Armed Polite Society
Main Forums => The Roundtable => Topic started by: MillCreek on November 08, 2017, 07:15:51 PM
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https://jamanetwork.com/journals/jama/article-abstract/2661581
http://www.latimes.com/science/sciencenow/la-sci-sn-pain-opioids-ibuprofen-20171107-story.html
This is a major finding: 400 mg ibuprofen (Advil) and 1000 mg. acetaminophen (Tylenol) combined was just as good for pain relief for injuries as are narcotic pain meds in the ER. I have got to remember this the next time my left hip acts up.
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That's very interesting. Having only a layperson's knowledge, I had always assumed, whether wives tale or just obsolete data, you never mix together something like Advil and Tylenol.
I'm going to make note of this though. I wonder if they have done, or are going to do any longer term studies regarding how long you can be on that regime. I'll certainly consider it for the one off pulled back, etc. where I would just want a couple of doses to get through the first day or so.
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Something similar to this came up a year or so ago here regarding back pain. I put the protocol described in the article to the test and it really helped my back long-term.
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I find that 750mg Naproxin (OTC Aleve)works really well for swmbo and I for a variety of aches and pains.
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Having been through shoulder surgery, sometimes you need the opioid for a short term.
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This is some potentially good stuff. However, aren't there worries about kidney problems with long term and/or high dosages with some of the NSAIDs?
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Having been through shoulder surgery, sometimes you need the opioid for a short term.
I'll 2nd that.
With a probable hip replacement in my near future I can absolutely confirm that Tylenol and/or other OTC NSAIDS don't do much for my arthritis pain in my hip. When it gets bad enough that it keeps me awake Tramadol knocks enough of the edge off to let me sleep some. The side effects can be a pain in the ass though. OIC can be a bitch.
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I find that 750mg Naproxin (OTC Aleve)works really well for swmbo and I for a variety of aches and pains.
Naproxen Sodium is my absolute 100% go to for just about all aches and pains. It's far more effective for me than Tylenol, and more effective than ibuprofen.
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This is some potentially good stuff. However, aren't there worries about kidney problems with long term and/or high dosages with some of the NSAIDs?
Yes, many of the NSAIDs can be hard on the kidneys.
But, a Tylenol overdose, or taking it with alcohol, and literally destroy your liver to the point where the only alternatives are a transplant or getting your will in order really quickly.
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What do you know! The medics were RIGHT!
(https://undertheradar.military.com/wp-content/uploads/2016/03/Devil-Dog-Nation-Motrin-poster-funny-military-memes-518x768.jpg)
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This is some potentially good stuff. However, aren't there worries about kidney problems with long term and/or high dosages with some of the NSAIDs?
It is important to note that the study looked at a single dose of meds in the ER setting and looked at pain relief two hours after the dose. You would not want to take this dose on an ongoing basis without checking with your medical provider first. Chronic high doses of ibuprofen and acetaminophen can do bad things to various organ systems.
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That's very interesting. Having only a layperson's knowledge, I had always assumed, whether wives tale or just obsolete data, you never mix together something like Advil and Tylenol.
I'm going to make note of this though. I wonder if they have done, or are going to do any longer term studies regarding how long you can be on that regime. I'll certainly consider it for the one off pulled back, etc. where I would just want a couple of doses to get through the first day or so.
I was always told not to mix them so you could alternate doses.
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It is important to note that the study looked at a single dose of meds in the ER setting and looked at pain relief two hours after the dose. You would not want to take this dose on an ongoing basis without checking with your medical provider first. Chronic high doses of ibuprofen and acetaminophen can do bad things to various organ systems.
Vs. opioid addiction?
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Vs. opioid addiction?
Interestingly enough, chronic opioids can be 'safer' from the long-term organ damage standpoint, especially if you are taking opioids that do not have acetaminophen in them. But you have to balance that against the respiratory depression and overdose leading to death potential of opioids.
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"But you have to balance that against the respiratory depression and overdose leading to death potential of opioids."
Not to mention chronic and often severe constipation.
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I avoid opioids as much as possible. However, with Factor V Leiden if I have surgery I can't take any NSAIDs (besides Tylenol) due them also being blood thinners and post surgery I'd also be on Lovenox. And, for me, Tylenol (at doses that can be safely taken) doesn't touch pain, even mild pain like a pulled muscle, or sore joint, or headache. But I'm also allergic to most opioids I've ever tried. So I'm kind of screwed if I need major pain relief like from a surgery.
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I will say Advil does as well as Tramadol did when I get a plantar fasciitis flare up. To bad I can't take it anymore due to it screwing severely with my blood pressure. And I did not like what Tramadol did to me.
