rather exclusive aura. No German doctor would prescribe them for headaches and people only really get them after serious surgery for a really short term. Advil (Ibuprofen) and Aspirin (ASS) are far more common here and used for pain management at a far broader extent than in th…

Your view looking into the US may be a little flawed, to be honest. Opioids are also regulated in the US. No one gets them for headaches. Doctors recommend Tylenol and Advil for most aches and pain. The times when my wife and I have received Opioids: broken ankles, back injuries from weight lifting, and after c-sections. I didn't receive them when I broke my collarbones (I've broken both, on separate occasions). > I…

I get fiorecet for migraines after the doctor tried me out on a few other preventative medications which either didn't work or had side effects like making me as sleepy as taking two Benadryl.

There as needed and I can go months between refilling the script sometimes but it's still for headaches

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