I get what you're saying, but ibuprofen and acetaminophen save lives. The problem is the western (American?) tendency to self-medicate and to over medicate with really potent stuff. That shouldn't be as normal as it is.
Not necessarily.
Fevers can cause seizures and they can have detrimental effects in paediatric patients. For the bulk of the general population, these painkillers/anti inflammatories are simply symptom relief.
For those talking about hyperthermia killing, yes but in almost all those cases the cause is not an infection.
In fact, I would say that paracetamol kills a hell of a lot more patients than it actually ‘saves’.
A study I have taken to heart is that permissive hyperthermia (up to 40 deg c) in ICU patients has a greater survival than those where fever is treated aggressively.
Physiologically, this resonates because high temperatures activate the immune system and raised temperatures are non-optimal for bacterial proliferation; so the immune system is primed by fever; suppressing it can dull immune system response.
In fact, malaria was used as a treatment for syphillis in the early parts of the 20th century because high temperatures kill spirochetes. There are also a decent number of case reports of cancers going into remission following fever.
However in my quick mobile google then I could only see the following study that demonstrated no advantage for either control of permissive hyperthermia group in ICU patients; so perhaps I was relying on a study that has been superceeded.
Fever can indeed kill. Raise the body temp a few degrees, no matter the cause, and things start going wrong very quickly. Google hyperthermia.
In fact, i cannot think of any disease that literally kills. Even with the big stuff like cancer or aids, it is always the symptoms that get you. They damage body systems and the decline of those systems (aka symptoms) eventually causes the cardiac arrest or internal bleeds that shut off nutrients to the brain. Those symptoms are just as lethal no matter thier cause. A massive fever that stops normal body chemistry, whether caused by flu or ebola, will kill you just the same.
Yes but the extra heat in the body causes the same cascade of chemical changes that will eventually kill. Initial treatment is different, to a point. If a fever is too high it will suddenly need the same treatment as hyperthermia: direct cooling.
Not a doctor: Isn’t fever (objectively, it seems) defined as a rise in body temperature? From what I’ve learned about protein denaturalization in high school, that doesn’t sound good if excessive.
And an acetaminophen tablet is a painkiller. While your statement is in fact true, ibuprofen is still a better choice for a fever. The latter is also generally considered a safer alternative, especially in long-term use — even though alternating the two would be ideal.
Acetaminophen is actually a pretty dangerous drug that is pretty easy to overdose on. It’s been said if it were discovered today it would be a prescription drug.
On top of that numerous recent studies have shown many potential problems.
> Heavy use of acetaminophen is associated with kidney disease and bleeding in the digestive tract, the paper reports. The medication also has been linked to increased risk of heart attack, stroke and high blood pressure, the study authors noted.
> One cited study even showed that overuse of acetaminophen can increase a person's risk of early death as much as 60 percent, the study authors found.
This. Just had friends visiting. Their teenage son had had his wisdom tooth pulled last week. Dentist had then given him (as a standard practice?) prescription for Ibuprofen (800mg tabs?) AND some opioid based pain killer! Needless to say, latter they said went directly to trash after they realized what it contained and for ibuprofen they halved the dosage.
To me and his parents this was pain management gone way over dose! But we’re not medical experts and should not be doing clinical decisions since at one end of this rabbit hole you will find anti-vaccination and other nut jobs.
I just had wisdom teeth extraction a few weeks back. I was given 800mg Ibuprofen and Norco. The pain was bad enough to wake me up at night when the meds wore off — and I did take both. Oral surgery is no joke. It took me about 8 days to taper to 400mg Ibuprofen.
These doctors don’t just give pills out randomly, they do it for a reason based on evidence and science. A side note is that my pharmacist made it very clear to only use the painkillers as necessary. You should always consult the doctor and pharmacist after major surgery to clarify these things if needed.
The pain varies wildly from person to person. A friend of mine was out of order for two weeks after having a single tooth removed. I had all 4 removed and recovered in a few days and without much painkillers.
