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83 Comments
- diggB, on 07/03/2009, -2/+14PILLZ HERE!
- inyearstocome, on 07/03/2009, -1/+11THC is still the safest pain reliever we have. Big Pharma is well aware of this, why do you think they lobby to keep it illegal? It would be havoc for them if the best pain reliever could be grown naturally in your own home and easily added to food.
- SpykerSpeed, on 07/03/2009, -1/+11Marijuana's still safe.
- enthreeoh, on 07/03/2009, -0/+7"I also wouldn't be surprised if oxycodone in low doses (like 5mg) becomes available over the counter for those over 18."
How do you even come to that conclusion? - elliotys, on 07/03/2009, -1/+8I think it is good this is becoming public knowledge. I have counceled thousands of patients on vicoden and percocet at my pharmacy, and have seen a complete lack of understanding when it comes to the dangers of the drugs. The opioids in the drugs themselves are relatively harmless, and the reason the doctors/pharmacist tell you not to take too much, or to not drink with them is because of the APAP content (drinking and APAP can really rain hell on your liver). In fact the APAP was put in there primarily as a way to limit the amount of pills a patient could take in a day, and secondarily as an analgesic. Thats why many times, for chronic pain patients who require larger amounts of opioids due to tolerance, instead of increasing the doses of opioids in the pills they simply decrease the amount of APAP in them.
- NoQuarter, on 07/03/2009, -0/+6Paracetamol (or acetaminophen) is a very valuable drug and its use is justified in just about every patient in pain. That said, it's very strange the way that the US has such high use of combination products such as vicodin.
In the UK, the only combination products we really see are with codeine or dihydrocodeine (both weak opioids, available over the counter in combination with paracetamol) and even those are heavily discouraged (for a variety of reasons - for one thing it means that the patient has to take an opioid and experience all of the side effects of these even if they only need the paracetamol to control the pain that day). Stronger opioids such as morphine, oxycodone and fentanyl are only used on their own in tablets, modified release preparations, patches or injectables. The doses of these can easily be titrated to effective doses without worrying about patients experiencing paracetamol toxicity because they took a little bit extra because they felt they needed to.
I'm not sure the reason behind this. It's possible that our regulatory agencies have ensured these products never made it over here which is probably perfectly justifiable. - SmokenJoe, on 07/03/2009, -0/+6acetaminophen is actually one of the more dangerous drugs available in large part due to marketing. I absolutely support removing mixed pills better hospitals have already started doing this. The risk for a acetaminophen OD is just too great and too easy to do accidentally even in the hospital. Also note that alcohol can have a serious impact on toxicity even a small dose well in the recommended dose of Tylenol with alcohol intake can kill your liver and you with it. I see a far more deaths from Tylenol OD than narcotic OD though ware I work may impact this. The FDA seems to really be underestimating the risk if this article is true. Read up before taking more than 4 grams a day 2 if you drink or simply avoid it like many nurses and doctors.
I just dont understand some of the drug recommendations are made it seems to have little to do with the real dangers. - Jeepinator, on 07/03/2009, -0/+6Grabbin' Peels!
- inactive, on 07/03/2009, -2/+8It's only fun if you are abusing it, because you're using it for recreation. If you're in a lot of pain, no painkiller is particularly fun, they just dull the pain a bit.
- tylerdurden09, on 07/03/2009, -4/+10Here's an interesting fact:
There have been 120 total deaths in the U.S. due to oxycodone overdose.
9,000 overdose deaths every year due to overdose from NSAID pain relievers.
Funny that the actual narcotic has killed less people...probably because it's stronger in lower doses and binds to opioid receptors in the brain, instead of inhibiting COX-1,2,3 (cyclooxygenase), which is found in almost every kind of tissue in the human body, which is primarily why liver damage takes place with acetimenophen.
"The classical COX inhibitors are not selective and inhibit all types of COX, and cause peptic ulceration and dyspepsia. It is believed that such lack of selectivity is caused by the "dual-insult" of NSAIDs - direct irritation of the gastric mucosa (many NSAIDs are acids), and inhibition of prostaglandin synthesis by COX-1. Prostaglandins have a protective role in the gastrointestinal tract, preventing acid-insult to the mucosa."