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I take 800mg Ibuprofen and 1000mg Tylenol up to twice a day for my pain. If that doesn't cut it, I start stacking on 5mg Hydrocodone.
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Yes, many of the NSAIDs can be hard on the kidneys.
But, a Tylenol overdose, or taking it with alcohol, and literally destroy your liver to the point where the only alternatives are a transplant or getting your will in order really quickly.
Tylenol and liver damage, that's the problem I was trying to recall. I wonder if Tylenol helps memory function?
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This one hits close to home.
Dr. is in trouble for dealing pills.
He fixed my shoulder in 2009 when I blew out a tendon.
http://www.newson6.com/story/36751991/claremore-doctor-under-investigation-for-obtaining-pain-killers-by-fraud (http://www.newson6.com/story/36751991/claremore-doctor-under-investigation-for-obtaining-pain-killers-by-fraud)
I know addiction can be a serious bitch but damn, you'd think a freaking doctor would know he won't be able to get away with it for long.
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I was always told not to mix them so you could alternate doses.
I have been told by multiple docs to take both ibuprofen and acetaminophen at the same time, starting with my knee surgery a decade ago.
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I know addiction can be a serious bitch but damn, you'd think a freaking doctor would know he won't be able to get away with it for long.
That's the problem with addiction, you lose rationality.
Oh, and from the article, we can see the march of civil asset forfeiture: "They said they also seized Thomas’ Jeep, saying it was used to transport the pills."
Forfeiture of assets should require conviction in court. They shouldn't be grabbing random assets just because they say it happened to be used for something.
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This one hits close to home.
Dr. is in trouble for dealing pills.
He fixed my shoulder in 2009 when I blew out a tendon.
http://www.newson6.com/story/36751991/claremore-doctor-under-investigation-for-obtaining-pain-killers-by-fraud (http://www.newson6.com/story/36751991/claremore-doctor-under-investigation-for-obtaining-pain-killers-by-fraud)
I know addiction can be a serious bitch but damn, you'd think a freaking doctor would know he won't be able to get away with it for long.
I was surprised by how often we came across doctors and nurses as buyers (and occasional dealers) when I was with the drug task force. For a lot, though, a little chronic pain and readily available meds made for a bad start...
Personally, when I broke my arm back in 2007 (open compound fracture of radius and ulna, two plates and 15 screws to repair), I started on a morphine pump (I asked for it to be removed the day after surgery), switched to oxycodone pills (which gave me nightmares so bad I refused the second dose), then a bottle of 50 Tylenol 4 (Tylonol with codeine) pills. I took one the first day, and one after my first PT session. Switched to Advil. Did 800 mgs 3 times a day.
A nurse working with me while I was post-op for my arm gave some advice...the longer I used the opiods, the harder it would be to stop using them. I listened.
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I was worried about the Codone I was taking and the Methadone, even though it was a low dose of the Methadone. I finally withdrew from Pain Management and got to where I take a 5mg hydrocodone pill or two if I just HAVE to and I don't do that regularly or often. I built up a large tolerance for codone/pain meds and had a surprisingly easy time getting off of a steady diet of them and I know that is the exception to the rule. These days I do the 800MG Ibuprofen/1000MG Tylenol cocktail and only when that doesn't do the trick do I start into the Hydrocodone.
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".the longer I used the opiods, the harder it would be to stop using them. "
Yeppers. Addiction starts early.
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For the last 9 years or so I've been taking 30mg of morphine up to 5 times per day. There have been times when I could go a day or two without taking any, or just one or two. No problems.
Those times are getting farther apart now though. Not that "I have to have my pills", it's getting to the point where I can barely stand upright. Even with that I still rarely take more than 3 per day,
And, thanks to the "opioid epidemic", my insurance company has decided they'll only cover ~ 3/5 of the doc's prescriptions for both DW & myself.
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^^^You are taking up to 150 MED (morphine equivalent dose) per day. Under our state guidelines, we would be asked to get you to 120 MED or below, with an eye towards eventually getting you to 90 MED or below. 90 MED per day as an upper limit for chronic non-cancer pain is becoming the new standard. To keep you above 120 MED, we have to show that we obtained a pain management consult, the pain consult agreed with the higher MED, that we tried various non-drug treatment options, and we have to certify that you still need that higher level. And we don't get paid for all of this various paperwork, etc.
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I can't imagine your pain level bud. I hurt but taking that much would have even ME on my @sk! In MY case, I can sit in my recliner and do nothing but use this notebook and life is bearable. Getting out of it and doing ANYTHING greatly reduces my comfort level and the pain takes off on an exponential journey up. I DID get a powered scooter coming from the VA last week and that will help when I have to go out/to the VA.
