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Last post 5 years ago by Numismaniac. 37 replies replies.
Opiods - An interesting study
teedubbya Offline
#1 Posted:
Joined: 08-14-2003
Posts: 95,637
https://jamanetwork.com/journals/jama/fullarticle/2718795

If you want the full study ^

The Key Points:

Question Is the use of opioids to treat chronic noncancer pain associated with greater benefits or harms compared with placebo and alternative analgesics?

Findings In this meta-analysis that included 96 randomized clinical trials and 26 169 patients with chronic noncancer pain, the use of opioids compared with placebo was associated with significantly less pain (−0.69 cm on a 10-cm scale) and significantly improved physical functioning (2.04 of 100 points), but the magnitude of the association was small. Opioid use was significantly associated with increased risk of vomiting.

Meaning Opioids may provide benefit for chronic noncancer pain, but the magnitude is likely to be small.


I'm currently working on a project to eliminate the use or at least drastically reduce it in dental procedures.
DrafterX Offline
#2 Posted:
Joined: 10-18-2005
Posts: 98,506
I hate dentists.. Not talking
Speyside Offline
#3 Posted:
Joined: 03-16-2015
Posts: 13,106
Interesting TW, I think on this issue you are far more well versed than anyone else here. Is medical marijuana a viable option in your opinion? Also, have any scientifically acceptable studies been done on medical marijuana and chronic pain reduction?
teedubbya Offline
#4 Posted:
Joined: 08-14-2003
Posts: 95,637
DrafterX wrote:
I hate dentists.. Not talking


https://www.youtube.com/watch?v=yAm0nq6NwH8
Phil222 Offline
#5 Posted:
Joined: 10-01-2017
Posts: 1,911
Meta-analysis = good stuff. Thanks for posting.
teedubbya Offline
#6 Posted:
Joined: 08-14-2003
Posts: 95,637
Spey I'll have to go reread this study I think they may have touched on it. I happened to have this cut and paste in my clipboard because I was using it for something I was writing. It's about synthetics.

Opioids vs Synthetic Cannabinoids
Low-quality evidence from 1 crossover trial suggested no difference
between opioids and nabilone for pain relief (73 patients;
mean difference, −0.13 cm [95% CI, −1.04 to 0.77 cm]
on the 10-cmVAS for pain, P = .77) or physical functioning (71
patients; mean difference, −1.2 points [95% CI, −4.50 to 2.10
points] on the 100-point SF-36 physical component score,
P = .48; eTable 12 in Supplement 2).


I think MMJ has merit but is being held up as more than it is. I'm currently personally dealing with something where hypothetically speaking MMJ may prove useful. I can neither confirm or deny that from firs hand knowledge. :)

Edit: I don't really see anything on MJ and haven't seen anything that caught my eye as solid enough for me. That does not mean no. That means maybe. I'm pro MJ however.

This study caught my eye.
dstieger Offline
#7 Posted:
Joined: 06-22-2007
Posts: 10,889
I didn't read the study...just your summary.
But, my reaction is 'really???'
I have only had prescribed opiates twice in my life.... once was Tylenol 3 after dental work, the other for kidney stone pain....both times, the effectiveness bordered on spectacular, in my mind....near 100% pain relief with little side effects beyond drowsiness. Now, this is extremely small sample size, but I think different, subjective pain levels, from different causes in different people makes such studies extremely problematic for useful extrapolations or conclusions. Even if you buy into a study 100%, you can't deny that certain opiates still might be right answer for certain people in certain controlled situations
teedubbya Offline
#8 Posted:
Joined: 08-14-2003
Posts: 95,637
The benefit of tylenol 3 is far exceeded by the side effects and risks. One of my projects years ago was to reduce the use of Propoxyphene in nursing homes. Remove it from the premises if possible. It's no more effective than regular tylenol but had all the bad side effects of narcotics. My project was cut short when the product was pulled from the market for that very reason. Yet I know many folks that swear by it. You can't convince folks.... thats the hardest part


I honestly believe the use of opioids is not really appropriate for anything other than some cancers, end of life and I've been convinced (in here) some emergency and surgical situations (mostly in hospital). Not for chronic pain.

But you are right about the difficulty measuring something like pain.