"selective COX-2 inhibitors are associated with a moderately increased risk of vascular events, mainly due to a twofold increased risk of myocardial infarction, and also that high dose regimens of some traditional NSAIDs such as diclofenac and ibuprofen are associated with a similar increase in risk of vascular events."
I wouldn't be surprised if they completely eliminate combination drugs like vicodin and percocet, and instead prescribe strictly different doses of oxycodone to patients with chronic pain.
I also wouldn't be surprised if oxycodone in low doses (like 5mg) becomes available over the counter for those over 18. - Niocan, on 07/03/2009, -0/+5Actually cannabis has a symbiotic affect with opioids as they both attach themselves to the same set of receptors. Using them together, will let you fell less pain *and* less side effects because you can use less [Opioid-based medicine]. The more you know ;)
http://biopsychiatry.com/canopinoc.htm - PM08, on 07/03/2009, -1/+5It would also help if consumers would actually take the time to know what they are taking and read the labels on any OTC items they are purchasing. But I guess that would be too much to ask, and now products will be taken off the market because people are too stupid and lazy.
- AbominableHoman, on 07/03/2009, -0/+4I definitely didn't request that be a part of the procedure -- didn't know I had an option.
The doctor is respected and was referred by friend and family, I hope he took it upon himself. Toxic hole probably isn't as fun as it sounds. - crit1caL, on 07/03/2009, -0/+4...waiting.
- Spire3660, on 07/03/2009, -0/+4IF we havent had OTC opiates by now, we probably arent going to see them anytime soon. Hell you cant even buy more then 3 packs of allergy medicine of w/e it is they make meth out of now.
- billpilgrim, on 07/04/2009, -1/+5generic comment in favor of legalizing pot
now digg me up - Ellipsys, on 07/03/2009, -0/+4Its strange that percodan isn't prescribed as much as it used to be, or even "straight" oxycodone or hydrocodone. APAP, due to the fact that it poses no immediate stomach problems has become so popular. There seems to be a bias against the (relatively harmless) opiates and opioids these day, and it really hurts patients. Unfortunately, pure preparations, especially long duration ones like Oxycontin are expensive (Oxycontin SHOULD be generic now, but they patent trolled and won more years of exclusivity. Read up on it) and stuff like MS-Contin or Opana, even though cheap and extremely effective, are really only prescribed for serious chronic pain conditions under the guidance of a pain control specialist. While I don't dispute that the "higher tier" narcotics should be limited use, when you have people popping two percocets or vicodins every 4 hours, it can really wreak havoc on the liver .
- dukeeeey, on 07/03/2009, -2/+5"The thing that bugs me is that the people think the FDA is protecting them. It isn’t. What the FDA is doing and what the public thinks it’s doing are as different as night and day." -Dr Ley former Commissioner of the FDA.
oh yeah, have fun consuming aspartame - Spire3660, on 07/03/2009, -0/+3Its funny that you have the 'using drugs recreationally is bad' mantra working against you. Using opiates to get an occasional high is ok, as long as you keep your head on your shoulders.
- crit1caL, on 07/03/2009, -3/+6TRY CANNABIS!
/mays - Jeepinator, on 07/03/2009, -1/+4The wording of the information on that site is appalling. They use words like "inadequate" to describe someone's shorter eyelashes. Since when are eyelashes even necessary to live?
- joshmoney, on 07/03/2009, -2/+5***** you, two of my friends died from inadequate eyelashes!
- inactive, on 07/04/2009, -0/+2Ideally, I think patients should be better informed and have a choice.
That said, I've never understood the combining of the two. Chances are if the pain bad enough to require opioids, Tylenol isn't going to help any. I've had trouble with chronic pain and when I began to need painkillers on a regular basis, I had my doctor switch me to ones that didn't contain Tylenol precisely because of the potential for liver damage. I also began taking N-Acetyl Cysteine, a special anti-oxidant that helps the liver break down complex chemicals.
FYI: I'm not health freak or anything-far from it-but taking Tylenol for a hangover is a terrible idea. When combined with alcohol, it becomes really, really toxic. - inactive, on 07/04/2009, -0/+2Damn near every drug has warnings about liver damage, so people don't understand which drugs are more harmful than others,
Also, Tylenol is a very popular, very familiar OTC, and so people simply underestimate it's potential for harm. - ewicki, on 07/04/2009, -0/+2You actually believe what you're saying? "Big Pharma" isn't evil. Pharmaceutical companies develop medications to save lives. Example: AstraZeneca develops a drug that I need to take in order to remain in good health.
