Combination Painkillers Do Not Provide Promised Relief

[Chiral]

A new article published in the journal Australian Prescriber warns that combination painkillers fail to provide the promised relief and that it may lead to serious side-effects. The article is contributed by National Prescribing Service, which conducts the review of the medicine in Australia.

The article made it clear that the fever medicine Paracetamol in combination with certain levels of codeine may give relief to people suffering from acute pain, after they undergo an operation. But, combining it with lower doses of codeine may make it less effective, as compared to when it is taken on its own.

A 60mg codeine dose is needed for acute post-operative pain. As per the review, pain relievers for toothache, migraine and back pain contain 8 milligrams of codeine per pill. According to the article, codeine combinations cost between $6 and $12, while a packet of Paracetamol costs $2 or less.

NPS acting Chief Executive Karen Kaye shared that codeine could be addictive, but as it has always been prescribed with medicines like paracetamol, aspirin or ibuprofen, people can overuse these products. Kaye said, “Overuse or misuse of products containing aspirin or ibuprofen can result in gastric ulcer perforation or, in products containing paracetamol, liver toxicity or death”.

_______________________________________________________________________________________________________________________________________________________________________________________________________

After finally freeing myself of a long term codeine addiction I recently aggravated an old back injury in my lower back simply by turning the wrong way...it was such a simple thing that lead to pain beyond my wildest dreams, I have been in excruciating pain/laying on the floor screaming for hours on end and basically unable to move, even a small twitch would send pain soaring around my body and have me crying in agony...it took me three days to be able to get out of the house and see a doctor...after all the consultations and emergency x-rays etc. I was asked to take Panadeine forte..I refused point blank and said I will not take a painkiller that has an unnecessary additive as it is what upsets my stomach, and gives me gastrointestinal problems...I tell you it took me some serious convincing and a lot of me bullying the doctor...I wanted some Valium for muscle relaxation and a pure opiate painkiller with no additives...he refused the muscle relaxers even after I begged him for the next two days...he did give me oxycodone though but was not happy about it. I went to my old doctor today and asked for muscle relaxers and he swiftly scripted me a box of 50. I have been in agonizing pain for 5 days now, unable to work or even sit on a chair, I have taken 2 5mg Valium this afternoon and already feel the relief I have been craving...the endone(oycodone) 5mg tablets made me slightly nausea's and as a pain killer I found to be quite weak, mind you this pain is brutal beyond comprehension...sometimes I have no use of my legs at all and have to drag my body around with my arms to get anywhere..I took 4 oxy's this morning so I could get to my old doctor and barely felt them.

These mixed paracetamol and codeine tablets are a fucking joke seriously, they make you sicker in the long run, and who is going to be accountable for this...?

What the hell is wrong with prescribing pure opiate pain relief without all the unnecessary crap in the tabs...so shits me off it really does...plus now I'm going to have to WD's after all this again as I'l need pain relief for another 2 weeks.

[Magicdirt]

Fuck, that sounds like my life for the last ten years man. After I broke my back I still get the same thing you are describing from time to time. You wouldn't wish it on Tony Abbot.

I've been that bad I was screaming for my girl to kill me, and at the time I really meant it too.

The only releif I can get is an icepack wrapped in a towel and I just lay on it and meditate and after half an hour or so the whole area goes numb.

Most of the time it works to numb the pain (well almost it takes the edge off the pain) and sometimes it just works and solves the problem.

After the pain has been numbed I do a few exercises from I book I have "Fix your own back" to release trapped nerves .I can't say who wrote it I'll have to dig it out. It works for me where all the best advice from doctors and chiro's didn't.

I'll dig it out and get the full details, author,title etc.

If you want I could send it to you.

[santiago]

reminds me of the movie fight club, if that stupid doctor in the beginning had just prescribed him something to help his insomnia instead of assuming he was a junkie he wouldnt of had to cry into bobs tits and then in turn become a dual personality maniac in order to cope with his long term problem.