I've seen a lot of these studies.... this one seems to be pretty solid. Time will tell.
opelmanta1900 Offline
#9 Posted:
Joined: 01-10-2012
Posts: 13,954
Some people can buy a pack of cigarettes, smoke them, achieve a ton of relaxation from them, and then not smoke cigarettes anymore... But because those people are the exception to the rule rather than the rule itself, I don't think cigarettes should be prescribed for stress relief...
tonygraz Offline
#10 Posted:
Joined: 08-11-2008
Posts: 20,173
DrafterX wrote:
I hate dentists.. Not talking


I like most dentists, but hate Novocaine. Rather the pain than the after effects.

dstieger Offline
#11 Posted:
Joined: 06-22-2007
Posts: 10,889
The dentist-prescribed Tylenol 3 was 30+ years ago....so I don't rely on memory of that experience for much of anything....for the kidney stone, I got Percocet about 2 years ago, and that chit was like magic....no discernable effects other than near 100% pain mitigation

Then again, I can't say what might have happened if I took it more than 2-3 days
ZRX1200 Offline
#12 Posted:
Joined: 07-08-2007
Posts: 60,473
Our 3 local hospice groups all use roxanol.

I like taking propofol mid fap session and see if I can finish before I pass out.
RMAN4443 Offline
#13 Posted:
Joined: 09-29-2016
Posts: 7,683
ZRX1200 wrote:
Our 3 local hospice groups all use roxanol.

I like taking propofol mid fap session and see if I can finish before I pass out.

well......Can you???Gonz
frankj1 Offline
#14 Posted:
Joined: 02-08-2007
Posts: 44,211
RMAN4443 wrote:
well......Can you???Gonz

looks like he passed out in mid-paragraph
Abrignac Offline
#15 Posted:
Joined: 02-24-2012
Posts: 17,216
teedubbya wrote:
https://jamanetwork.com/journals/jama/fullarticle/2718795

If you want the full study ^

The Key Points:

Question Is the use of opioids to treat chronic noncancer pain associated with greater benefits or harms compared with placebo and alternative analgesics?

Findings In this meta-analysis that included 96 randomized clinical trials and 26 169 patients with chronic noncancer pain, the use of opioids compared with placebo was associated with significantly less pain (−0.69 cm on a 10-cm scale) and significantly improved physical functioning (2.04 of 100 points), but the magnitude of the association was small. Opioid use was significantly associated with increased risk of vomiting.

Meaning Opioids may provide benefit for chronic noncancer pain, but the magnitude is likely to be small.


I'm currently working on a project to eliminate the use or at least drastically reduce it in dental procedures.



Not to mention the fact that the longer one uses opioids to treat pain, the higher the therapeutic dose becomes. Higher doses also encourage use of laxatives. No matter how you figure it, it’s still a crapshoot.
ZRX1200 Offline
#16 Posted:
Joined: 07-08-2007
Posts: 60,473
You can offset the constipation with Papa Murphy’s.
Gene363 Offline
#17 Posted:
Joined: 01-24-2003
Posts: 30,660
I know not everyone feels pain the same way or to the same degree, but I suspect we could go a long way figuring out what is really pain and what is perceived pain. I had carpal tunnel surgery and got quizzed by the pre-op nurse to determine I had a prescription for pain meds. I said, no, the doc and I already discussed it and I have some pain pills I didn't take when I had back surgery and foot surgery. I'm sure she wanted to avoid me coming back with a pain complaint so she spoke with the doc. Again, the doc and I agreed I was good to go. I took one over the counter Ibuprofen the first night.
Whistlebritches Offline
#18 Posted:
Joined: 04-23-2006
Posts: 22,127
I'd rather suffer the pain than the side effects I suffer from opioids.But I have a very high pain threshold.........to each his own.
Speyside Offline
#19 Posted:
Joined: 03-16-2015
Posts: 13,106
I have used opiods twice for short periods of time. Once for broken ribs I was prescribed Vicodin. It did nothing for me So I stopped and switched to Acetaminophen which worked just fine. Then when I had my open heart surgery they started me on Oxycodone which did nothing for me. After 12 hours I think, they changed me to Percocete, which worked well. After 12 more hours I demanded they switch me to Acetaminophen, which worked well. I have concluded that at least for me opiods do not work.
Mr. Jones Offline
#20 Posted:
Joined: 06-12-2005
Posts: 19,357
#1 ^^^^ you are the enemy of my dentist.....

Your new project BLOWS...

I LIKE MY OLD DENTAL OXY INVENTORY....
Quit your job and leave good prescribing dentists alone...