Oh, and they're so greedy that they send me a 3 month's supply of the drug at a time free of charge because I qualify for one of their many patient-assistance programs. - misterhat, on 07/04/2009, -0/+2my guess is that he improperly self diagnosed his occasional headache as a migrane
- Phoenix99, on 07/03/2009, -0/+2From personal experience, I can say, acetaminophen does jack ***** for me. Tylenol doesn't work for me, etc..etc. Now what works for me is a nice does of ibuprofen. That works wonders. But hey, I'm a different person, different chemistry, biology, and so on. So what works for me may not work for others. They should have vicodin, percocets, etc with either acetaminophen or ibuprofen mixed in, your personal doc should know which one to prescribe you to. It should be a choice not a complete ban of one.
- Czaja, on 07/03/2009, -0/+2Source(s) please.
- misterhat, on 07/04/2009, -0/+2"There have been 120 total deaths in the U.S. due to oxycodone overdose.
9,000 overdose deaths every year due to overdose from NSAID pain relievers.
Funny that the actual narcotic has killed less people...probably because it's stronger in lower doses and binds to opioid receptors in the brain, instead of inhibiting COX-1,2,3 (cyclooxygenase), which is found in almost every kind of tissue in the human body, which is primarily why liver damage takes place with acetimenophen."
You can't draw the conclusion that oxycodone is safer than NSAIDS because of pure numbers alone. The fact that NSAIDS are available over the counter and oxycodone requires a doctors prescription. That alone should account for the difference. - dukeeeey, on 07/03/2009, -0/+2did you ask the dentist to remove the periodontal ligaments when he removed your wisdom teeth ?
if they aren't removed the top of the hole will just heal over but the bone wont regenerate underneath, leaving you with literally a toxic hole in your jawbone.
http://www.nvbt.nl/hot-cvs.html - mockupscaledown, on 07/03/2009, -0/+2If one paracetamol gets rid of your migraines, you're either the luckiest migraine sufferer in the world, or you're taking a pill the size of a pringles can.
- Spire3660, on 07/03/2009, -0/+2Yeah I saw that advert. I think it should be illegal once again to advertise prescription drugs on TV. Your doctor should be suggesting medicines, not a markedroid.
- bagelmaster, on 07/03/2009, -1/+3You're a ***** moron. Good grammar/spelling has nothing to do with how intelligent a person may be. 1) This is the internet, no one gives a *****. 2) Some people are really good at sciences and math, understanding the concepts completely. But those same people may not give a ***** about grammar or writing. Does that make them stupid in your eyes?
- Harbinger67, on 07/03/2009, -0/+2@inactive
...that's exactly what abusing a drug is; using it for recreational instead of medical purposes. You may have your own definition, but you perfectly described what drug abuse is as defined by virtually everyone else + the government + doctors. - abadonn, on 07/03/2009, -0/+2Its save as long as you don't pop them like candy. Just don't be an idiot about it and don't take pain killers for every little headache.
- ipushmycar, on 07/03/2009, -0/+2I hate vans
- daronicus, on 07/03/2009, -0/+2Also, you're confusing the issue at hand. Acetaminophen is not an NSAID, so the death count for that drug type is irrelevant, because they're not talking about ibuprofen-combination drugs.
- Beylan, on 07/03/2009, -1/+3"That said, it's very strange the way that the US has such high use of combination products such as vicodin."
Its a patent issue. The patent on drugs expire in 20 years.
So you invent a new painkiller. You patent it immediately. 7 years later you get FDA approval to sell it. That leaves you 13 years to sell it at high cost before the generics start taking all your profit. But there is a technicality in the patent law that says that if you combine 2 or more drugs together they magically become an entirely new drug and can be granted a new 20 year patent.
So when your 20 years starts to run out you combine it with tylenol and suddenly you get another 20 years patent/profit on your drug.
They use acetaminophen because it is cheap and plentiful an easy to include (virtually no change of cross reactions) while still being a drug under the eyes of the patent office and the FDA. - anonymousmedic, on 07/03/2009, -0/+2Your post is bad and you should feel bad.
- cornstarch5, on 07/03/2009, -0/+2Doing away with acetaminophen-containing pain medication, or at least cutting back on the amount of prescription painkillers containing it, would curb a serious health issue that I have personally seen many people have to deal with.
