teedubbya
7 years ago
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
7 years ago
I hate dentists.. 🤐
Speyside
7 years ago
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
7 years ago

I hate dentists.. [-(

DrafterX wrote:



Phil222
7 years ago
Meta-analysis = good stuff. Thanks for posting.
teedubbya
7 years ago
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
7 years ago
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
7 years ago
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
7 years ago
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
7 years ago

I hate dentists.. [-(

DrafterX wrote:



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

dstieger
7 years ago
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
7 years ago
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
7 years ago

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.

ZRX1200 wrote:


well......Can you???[gonzo]
frankj1
7 years ago

well......Can you???[gonzo]

RMAN4443 wrote:


looks like he passed out in mid-paragraph
Abrignac
7 years ago

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.

teedubbya wrote:




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
7 years ago
You can offset the constipation with Papa Murphy’s.
Gene363
7 years ago
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
7 years ago
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
7 years ago
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
7 years ago
#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.
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