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Addiction - Best non-narcotic pain reliever?

Discussion in 'Opiates & Opioids' started by NeoGeo64, Nov 26, 2009.

  1. NeoGeo64

    NeoGeo64 Newbie

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    Just wondering what swiy's opinion is on the best NSAID pain relief product out there, when You is out of or cannot get access to narcotic pain relievers?

    SWIM's favorite is plain Tylenol. I am poor and found some old Tylenol caplets from 1991. The expiration date says April 1998. Would they be safe to take?
     
  2. Helene

    Helene Gold Member

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    In swim's opinion, non-opiate NSAID (non-steroidal anti-inflammatory drug) painkillers really don't compare to opiate based ones, when used alone in the context of genuine pain relief.

    When using opiate narcotics for pleasure-seeking, hedonistic purposes, we tend to overlook the importance of their discovery, the extraction of morphine and the further synthesis/ extraction of all the countless other opiate based drugs. In terms of the benefit they have given to so many people, by way of their pain relieving properties, opiates really are life saving drugs.

    This weekend, a couple of days after having a rather nasty wisdom tooth extraction that involved swim having some of the surrounding jawbone removed, I have been having some trouble trying to find an effective (and safe) level of adequate pain relief from opiate based meds. Of course, this difficulty is a direct result of swim's high opiate tolerance caused by her heroin habit. Yesterday swim phoned up the hospital and spoke to a maxillofacial surgeon, he told swim she had a dry socket, and to make an appointment with her GP for Monday morning when he'll sort her out with some tramadol.

    But until then she's really been having a hard time keeping the pain at bay; the prescribed codeine isn't working at all, and so she's been taking some morphine sulfate tabs which seem to be doing the trick, however she only has a limited supply of these. As a result, she's been trying various different NSAIDs in addition to the opiates, as swim's opiate tolerance won't have an effect on the efficacy of these. Swim's tried aspirin, paracetamol (acetaminophen) and ibuprofen, but the only NSAID she's found that really works in this situation is diclofenac (Volterol). When used in combination with opiates, strong NSAIDs really do seem to work to improve pain relief. Although when used alone, they're not gonna do much at all. Of course, I am talking about moderate to severe pain here, she's not suggesting people should take some morphine instead of aspirin, paracetamol or ibuprofen whenever they've got a headache.

    In the context of treating pain caused by chronic medical conditions, or acute post-operative pain, opiates (such as codeine, tramadol, morphine, oxycodone etc) are always going to be the main (and best) source of pain relief. But it should be kept in mind that, depending on the cause of pain, it can be very advantageous to use a NSAID concurrently. If the pain is as a result of any swelling or trauma, NSAID drugs such as diclofenac can work wonders. It must be remembered that, although brilliant at blocking pain, opiates don't actually treat the root cause of it. Strong NSAIDs such as diclofenac offer pain relief whilst also lessening swelling. So due to their anti-inflammatory properties, they're actually treating the cause of the pain, not just blocking the pain message in the brain and preventing you from feeling it.

    I feel the need to emphasise the fact that it's really not a good idea to start taking any non-OTC pain relieving medicines (for the purpose of pain relief) without first speaking to a doctor - especially if you have a genuinely serious health concern. Any ongoing pain means medical advice should be sought. Opiates are great at blocking pain, but you must remember that pain is there for a reason. And by blocking it you may be ignoring an important message your body is trying to tell you, i.e. that something is wrong with it, and medical attention is required.

    H
     
    Last edited: Feb 7, 2010
  3. Dr_Janus

    Dr_Janus Newbie

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    Not that it has been said, but I think it's important to clear up a common and popular misconception, just incase and swiys believe it.

    Tramadol IS a narcotic medicine.

    It has a naturally low affinity for the μ-opioid receptors and its M1 metabolite o-desmethyltramadol has a high affinity, 200x that of morphine.

    The sources for this are everywhere on the internet yet for some reason everyone is always posting "bla bla tramadol is an NSAID it's not a narcotic bla bla" which is absolute bull-crap.

    Please not that I amn't intimating that anyone has done that in this thread!! Quite the opposite, he was very interested. But wanted to take this opportunity to clear this up for other readers who hold this incorrect viewpoint.

    I would say that the best non-narcotic pain reliever would be Anadin Extra, a product we have here in the UK that contains aspirin, caffeine and paracetamol. Always works for minor/moderate pains for swim. I'm sure there are international equivalents.

    Good luck!
     