DRAFTERX agrees with me.
teedubbya Offline
#21 Posted:
Joined: 08-14-2003
Posts: 95,637
We use special drugs on you Jones.
DrafterX Offline
#22 Posted:
Joined: 10-18-2005
Posts: 98,506
I have a special purpose... Mellow
opelmanta1900 Offline
#23 Posted:
Joined: 01-10-2012
Posts: 13,954
Is it agreeing with Jones?
rfenst Online
#24 Posted:
Joined: 06-23-2007
Posts: 39,096
Speyside wrote:
I have used opiods twice for short periods of time. Once for broken ribs I was prescribed Vicodin. It did nothing for me So I stopped and switched to Acetaminophen which worked just fine. Then when I had my open heart surgery they started me on Oxycodone which did nothing for me. After 12 hours I think, they changed me to Percocete, which worked well. After 12 more hours I demanded they switch me to Acetaminophen, which worked well. I have concluded that at least for me opiods do not work.


Vicodin is hydro and acetaminophen.
Percocete is oxy and acetaminophen...
rfenst Online
#25 Posted:
Joined: 06-23-2007
Posts: 39,096
Opiates are fine for acute pain. Their use for chronic pain needs to be evaluated on a case by case basis (ideally by a pain management doc).
tonygraz Offline
#26 Posted:
Joined: 08-11-2008
Posts: 20,173
DrafterX wrote:
I have a special purpose... Mellow


So does Steve Martin.
DrafterX Offline
#27 Posted:
Joined: 10-18-2005
Posts: 98,506
TW has acute earing... Mellow
Speyside Offline
#28 Posted:
Joined: 03-16-2015
Posts: 13,106
Thanks rfenst. I knew the makeup of Percocet, but not Vicodin.
grmcooper Offline
#29 Posted:
Joined: 10-10-2006
Posts: 20,430
Pain killers make me feel good when washed down with a 40 of delicious MALT LIQUOR.
delta1 Offline
#30 Posted:
Joined: 11-23-2011
Posts: 28,753
After knee replacement surgery, I was prescribed oxycodone after a day and a half of post-operative morphine drip...first 12 hours after they stopped the morphine was rough, but then the oxy effectively relieved the pain...

I was sent home on the third day after surgery with a prescription for oxy for 3 days, then a switch to norco...the difference between oxy and norco was immediately felt and I was in pain for most of the weekend because the doctor was unavailable to refill the original prescription for oxy..the nurse who was answering his calls suggested I take a double dose of norco...didn't help...miserable week-end strapped to an ice machine 24/7...

when I saw my doctor on Monday morning, he reluctantly extended the prescription for another 3 days, suggesting I take half doses on the second day to see if that would relieve the pain...it did...and I was able to switch to norco...after a few days, I switched to OTC acetominophen and ibuprofen...I still have a few pills of oxy and a dozen norco tabs left...
DrafterX Offline
#31 Posted:
Joined: 10-18-2005
Posts: 98,506
Can I have them..?? Huh
tonygraz Offline
#32 Posted:
Joined: 08-11-2008
Posts: 20,173
Important information

Hydrocodone can slow or stop your breathing. Never use Norco in larger amounts, or for longer than prescribed. Narcotic pain medicine may be habit-forming, even at regular doses. Never share Norco with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
RMAN4443 Offline
#33 Posted:
Joined: 09-29-2016
Posts: 7,683
So, no Drafter, you can't have them?Not talking
8trackdisco Offline
#34 Posted:
Joined: 11-06-2004
Posts: 59,987
tonygraz wrote:
So does Steve Martin.


Thank you.
grmcooper Offline
#35 Posted:
Joined: 10-10-2006
Posts: 20,430
No need for pills man... I found the weed!
RMAN4443 Offline
#36 Posted:
Joined: 09-29-2016
Posts: 7,683
grmcooper wrote:
No need for pills man... I found the weed!

works for me Applause
Numismaniac Offline
#37 Posted:
Joined: 01-13-2012
Posts: 12,222
Rather enlightening, at least the Coop part, LOL!!!

You still got that CDL, COOP?

We have a friend that's over the local drug testing lab, and she's run across at least one individual that tested a slight positive because of the CBD oil?!?!?! I didn't think that was possible, but it could happen.

I'm sorry your pain must be so bad that you have had to look for relief, but I can assure you the MMJ is THE BEST route currently!
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