Pain Medications

I am trying to find a way to tie my current frustration into today’s topic.  It is a bit of a stretch, but the only segue I can think of is that today’s parenting style can sometimes be a real pain.  I know that I should defer to the experts as I am no child psychologist.  This was very clear about five minutes ago when I tossed my incessantly complaining seven year old, fully snow suited into a kid-filled minivan on its way to a ski mountain.  I am not sure that she could have complained more nor could it have possibly taken longer to find suitable ski clothes, i.e. not too bunchy, crunchy, tight, loose, swollen – that was a new one – bendy, or itchy.)  Little ingrate.  When I had a snow day, I had to walk to school uphill both ways just to make sure that no one was there.  But that episode didn’t even cause my current new age parenting complaint.  That happened when I was watching a show with my five year old this morning and a group of normal appearing adults in a park broke into a song called the Potty Dance which apparently has real moves, like the Electric Slide, that all the cool moms and dads know.  I mean, come ON.  Is nothing sacred?  Have we as parents lost all self-respect?  The only thing that I can possibly think of that is worse than toilet training is being forced to sing and dance about it.  The very thought is giving me a headache which is why I am going to pop two Advil and segue smoothly into pain medications.

Not all pain meds are created equal.

1.  Acetaminophen (Tylenol) – When you are pregnant, you are told that regular strength tylenol is the only safe pain killer.  This is actually not true as Ibuprofen is safe up until your third trimester but in the ongoing attempt to keep the pregnant woman down, no one will tell you that.  Acetaminophen is a pain killer and fever reducer – that’s it.  It works for mild aches and pains.  It is metabolized – gotten rid of – by your liver and therefore can be toxic to the liver if taken in large quantities or in conjunction with liver disease.

2.  NSAIDs (pronounced en-said) – Non-steroidal anti-inflammatory drugs are, true to their name, very effective at decreasing inflammation.  Over the counter NSAIDs include Ibuprofen (Motrin, Advil), Naproxyn (Alleve).  They have the side effect of causing stomach ulcers if too much is taken as well as kidney damage, especially in those with pre-existing kidney disease.  They are useful for anything from headaches and fevers to arthritis and post-surgical pain.  You need a prescription for other brands like Toradol, Celebrex and Mobic.  Often, you may be instructed to take an NSAID on a schedule, like an antibiotic, in an effort to reduce inflammation and keep in down.

3.  Other non-Narcotics – there are other classes of drugs that are used successfully for the treatment of pain, especially chronic pain.  Certain anti-depressants, anti-seizure meds, muscle relaxants and anti-anxiety medications can lessen pain and are being used more and more because of the concern over addiction.

4. Narcotics – These are drugs that decrease the perception of pain and cause a state of euphoria.  While they are often very effective, people can build up a tolerance to them very quickly, requiring higher doses to produce the same effect.  Morphine is probably the most well-known.  Other prescription narcotics include Codeine, Oxycodone, Vicodin and Fentanyl.  Narcotics can be mixed with other medications to increase their potency, e.g. Percocet (oxycodone and acetaminophen), Tylenol No.3 (codeine and acetaminophen).  The biggest danger with these meds is addiction – think of the horrible waste that was Heath Ledger’s death.  It starts out as a treatment for real pain and ends up as a crutch for real life.

5.  Alcohol and illegal drugs – These are extremely effective at reducing both physical and mental pain.  You have heard the term self-medicating and if you read YesFive occasionally, I am sure you are wondering what kind of pain I must have to love wine as much as I do.  No pain – I assure you (other than being forced to watch grown men and women do the potty dance.)  If you or someone you love suffers with chronic pain or emotional pain, it is crucial that you are aware of the potential to misuse and abuse drugs -both prescription and illicit – and alcohol in an effort to dull the pain.

Your response to pain medication depends on a variety of factors and its effect on you may be very different from its effect on someone else.  Your addictive potential is also a very individual thing.  In general, take pain medications only when you are actually in pain.  But, if you are suffering from an injury or from a surgery, take what you have been prescribed.  The idea is to stop the pain from escalating so do not wait until you cannot take it anymore.  Don’t be a hero.  Even Superman needed a couple Percocet every now and then.

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  • Harry Bush

    Very good post. thanks for sharing such a nice information. According to my some research I find that Celebrex is nice drug for pain relief.

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  • Wdtracey

    you are posting incorrect information NSAIDS are metabolized by the liver.

    • Dr. Latimer

      Thank Wdtracey. You are right and I will adjust my text. When trying to reduce a fever in a child, I have often said the reason you can alternate motrin and tylenol to concerned parents is because it is metabolized differently. It is kind of a short cut to the facts that are harder to explain and need more background. In YesFive, I try to simplify as much as possible, for ease of reading and remembering. Tylenol has more risk of liver damage, Motrin to kidney damage because of different mechanisms of action. Technically, though, they are both metabolized by the liver. Thanks for the correction.

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