[kindness]

I was just reading about pain relief and its various forms today... the book I was reading was about aging and how, (as I understand it) it is important to be aware of the different way an older body metabolises a drug and levels of toxicity that can build because of the slower speed or something, it was also saying that other pain relief methods are really important to utilise - not just the anti-inflamitory or opiate pain killers. I can't remember all the ways but I do know they said meditation, trying to focus on another area of the body, acupuncture or accupressure... a few other things....

just some thoughts - I can imagine you sitting there in intense pain and reading this though Chiral and thinking go meditate on this

not that I would encourage such a thing as using a herb to help your body in a time of need or anything but... do you have any pods? I wonder if they would be strong enough to take the edge off in a really potent tea? or if it is possible to get a preparation from a Chinese medicine practitioner. Do you have an acupuncturist at all?

I was also under the impression that there were straight opiate derivatives available on script, shoulda asked for some ms contin

[ref1ect1ons]

if that stupid doctor in the beginning had just prescribed him something to help his insomnia instead of assuming he was a junkie

insomnia is an ongoing problem, so why is their main concern dependency, rather than helping restore a patients normal sleep cycle. Or relieving long term pain effectively and without the liver damage

whats the diff between oxycodone and ms contin?, is ms contin short for oxy contin?

[kindness]

One of the better equipped chemistry head members could explain it better than me. ripped from wiki today:

'Oxycodone is an opioid analgesic medication synthesized from opium-derived thebaine. It was developed in 1916 in Germany, as one of several new semi-synthetic opioids in an attempt to improve on the existing opiates and opioids: morphine, diacetylmorphine (heroin), and codeine.[2]'

I don't think it did improve on morphine. Always happy to be educated and proved wrong though.

[Sonny Jim]

insomnia is an ongoing problem, so why is their main concern dependency, rather than helping restore a patients normal sleep cycle. Or relieving long term pain effectively and without the liver damage

whats the diff between oxycodone and ms contin?, is ms contin short for oxy contin?

 

Oxycodone is oxycodone. ms contin is morphine sulfate in a tablet form that dissolves slowly in the gut allowing a slow release of morphine sulfate into the blood stream. Just as oxycontin is a tablet that slowly dissolves in the gut allowing a slow release of oxycodone into the blood stream.

[Chiral]

Fuck, that sounds like my life for the last ten years man. After I broke my back I still get the same thing you are describing from time to time. You wouldn't wish it on Tony Abbot.

I've been that bad I was screaming for my girl to kill me, and at the time I really meant it too.

 

Fuck man so true...I actually asked my missus to go to the shed and smash my head with a large hammer and let be free of pain...thing is i was serious I really wanted it badly...the pain is indescribable, I couldn't imagine anyone else dealing with it to be honest, I have a really strong threshold to pain but this is just out of control and debilitating..every movement involves me swearing/screaming loudly, curse words are loud and I feel I can't stop...even when it in the doctors I was screaming obscenities and having to apologies profusely.

I feel somewhat better now I have dose 20mg of valium, Im actually able to walk some...sleeping on hard lounge room floor tonight will help hopefully...fucking doctors are so dam inconsistent and are worying about prescribing pain and benzos for genuine and acute pains...fuck get over it and give the person some proper meds and monitor closely...I thin they think everyone who needs pain meds or benzos is junkie...so frustrating when they say or go take some Panadol and rest for day....

[stiched up]

anyone know anything about the correlation between "anger" and "pain threshold" ??? apparently those with higher anger levels have a lower pain tolerance

[Magicdirt]

anyone know anything about the correlation between "anger" and "pain threshold" ??? apparently those with higher anger levels have a lower pain tolerance

 

Maybe that's just a cop out used by incompetant medical practionioners.

If someone has been in that sort of pain for several days or even weeks and has not even slept for second in that peiod I can assure you they are going to be one cranky short tempered son of a bitch. I know I am when I'm in that condition.

It's easy observe that people in agony are angry and draw the wrong conclusion. Screams of pain aren't just pain when you've been at your limit for an extended period, the scream is from pain, anger and frustration. Taken out of context (which they generally are) these screams just sound like the rants of an angry person.

By the time you get to the hospital you are commonly met with an arguement by some incompetant twat who won't help your condition and this is like pouring petrol on a burning man. Try argueing with a doctor when you've got a broken back and see how angry you get.

To demonstrate the weakness of that theory, when I have had reconstructive surgery on various joints involving removal of bone, bone and tendon grafts and such I have never required pain medication post operation (I just suck it up) This has always amazed the nursing staff and doctors alike to the point where they have documented my pain threshold.