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Been dealing with this for decades. Many, many doctors in 3 different states; accupunture, physical therapy, chiropractors, stretches, cordizone injections, etc. etc. etc. Sometimes it's bad, knife stuck in the low back kind of bad, but gotta do what needs to be done. If things go as planned (yeah, right) I'll be able to retire in 6 or so years.
What's pissing me off is that both DW & I are getting caught up in the "fight" against the "epidemic".
And we don't get paid for all of this various paperwork, etc.
That sucks. One should be reimbursed for work performed. You don't bill for office visit(s) or outpatient treatment?
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".the longer I used the opiods, the harder it would be to stop using them. "
Yeppers. Addiction starts early.
I think it depends upon the person. I've had friends with back issues on opioids for years, finally get a surgery that works and they go off of the opioids with no problem.
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for a number of years, I was taking Tramadol or norco 10/325 for my severe osteoarthritis hip pain. Never had an addiction issue, but I'd rather not take 'em. Doing some research on my own, and enlisting two friends with PharmD degrees, and talking to some friends that were PhD in Pharmaceutical Chemistry, I found that a combination of Tylenol and an NSAID such as Motrin, would do the same job as the oxycodone tabs. Nothing new in the cited reports.
My Cardio doc hates me taking NSAID, and preferred me to stay on the Norco tabs. Since I had my hip replaced though, I don't take any of that stuff these days.
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I think it depends upon the person. I've had friends with back issues on opioids for years, finally get a surgery that works and they go off of the opioids with no problem.
It really does depend on the individual. Measurements of 'addictiveness' are population measurements. It's why you get people addicted to non-chemical things like gambling all the way to somebody who used Heroin for decades and then just stopped.
Where this gets annoying is the people who have a high resistance to addiction, at least the things they've encountered in their life, thinking that it is, or should be, that easy for everybody.
I'd rather view it a bit like cancer. Some people get cancers that are relatively benign. My grandfather's colon cancer that, well, he was going to die of something else before that was hazardous. Dad's skin cancer needed treatment, but relatively straightforward. Grandmother's lung cancer? That one was lethal.
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It really does depend on the individual. Measurements of 'addictiveness' are population measurements. It's why you get people addicted to non-chemical things like gambling all the way to somebody who used Heroin for decades and then just stopped.
I know of a lot sober alcoholics and drug users that use religion as their addiction now.
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If you want to keep a sober alcoholic happy, buy him/her a bag of chocolate kisses. ;)
bob
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If you want to keep a sober alcoholic happy, buy him/her a bag of chocolate kisses. ;)
I'm a sober alcoholic, but a bag of chocolate makes me happy anyways.
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Several years ago, when Bill Buckley was still alive, The National Review dedicated an entire issue on the War on Drugs. One of the bits that stood out in all of the articles that the magazine contained that month was about opioids. The gist of the article was the vast majority of people who took opioids for a particular reason, when that reason went away, nearly 100% of them stopped taking opioids. There will be addicts and addicts will be addicted. But it seems that the notion is that those who need a thing for a reason, should be denied that thing because a few will abuse it. I think that's stupidity and herd mentality of the highest order. I once had a fellow ask me if I had ever tried cocaine. I said no, but that I was curious about it. He said "Don't do it." I said "Why". He said "Because you'll like it." That, ladies and gentlemen, scared the crap out of me because I know me. If I like something, I tend to overindulge. I never tried it and I'm eternally grateful for the advice. Now chocolate....that's another matter.
I have been suspicious of this whole Opioid Epidemic since the day, all of a sudden, out of the blue, we were told we had an epidemic. I have never come to understand why this so called epidemic dropped out of the sky one day. There must be some reason. I sure don't know what.
I've come to the conclusion that nothing that is in the MSM, radio, print, TV, or even the internet is trustworthy. Maybe it's just because I'm 74 and have learned that being cynical and untrusting is more comforting and contentful than to be all caught up in each new phony catastrophe that presents itself each day. It seems that we are being fed nothing but negativism on a grand scale, so I've decided to not partake or participate.
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face it. A whole lot of folks like to get stoned, drunk or otherwise alter their reality. The 'addiction' thing is not really a factor in their decisions. That their life style choices sometimes go awry, does not make me feel sorry for 'em.
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I am terrified of opiates. I know there's history of addictions in my family, and I've seen what they can do.
I have VERY rarely had pain bad enough for them, and even when it is, I avoid them unless the pain is unbearable. As soon as is practical I switch to motrin. THen I usually turn in to the pharmacy a nearly unused bottle of them.