  4. OpiLuvnOldLady

    OpiLuvnOldLady Silver Member

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    SWIDrJanus would be correct. Trammadol is technically a narcotic. It's level is low enough though that it is not treated as a 'controlled substance' here in the states, as would be done with even a schedule III narcotic.

    As for the US equivalent of Anadin Extra, here it would be marketed under the name Excedrin.

    For SWIM the thing that she's found to be the most useful is what they call crosshatching. She will take a recommended dose of the Excedrin equivalent, 2 hours later she will take a recommended dose of ibuprofen, and then 2 hours after that she will take acetaminophen. If it's gone beyond that window and those are not helping at all, then she knows she's just stuck with whatever is hurting unless she chooses to medicate with something heavier.
     
  5. blink1989

    blink1989 Silver Member

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    SWIM sometimes gets Methylprednisolone IM injections to ease arthiritis pains, He says this works quite well.

    Its a Steroidal Anti inflammatory drug.
     
  6. Helene

    Helene Gold Member

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    It really is best to keep the use of steroids to a minimum (in terms of frequency and dosage), due to the serious side effects that occur with long term, high dosage use. Also, abrupt cessation after regular use of any steroids should always be avoided; when treatment is no longer necessary doses should be tapered down slowly under medical supervision.

    H
     
  7. slavka

    slavka Newbie

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    In the USA, my doctors have prescribed Ibuprofen and Naproxen to help with pain. These are OTC meds, but prescription doses are higher. I got an Ibuprofen rx recently after similar dental work. The dose was 800mg.

    Please be careful with Naproxen (alleve) since there is a decent risk of harm by taking too much over too short a time. Your doctor should be able to advise a proper dose.

    I would like to raise awareness to Metamizole which is formerly OTC in the USA but is still available in most countries. I found this to be a very effective pain reliever per the label directions on the OTC product (obtained in Russia as 'spazmalgon.') This may still be available for your doctor to rx.

    All of the medications I have mentioned are quite cheap.
     
  8. Helene

    Helene Gold Member

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    Some information on Metamizole, the risks associated with its use, and its subsequent banning in certain countries (from Wikipedia):
    H
     
  9. Tux27

    Tux27 Newbie

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    I believe that different NSAIDs work differently for different people. Acetaminophen, for example, works well for you, but doesn't do a damned thing for SWIM(I know it's not an NSAID).

    SWIM mostly alternates Naproxen and Ibuprofen. I was once prescribed Sulindac for pain(this was when his new doctor prescribed him vitamin B for pain instead of continuing the Vicodin he'd been successfully taking for years). He had never heard of it, and never found anyone else who had, but the pharmacist told him it's one of the strongest NSAIDs(and therefore shouldn't be taken within 24 hours of other NSAIDs). It didn't work for SWIM at all, but it must work for someone.
     
  10. Dr_Janus

    Dr_Janus Newbie

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    Certain NSAIDs work for swim but obviously it's very dependent upon the specific pain.

    Neuralgia = Ineffectual, swim prefers opioid pain relief

    Musculo-skeletal = Effectual, swim prefers NSAIDs (or in combo with opioids)
     
  11. RetroHousewife

    RetroHousewife Silver Member

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    SWIM's not up on all the best pain meds, but she has a few suggestions, and also a question.

    First, to the OP, I like to take 800mg of Ibuprofin every 6 hours, then 1000mg of Acetomenophen (Tylenol) in between. I hit on this combo after having some minor surgery done in my doctors office and that's what she suggested. I have a low pain tolerance and she offered to call me in something stronger if that didn't work, but it really surprised me and took care of the pain. For something stronger though, I don't know what to suggest. The only other NSAID I have seen prescribed around here is Naproxen (Naprosyn) and it's always upset my stomach. It's also OTC, like someone else suggested. I personally like aspirin for pain that's not too severe. I think its not used enough, what with all the things like Tylenol etc out there. At least for me anyway.

    Now, on to the second point. To youHelene, I've had quite a few dental problems and some extractions (4 wisdom teeth, 2 regular molars later on, and 4 teeth near the front when I got my braces on) and I remember the dentist suggesting that I get a regular tea bag, like Lipton's or Luzianne or Earl Gray I would imagine works good, as long as it's regular tea, wet it and put it on the socket and bite down on it. Of course it's not going to work like something prescribed, but it does help with the pain, and I've had a couple dry sockets before, and they hurt like hell! Do you have anything there that's a numby type gel you can get at the drugstore to go on it? I'm sure the pain is much deeper than that, but I think when you are hurting and stuck without a prescription, that you should use whatever's safe and available OTC like that. Maybe if you tried the numby stuff, then the tea bag, it might give a little relief together like that.