Opiate addiction is a terrible thing, but the fact of the matter is that there are a lot of people addicted to prescription pain medication. Many of the people addicted to these pills are not aware of the dangers of continued, high doses of acetaminophen and other NSAIDs. Still, many are, but choose to abuse these medications anyway. What 10-20 Lortabs/Percocets a day can do to a liver is... frightening.
Since opiate addiction is a reality, and that there are going to be people getting high... regardless of the risk factors involved, I think that cutting back on the number of prescription opiate-NSAIDS would be an excellent way to reduce the number of deaths caused by opiate addiction.
Putting acetaminophen in these medications isn't even necessary anyway. Oh, and by the way, I don't see advertisements for Vicodin and Lortabs on television. - bigd063, on 07/04/2009, -0/+1***** all you hypocrites and your "legal" drugs alcohol, tobacco, or whatever random drug doctor sees fit to prescribe you.
If I take a zanax twice a day for anxiety, that's abuse, but if a state licensed doctor charges me money for information I already know and writes me a prescription for the xanax, it is no longer abuse. Wake up. - anonymousmedic, on 07/03/2009, -0/+1Oxycodone is too addictive and too depressing on the respiratory system to be made OTC. IIRC it's a Schedule 3 medication.
- Rxbrent, on 07/03/2009, -1/+2Now what are we going to use to kill off all the pillheads? Noone seems to know that just 8 lortabs a day is your max dose of Tylenol.
- freakFlag, on 07/04/2009, -0/+1My favorite, grind it and snort it. ahhhhhhhhh .... that's the stuff.
- cornstarch5, on 07/04/2009, -0/+1Correction: Acetaminophen is not an NSAID (my apologies, didn't think that out all the way), disregard NSAIDs in the above article, but please still consider what I said about acetaminophen.
- ThinkBox, on 07/04/2009, -0/+1Louis MUST die first!!!
- rda1441, on 07/04/2009, -0/+1Nine digg downs? What, are the FDA thugs digg users too?
- Ellipsys, on 07/04/2009, -0/+1@Spire3660 - Yes, its true that they're supposed to be synergistic, however, as others have mentioned you can take the carrier drug separately, and you don't need to use tylenol. There are aspirin preparations and other nsaids too that combine well.
@inactive - Different opiates are developed for different things. Admittedly, some of it is stigma, but there are short and long acting variants. A lot of it has to do with time release - hydrocodone and oxycodone common prescriptions for moderate to severe pain and post-op (vicodin/percocet) are generally 4 hour. Oxycontin is 8 hour and contains no APAP. MS-Contin IS morphine, as the name translates to Morphine Sulfate, Controlled Release, another 8 hour. Opana is another high tier opiate that is long acting. Dilaudid is given in hospital situations and is incredibly powerful for its dose , but short acting in IV form, though there is a PO form as well.
Mostly the idea is to expose people to the weakest type and amount of opiate/opioid that works for their pain. Increased strength and duration means increased side effects, and also an increased possibility something will go wrong. - lenenterprise, on 07/04/2009, -0/+1I truly concur with you. I also think that if we focus on first some alternative means(alternative medicine) we also wouldn't have such high cases involving "accidental' overdosing. All prescription contains an active natural root ingredient. We should consider finding come of these first before taking the manmade and altered form. http://www.mannapages.com/lenenterprise
- arrow85, on 07/04/2009, -0/+1I never took the stuff growing up we were an advil family. When i got to college my suite mate was a pharmacy student and she quickly told me all about it. I never did the stuff to begin with but i spread word to my friends who used to take 2 Tylenol before bed after a night of drinking. It was explained to me how many times x factor horrible it was for your liver in the long run. i my self take the APAP only in my migraine medication cause that is what is mixed with it. I never take it with alcohol and plenty of water and a single dose a day that is how conservative i feel about it. I think they should have pulled APAP a long time ago there is no need for it mixed in the drugs, they claim it works as a binding agent to speed the uptake of the Opiates. I do not want to go all pro pot here but lets face it there is no liver damage it is effective in pain treatment and it has little long term side effects. I would love to see harvested THC in drugs to replace the current crop of drugs with sutch nasty side effects. I am ok with a little THC it washes clean in 20 days my liver does not from APAP.
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