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See, I don't like to be drunk/stoned. I'm way too Type-A "must be in control of myself" for that. I come from a family tree full of alcoholics. My wife is a sober alcoholic. Why I have such a low tolerance for alcohol and such a high tolerance for codone, I'll never know!
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for a number of years, I was taking Tramadol or norco 10/325 for my severe osteoarthritis hip pain. Never had an addiction issue, but I'd rather not take 'em. Doing some research on my own, and enlisting two friends with PharmD degrees, and talking to some friends that were PhD in Pharmaceutical Chemistry, I found that a combination of Tylenol and an NSAID such as Motrin, would do the same job as the oxycodone tabs. Nothing new in the cited reports.
My Cardio doc hates me taking NSAID, and preferred me to stay on the Norco tabs. Since I had my hip replaced though, I don't take any of that stuff these days.
I'm curious as to why you haven't gone the hip replacement route?
I get that it is a major surgery with all the inherent risks.
My position is that this OA in my hip has already "stolen" a couple of years from me being able to do things I want to do. I know it won't get better, it will only get increasingly worse.
Today marked the first time I had to get my wife to pull my sock on to my right foot, also the 2nd time she had to trim my toenails on that side.
I'm more than ready to face a hip replacement surgery
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I am terrified of opiates. I know there's history of addictions in my family, and I've seen what they can do.
I have VERY rarely had pain bad enough for them, and even when it is, I avoid them unless the pain is unbearable. As soon as is practical I switch to motrin. THen I usually turn in to the pharmacy a nearly unused bottle of them.
I don't understand the recreational aspects of opioids. When I need them I use them. But I don't like what they do to me, never mind the rashes. The Dilaudid wasn't too bad. I got to sleep with that stuff and go decent pain relief. But to the extent I get "high" on them I just feel like I'm incoherent, and it's nothing remotely pleasant. Due to the side effects/allergies I prefer NSAIDs when the pain is within the limits of what they can handle. I have scads of leftover opioids in the pantry. Probably should take them to a disposal site so little fingers don't find them.
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I don't understand the recreational aspects of opioids. When I need them I use them. But I don't like what they do to me, never mind the rashes. The Dilaudid wasn't too bad. I got to sleep with that stuff and go decent pain relief. But to the extent I get "high" on them I just feel like I'm incoherent, and it's nothing remotely pleasant. Due to the side effects/allergies I prefer NSAIDs when the pain is within the limits of what they can handle. I have scads of leftover opioids in the pantry. Probably should take them to a disposal site so little fingers don't find them.
ive never understood recreational use either. I don't do well with them. They make me sick . When I have had them, I usually break them in half.
I wonder what they do with the ones I returned
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I wonder what they do with the ones I returned
The returned drugs get shipped to a disposal facility and are incinerated.
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The returned drugs get shipped to a disposal facility and are incinerated.
...he said defensively. You don't have to lie to us, MillCreek. We know why your office holiday parties are so lit.
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Can't remember exactly where it happened, but here on the East coast somewhere a police lieutenant was recently arrested for stealing opiates out of the turn in box and from the evidence locker.
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I don't understand the recreational aspects of opioids. When I need them I use them. But I don't like what they do to me, never mind the rashes. The Dilaudid wasn't too bad. I got to sleep with that stuff and go decent pain relief. But to the extent I get "high" on them I just feel like I'm incoherent, and it's nothing remotely pleasant. Due to the side effects/allergies I prefer NSAIDs when the pain is within the limits of what they can handle. I have scads of leftover opioids in the pantry. Probably should take them to a disposal site so little fingers don't find them.
The 8 days I was on Oxycotin after shoulder surgery, I was mentally so happy with I could care less attitude from the drugs. Kind of like being euphorically buzzed for the week. You could of killed my wife in front of me, I would have noticed but I wouldn't of cared at the time.
I totally see why people can get addicted to that feeling.
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...he said defensively. You don't have to lie to us, MillCreek. We know why your office holiday parties are so lit.
Oh, how I wish. With Viagra as the party favors.
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Oh, how I wish. With Viagra as the party favors.
I guess that would depend on which side of the equation you are on....
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I guess that would depend on which side of the equation you are on....
Nah, it's the Seattle area, it doesn't matter to them. ;) >:D
bob
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Nah, it's the Seattle area, it doesn't matter to them. ;) >:D
bob
they all use the same bathroom?
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they all use the same bathroom?
It is like going to the nudist beach: the people that you see nude are not the people that you want to see nude.
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It is like going to the nudist beach: the people that you see nude are not the people that you want to see nude.
It's like that everywhere outside the college years.