But when my back is in the condition Chirals' is in, the pain is on a scale that doesn't even come close to major reconstructive surgery. I have been in hospital crying like a big girl from the pain in my back and several times it has been suggested to me that I have a low tolerance to pain (only from younger doctors) and they have also noted my "angry demeanor" basically suggesting what you have above.

There is some credence to the theory in that pain wears you down if you suffer it long term, so I don't don't know if it is cause or effect.

[naja naja]

gorw ur own poppies, now u have had a script for val once, it will be easy for u to repeat. Valium and codiene is wat I use for bacc pain, codene alone doing very little unless in large doses, and that is more just the euphoria making the pain barable, not any real reduction in pain. And maybe hassle ur doc for kava tablet script aswell, can't hurt.

but ime, u NEED valium with sum sort of pain releif

Maybe restavit (a strong dose of doxylamine succinate) would help. Dolased is a lower dose of doxy with codene and paracetamol. Works wonders for me, one tablet and I'm out cold. I am intersted in maybe 2 N+ and 1 restavit tab. Should work sweet me thinks, but I have never tested restavit or doxy for bacc pain, only headache. However, doxy is a muscle relaxant and should work to replace valium to sum extent, just without the loverly euphoria and long lived feel good effect.

[shruman]

I read the article wrong. I'll prob come back later. Sorry

Edited August 4, 2010 by shruman

[Amazonian]

Are you feeling any better Chiral? What is actually wrong with your lower back,is it sciatica or a slipped disc or?? A herbal spa bath (if you can get into it) and a loving massage might help temporarily. You can't keep numbing the pain. Can the condition be fixed either surgically or by manipulation. ( rather the latter).Good Health vibes being sent your way.

Edited August 5, 2010 by Amazonian

[Amazonian]

Well , given your ecstatic message of love and happiness over at 'Chill Space' , i take it that you have made a miraculous recovery. The combination of painkillers may have helped. You seem better and that is the important thing.

[Chiral]

Man seriously that was the most hardcore 6 days of my life...I had to take 4 out of 6 days, off my job, and remember it isn't labour intensive, it was just that I couldn't drive my car...seriously i couldn't even get in it. I was screaming the first time i tried to get in and got trapped in the door in a bent over ball of hellish pain...Once i finally got the endone from one doctor I went back to my original doctor and he swiftly printed me out scripts for mobic, valium, tramadol etc....the story takes a serious turn for the macabre as I explain here...vvvv

I did something insanely stupid yesterday...after my shift at work I was in excruciating pain and had to drive home...I had only taken 2 endone all day and they where wearing off quickly...just getting in my car was a serious chore, so I dropped 2 more oxycodone, 5mg valium and a 100mg tramadol...I got in my car and stated driving thinking I would be pain free driving home and by the time I was home I would be feeling better...maybe even slightly high and well out of it a bit...I felt like i needed it.

Well about half way home I appeared to black out at some points whilst driving, and to this moment have no recollection of even driving the 40odd klms home through the busy city, across the harbor bridge, paying a toll etc.. and highways, traffic lights etc..."fucking stupid I know" thing is I had no idea what I was doing, I had no idea I would be so fucked out like that...I was muttering words like "buzz mumma" MUMMA BUZZ over and over and over, sometimes shouting them out...when I finally got home there was food all over my lap...pies and donuts, and coffee...I have no idea how I got them and don't recall at all buying them on the way home...I made it home, believe it or not, parked skew wift, fumbled my keys stumbled inside and apparently collapsed on top of my wife on the lounge and didn't move again till 6am the following day...I had goten home at somewhere between 5 and 6pm apparently. When i woke I then went and puked and shit like hosepipe for half and hour in the bathroom....it was so painful and was I was crying like a baby from the pain....sometimes letting out screaming prayers to god and Buddha to please help me.

After I straightened out this morning I took a shower, made breakfast of banana, vegemite toast and coffee,then dumped 2 tramadol and 5mg of valium..I felt great again, my back pain was minimal for a change and so I went to work.....pretty fucking jaded though and hungry all day...when my shift finished I dropped one tramadol and 5mg of valium and was feeling totally awake and drove home safely as, very coherent and safely.

fuck I'm a serious dickhead sometimes though, but I had no idea that oxy's and tramadol would synergise so heavily like that...I'm lucky to be alive and lucky to not have killed anyone else on the road.