    The next point is about Tramadol. I heard of it when I had tennis elbow years ago. My doctor told me about it and said it was "like a NSAID but not an NSAID, and works on the same receptors that opiates do but not an opiate". I had always thought it was non narcotic. I know the nurse practitioner in my state can give prescriptions for it, and they can't give stronger things. Lately though, they have been cutting way back on prescribing it, as people have been abusing it a lot. When I took it before, she took more than the amount prescribed, but never felt anything from it at all, so maybe it effects other swimmers differently. I'm not trying to argue about if it is or isn't a narcotic, I believe you that it is, maybe the doc said that so as to discourage people from trying to abuse it or something. She was an Osteopath, if that makes any difference.

    Also, for certain types of pain, like for a broken bone, muscle pain, arthritis type pain etc, I've used DMSO (some kind of horse linament) and put a comfrey poultice on top of that. The DMSO is perfectly legal, as is the comfrey. Comfrey is an herb, and it's worked great for me, when I've used it topically. I believe it's pretty dangerous to take internally though, so I wouldn't reccommend it at all. Some people freak out about the DMSO, but you have to do some research on it and make sure your skin and hands etc are VERY CLEAN when you put it on the skin, so don't anybody just go buy it and slap it on ok? (Side note, when my midwife told me about it, we used it for my husbands knees. Old football injury. Anyway she said it's a carrier. It carries anything into the skin. She said back in the late 60s at protests, people used to fill up squirt guns with it and LSD and squirt it at the cops. It would make them trip even if they wiped it right off, so it's probably pretty good at being a carrier, so be careful using it. I'm NOT suggesting anybody try that with the squirt gun etc btw, not at all, just an interesting factoid she told me about)

    Also, for the OP, have you gotten any pain relief using homeopathic remidies? They have worked pretty good for me on several occasions. However, on other occasions, they just don't help squat.

    I used the first person in all this because it's all perfectly legal. If anyone wants me to edit it, please let me know.
     
    Last edited: Mar 5, 2010
  12. Textual Agenda

    Textual Agenda Newbie

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    SWIM suffers from degenerative disk syndrome which has required surgery twice and he's had dramatic effects with Orphenadrine(Norflex). It's technically an anticholingeric drug but can be used off labell for pain. Has great synergy with narcotics as well. I used to take 80mg of oxycodone a day for his condition, now SWIM can take 20-30mg oxycodone with 100mg Norflex and the relief is much greater than 80mg of oxycodone once gave. It has been SWIM's miracle drug as it's alleviated a lot of pain and need to take high doses of narcotics.
     
  13. Helene

    Helene Gold Member

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    Tramadol is definitely an opiate - it is a mu opioid agonist, but it also inhibits the reuptake of norepinephrine and serotonin. Due to its action on the mu opioid receptors, it has the potential to cause addiction, withdrawal and overdose, in the same way that other opiates do. In terms of its opiate action, tramadol is about 1.5 times stronger than codeine.

    H
     
  14. Synchronium

    Synchronium Palladium Member

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    Various channel blockers might be useful, depending on the type of pain.

    Gabapentin, (likely a voltage gated Ca2+ chan blocker) is useful in neuropathic pain.

    I think Carbamazepine (voltage gated Na+ chan blocker) may also be useful for trigeminal neuralgia.
     
  15. JaWill88

    JaWill88 Titanium Member

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    in swims opinion the absolute best non narcotic pain reliever is pregabalin (Lyrica). i know its' not NSAID but it is absolutely incredible!!
     
  16. Pieces Mended

    Pieces Mended Silver Member

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    What has You taken Lyrica for? Are there any effects besides pure pain relief?

    Honestly, it depends what you are taking the medication for. Muscle relaxers are actually very underrated, but also rarely used because everyone and their brother abuses things like Soma. Robaxin is a very good drug for back/muscle pain with hardly any noticeable side effects and no abuse potential.

    Tramadol is good, but there are too many people with bad experiences for SWIM to say it's something everyone should consider as a "go-to" plan. Honestly, Vicodin has fewer issues and may even be abused less. If you know your doctor isn't refilling your 30 Hydrocodone pills, you're far less likely to be liberal with use than if you know he'll give you limitless Tramadol.