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THE UP’S AND DOWN’S OF TAKING LOTS OF MEDICATION FOR PAIN…

I’m sure many of my readers like myself happily take pills if they help with the pain but of course none of them come without side effects and addiction.

Some easy mistakes you can make with your medications could actually be quite life threatening.

After reading an article about a man who died through taking too many paracetamol tablets, it made me really think about the amount of drugs I am currently taking.

Apparently he suffered from bad sciatica and was warned he was using too much paracetamol but as he thought the ones prescribed by his GP were too strong, he just carried on taking the paracetamol.

His brother said that he would have a drink every night with two paracetamol and then take another two later.

The post-mortem examination found a high level of paracetamol in the man’s blood and damage to his liver. The cause of death was liver failure due to paracetamol overdose.

Of course with paracetamol readily available from a number of shops, I’m sure a lot of people do not realise just how many they are allowed to take.

Many people take over the counter pain killers like paracetamol without even reading the dosage on the box. So instead of maybe taking one four times a day, they take double that. And at the same time they may also take the prescription drugs that they have been given by their GP.

Unless your GP has approved the over the counter pain killers then do not take them until you have either read all the instructions on the back or spoken to your GP.

BUPA wrote in their article about over the counter painkillers that if you have mild-to-moderate pain, start by taking a non-opiate painkiller (such as paracetamol) or a non-steroidal anti-inflammatory drug (such as ibuprofen). Take it regularly and up to the largest recommended amount. If that doesn’t work and you still have pain, try a weak opiate medicine such as codeine. If that doesn’t work, talk to your pharmacist or GP.

You can buy over-the-counter (OTC) painkillers in several different forms, including:

  • tablets, caplets (longer tablets that are rounded at each end that may be easier to swallow) or capsules that you swallow
  • a powder or tablet to dissolve in water
  • a liquid or syrup
  • suppositories – soft, shaped tablets that you put into your anus
  • gels or sprays that you rub into your skin
  • patches that you put on your skin

You can buy OTC painkillers from a pharmacy, supermarket or other shops without a prescription from your GP. You can only buy packs of 16 tablets of paracetamol from a shop or supermarket. If you buy paracetamol from a pharmacist, you can buy a pack of 32 tablets or capsules. Shops and pharmacies can’t sell you any more than a total of 100 tablets or capsules in one go. This is to help prevent people from overdosing or accidentally taking too many.

They also point out that any medicine can be dangerous if you take too much of it. If you take too much paracetamol, it can cause serious liver damage, which can be life-threatening. Sometimes, there are no symptoms until a day or so afterwards. Taking too many NSAIDs can make you feel or be sick or cause hearing problems such as tinnitus. Taking too much aspirin can cause you to hyperventilate (breathe abnormally quickly) as well as hearing problems, and you may sweat a lot.

It’s getting a balance with your pain killers that is important. I weaned myself off the opioids I was on and felt so much better for it but recently my pain has been so bad that I have needed the odd one. I was shocked at how different I felt while taking them and it certainly made me think twice before taking too many of them.

The NHS website points out that the type of medicines that you need to treat your pain depend on what type of pain you have. They say that for pain associated with inflammation, such as back pain or headaches, paracetamol and anti-inflammatory painkillers work best.

If the pain is caused by sensitive or damaged nerves, as is the case with shingles or sciatica, it’s usually treated with tablets that change the way the central nervous system works.

The aim of taking medication is to improve your quality of life. All painkillers have potential side effects, so you need to weigh up the advantages of taking them against the disadvantages. The NHS website has a list of pain medications and the type of side effects you can experience with some of them.

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MUSCLE RELAXANTS INEFFECTIVE AT REDUCING LOWER BACK PAIN…

A handful of articles online including from Web MD and US News say that a new Australian review finds there is absolutely no evidence that muscle relaxants ease lower back pain.

Spine Health explains that “Muscle relaxers are not a class of drugs—meaning they do not all have the same chemical structure or work the same way in the brain. Rather, the term muscle relaxer is used to describe a group of drugs that act as central nervous system depressants and have sedative and musculoskeletal relaxant properties.”

I was put on muscle relaxants a long time ago and was swapped from one type to another. The pain team really wanted me to try and take about five at night as they said it would help me sleep in less pain. The dry mouth and other side effects meant that I only take 2 at night but I have taken them for so long I am not sure if they work at all.

With all types of medications when you have been on them for a while your body starts to get used to them and you do not really know if they are working or not unless you come off the medication. I also take a CBD Gummy just before I go to sleep and have felt I do not wake up as often taking one of these. The trouble is they are so expensive.

My many spinal surgeries when I was younger have left me with chronic pain from the discs above and below my fusions so I have no option but to either try different types of medication and/or steroid injections. All of which I do use regularly. But, I do feel they all start to be less effective over time.

In July 2020 Web MD wrote that “muscle relaxants for back pain were soaring but were they safe? Experts worry that muscle relaxants may not help much and could cause troubling side effects, especially in older patients. The study found the rate of long-term prescriptions for muscle relaxants to treat back and other muscle pain tripled between 2005 and 2016.

Web MD continued with the fact that “also concerning, nearly 70% of those prescribed muscle relaxants were given a prescription for an opioid pain-relieving medication like oxycodone (OxyContin) at the same time. Taking these medications together increases the potential risk of ill effects, the researchers said.

This is certainly quite frightening.

The review found that most patients wouldn’t be able to feel any difference in their pain compared to taking a placebo, or sugar pill. Side effects like I pointed out with a dry mouth can also include dizziness, drowsiness, headache and/or nausea, in addition to the risk that patients will develop a lingering addiction. They advise you not to take alcohol with them so if I fancy a drink then I cannot take my relaxants.

They now suggest that we should embrace techniques that focus on alternatives to medicine or surgery. The trouble with this is that you are on a waiting list for any type of treatment like this so what should you use while waiting. It’s a catch-22.

Source: Web MD, Spine Health, US News