IMHO the doctors should prescribe less at first and see if it would be enough, but I also get that they are overcrowded and the same patient coming back for just more painkillers might be a little too much.
One thing is not to put medicines, OTC or not, into the trash. They are nasty stuff to have in the dump.
As for the drugs: don’t take analegics if you don’t need to; do if you can’t tolerate the pain. Everybody has a different level of pain and tolerance and I bet the prescription said something along the lines of “...as needed”
As for other prescriptions, do your research; odds are you do need it but not always.
What to do? IMO: follow the doctor's/pharmacist's instructions precisely. In my case we were instructed to only break out the opidoid in the event of severe pain (has never happened to me but I guess it's possible), and there were quite specific instructions regarding it. If you don't end up needing it, dispose of it.
Exactly this. Removing wisdom teeth in particular seems to affect everyone in totally different ways that can't easily be predicted, so doctors over-prescribe and give strict only-as-needed instructions.
I had a similar experience. My oral surgeon, who did a great job, highly recommended I fill the painkiller prescription and take it. He recommended this several times throughout the process, before and once before I left, as did the nurses (?) at the counter, as I expressed some concerns about it.
I finally caved and then took a half dose right after the extraction because I was fearing terrible pain, especially since the surgeon said mine was a fairly difficult job that would probably end up causing more pain than is typical.
The half dose of painkiller made me extremely nauseous, and so I decided to just try the 800mg of ibuprofen, and it did the job perfectly. I did feel a little sore and stiff, but never in pain unless I waited too long for another ibuprofen dose. It was the same for my girlfriend, who was also prescribed the pain killer but didn't take it because she didn't feel she needed it either.
The pain killer being prescribed didn't bother me per se, and neither did the recommendation, and I don't think anything nefarious was going on. Also, everyone's body is different. But given the side effects, and potential side effects, I just felt that even a simple "we recommend you get this prescription filled, but please see how the ibuprofen works first, and only take the pain killer if you can't handle the pain on ibuprofen alone" would have been a better way to handle it.
There's probably nothing wrong with taking 800mg of ibuprofen at least for a short period of time. Ibuprofen can have some negative effects from long-term use though.
Regarding opioid based pain-killers... for all the negative attention they get, they're also usually fine for most people - when used as directed and, again, for a short-period of time.
Not everybody who takes a few Oxycodone tablets winds up addicted and then reduced to using heroin to get their fix.
This is why I hate reading these type of posts on HN. Especially like in this case where there's still a lot to be researched on and to drawn conclusions from, and the outlook isn't positive.
My recommendation is to go and talk to your doctor and confront him or her with this "finding".
Also, most importantly, this "finding" has been out for almost a year now. I wonder what's the more recent development on it.
Move to Europe where we don't get as many drugs prescribed? I think the only time you get opioids is after major surgery. Personally I don't know anybody who had to take them.
No opioids after my wisdom teeth extraction would have resulted in potentially suicide. The pain was unbearable, and 3-4 days of hydrocodone was absolutely proscribed.
There is nothing wrong with opiates being used for acute pain relief. They are a modern miracle when put to such uses.
The problem comes when you start using them for long-term pain relief - a use-case in which they are neither appropriate or effective.
A typical 2-3 day prescription after major dental (or other) work is not remotely a problem, and I really have no idea why this is where the focus is. It's always been long-term abuse as the actual problem - the weird overreaction over a few days use for acute pain is utterly absurd and only hurts people in some bizzare way for folks to feel they are "helping" fix the abuse problem.
Definitely varies by individual, and by the nature of the situation. My personal experience, as somebody who considers himself to have a pretty high threshold of pain tolerance, is that I never needed any of the Vicodin I was prescribed after wisdom tooth removal... but I can't imagine how I would have survived without Oxycodone in the first week after rotator cuff surgery.
Co-codamol (codeine and paracetamol) is widely prescribed IME in the UK, eg for back pain, muscle pain.
I had Oramorph for abdominal pain (in hospital, no surgery thankfully). The condition may have been caused by medium term use of Ibuprofen (in my non-medical opinion).