Finally my back pain is subsiding and I can slow these drugs down and get sober again...my bosses told me I should have taken more time off but I'm so stubborn and wont take time off unless I'm dead.

the closed eyes visions are so ridiculously insane...I was laying with my daughter before and shut my eyes and was having conversations with these people in my thoughts...crazy mad shit or what...they even happen during the day when other people are actually talking to me at work...INSANITY.

[Amazonian]

 

You might have been date raped on the way home as well.

 

[stiched up]

im not making any claims just something i heard along the lines .. and thought interesting it appears that anger is much more sapping than anticipated still many variables though

Robert D. Kerns1, 2 , Roberta Rosenberg1 and Mary Casey Jacob3

(1) West Haven VA Medical Center, 06516 West Haven, Connecticut

(2) Yale University, 06520 New Haven, Connecticut

(3) Departments of Psychiatry and Obstetrics and Gynecology, University of Connecticut Health Center, 06032 Farmington, Connecticut

(4) Psychology Service (116B), VA Medical Center, 950 Campbell Avenue, 06516 West Haven, Connecticut

Accepted: 8 April 1993

Abstract Intensity of angry feelings and styles of expressing anger were examined for their relationship to measures of the chronic pain experience. Subjects were 142 chronic pain patients. Multiple regression analyses revealed that a style of inhibiting the expression of angry feelings was the strongest predictor of reports of pain intensity and pain behavior among a group of variables including demographics, pain history, depression, anger intensity, and other styles of anger expression. In a similar manner anger intensity contributed significantly to predictions of perceived pain interference and activity level. More conservative hierarchical regression analyses supported these findings. Results are consistent with explanatory models of pain and disability that hypothesize an etiologic role of a pervasive inability to express intense negative emotions, particularly anger.

http://www.springerlink.com/content/k2x10162268873n8/

[Chiral]

Anger and frustration are increased ten fold when u have dibiltating back pain...I mean the anger is worse than if you wanted to punch someones lights out...the pain is constant and unforgiving no matter how many drugs you take...the pain shoots off in so many different directions at so many random times it becomes unpredictable and we lose control of our movements and destiny as far as preparing for it...imagine trying to sit on the toilet and scream with agaony at the bent back over the seat, then realise u have absolutely no way of cleaning yourself because the pain feels like you are actually dying of the most severe gunshot to your head or something...or dragging your body around the house by your arms only and losing the complete loss of your leg movements...your daughter is crying and upset because she doesn't know or understand why I am acting like a scary lunatic....so much anger and frustration builds up to a point where death seems like a eally fucking great idea.

anyways I'm getting better and am still stiff though it kills to sit for any length of time in a chair...try 8 hours of it at work and u will feel like smashing all the equipment.

I have to live with it now forever and the worse part is I never know when it will come back again...when I'm 70 or 80 I'll be totally fucked and wont be able to get off the ground...I'm saving up for a couple of vials of acid for that day you can rest assured.

[hutch]

EDIT - Double post.....

Edited August 7, 2010 by hutch

[hutch]

Welcome to my world an that of the many others of us who suffer this same problem. I know your pain and you must get access to Valium as it is the only thing that will relax your muscle which is in spasm some times to the point that it is trying to pull the muscle away from your bone. The attached photo is me nearly two weeks after a back muscle spasm still trying to walk it off...try being stranded in a caravan park when you do it. Happens to me a couple of times a year hence I take anti inflamatory pills daily...I have a wife who is permanently incapacitated, now throw me in the mix as her carer when I do my back...We are as useless as two children playing together in a crib...I do save the valium though for when I need it only. I don't really understand how anyone can get off on it...may as well just be really stoned

Should have had private medical benefits all those years back. Frustrating to watch sport stars do their backs in one week and been operated on the next...public system will most likely mean I never get fixed... I have had the problem since 1982...best to avoid getting fat around the gut region...stay strong at your core is supposed to be the secret...

[t st tantra]

valium is not for long term use.another option is needed.

chiral,how often do you need medication?is it likely to be almost every day of your life?you prob need a long term plan?

t s t .

personally i dont fully medicate.i take enough pain releif to get by but not be affected too much and put up with a fair amt of pain.higher amts of meds and i am half asleep almost all day but there is no pain.

Edited August 7, 2010 by t st tantra