Idk if there's a better comm for this, but.
Let's say, purely for the sake of argument 
that I am currently on a super-cool prescription painkiller that works great. Let's also say for the sake of argument that the bone/sinew structure that's supposed to hold my ribs together is trying to kill me constantly by conspiring with the base of my skull to cause me unbearable chronic pain. If I skip more than like one day of the cool prescription painkillers, then even just walking around becomes challenging. But also, if I just keep taking the cool prescription painkillers, I'll build up a tolerance. I'm on like 75mg a day right now and even that could be playing with fire.
I need something cool that's gonna dummy out my pain receptors long term. What's a good painkilling solution? I've tried cymbalta, taking way too much paracetamol and ibuprofen, and this cool highly addictive prescription thing. I'm game for any suggestions.
for me naproxen/aleve works better than ibuprofen and lasts longer (its also an NSAID iirc). Not a full sub for your prescription I assume but it might help.
I would avoid paracetamol, its questionable if it works for pain like, at all beyond placebo and the difference between an effective dose and a "harms your liver" dose is not huge
weed helps in its own way but if you don't want to get high and can't smoke/vape you'll have to experiment with different stuff like cbd, hhc, and other weed adjacent compounds in edible form (imo harder to tell if its working or not since it sets in so slowly)
I'm thankful to have another option for other stuff, cause I also get intermittent random back pains, headaches, my joints are totally for shit, etc.
Yeah honestly agreed...
The difference in effective and toxic doses of paracetamol/acetaminophen ARE in fact huge. 3500-4000mg/day is generally considered borderline toxic for a healthy liver.
They really aren't when compared compared to other common otc drugs. At least near me, they sell huge bottles with 500mg pills and say "take these 2 at a time every 6 hrs" (they also have a warning not to take more than 4000mg, but still, you get there pretty fast at the recommended dosage) You take them 4 times in one day instead of the recommended max of 3 and you're in the toxicity zone.
ibuprofen has a much smaller dose, is more effective, and can be taken at the recommended dosage much longer without worrying about total daily intake coming into play.
the ratio between a toxic dose and an effective dose is more like 2:1 for acetaminophen vs like 5:1 for ibuprofen (maybe more?)
Just because the bottle tells you to take that much doesn't mean that's the least amount you need to be effective.
Ibuprofen has different toxicity concerns, primarily to do with kidney toxicity and dissolving the lining of your stomach. Some people need 800mg three times a day for pain relief which is more than half the recommended maximum daily dose.
Totally different drugs, but acetaminophen is safer than ibuprofen/NSAIDs full stop.
I am not basing it solely on the bottle, but I mentioned that because that's the only info the average person is going to get.
regardless I stand by the therapeutic index being way worse for acetaminophen, and the evidence for its use as a broad spectrum painkiller very spotty. There are certainly issues with nsaids too, but there's a reason acetaminophen is like a leading cause of liver failure
idk why I care, maybe you are right. But its not harmless like many people seem to think
Fair enough
spoiler
I do think a significant number of acetaminophen linked liver failures are due to people taking a bunch intentionally to attempt suicide, but just ending up destroying their liver.
have you heard of medical marijuana
could probably unironically help you reduce your dosage but don't expect miracles obviously. Try vaping some herb, maybe it helps. If you don't wanna get high, try pure CBD strains.
I have, that's one of the things I had in mind but I don't know what a dudeweed is, I'm pretty straightedge. Also though I have athsma so it's probably a bad idea to smoke or vape anything. Pure CBD strains, I see.
Depending on the specifics of your asthma, you might be able to get away with some dry herb vaping. But otherwise, edibles would be your best bet. They do make edibles with different amounts of THC and CBD.
I definitely wouldn't recommend smoking in that case, but vaping you could try if you make sure the vape is not getting too hot. If you do vaping right it's basically warm, spicy mist - still may make you cough, but could be manageable if you're careful. The effect is a lot more immediate from vaping, is the only reason I'd at least consider it in your case. You can also try ingesting it orally for a slower uptake, though I'm not sure what a good dosage or way would be for you. Can't really OD on CBD though, so don't stress it too much. If you go that way just beware, there are a lot of snakeoil products out there with CBD. I'd try going for a basic oil extract from a reputable vendor that ideally also sells whole flower, that should give you a pure, reliable, versatile solution for oral ingestion. You could put it on food or even bake with it (I think), take it any way you would ingest oil. Alternatively, you can solve it in alcohol, but I don't think that's a great idea for your use case.
There's probably also CBD in pill form some way or other, I'm sure
We do have actual marijuana dispensories up here in
so that's something at least. Ty for the ideas!
https://nootropicsdepot.com/a-sensory-journey-to-the-heart-of-pain
You want to add an nmda antagonist like agmatine to prevent tolerance build up, and you might have good luck with strong anti inflammatories like turmeric. And you can hit the cannabinoid system with PEA or Tetrahydromagnolol or CBD/CBT/CBC/CBG. THC is very good if you don't mind being inebriated.
I assume weed doesn't do much/anything? That's a pretty safe drug to take daily, so it's worth a shot.
You could try Kratom, I don't have any personal experience with it, but iirc, it acts on the same receptors in your brain as opiates. Long term though, I believe it can cause liver issues. And it's also addictive. And tolerance builds pretty rapidly. So, assuming it even works for your pain, you'll have to weigh it against the medication you're already on.
I've never touched weed in my life but am open to it as long as I don't have to smoke it
Lmao okay, well that sounds exactly fuckin like tramadol to me. The main issues I'm trying to avoid are tolerance and addiction or else I'd just scarf opiates forever, doctor.
The addiction part isn't necessarily true. I've taken Kratom for many months at a time and have never felt compelled to use or had withdrawal symptoms after stopping cold turkey. I do have a friend that said he was straight hooked on it but that hasn't been my experience. Also don't feel like you really build up a tolerance that fast because if you take too much it starts to feel like standard opiates where you become very eepy and nauseous. I only take it for fairly common aches and pains though.
Are opiates really supposed to make you eepy sleepy and nauseous? I must be taking this shit wrong.
Prescription painkillers usually just make me super itchy. I don't typically react the same way most people seem to on a lot of drugs, but I think that might just be the undiagnosed ADHD.Big ups to ADHD :) The fucked thing is tramadol works splendidly for making all my pain receptors shut up, so it sucks it's not viable longterm.
I used to take Meloxicam/Mobic every day when it was believed I had ankylosing spondylitis Supposedly it’s like the safest nsaid to take long term. Not sure if the strength is what you need though, I don’t think it’s super strong.
Yeah I would ask your doctor for a meloxicam prescription. Its non-addictive and works in the same way as ibuprofen (you will need to stop taking ibuprofen or any other OTC NSAID if you take meloxicam though)
Have you tried using a TENS unit? I don't know how that would interact with your specific chronic pain but I know that helped my dad a lot with all the accumulated injuries he had.
TENS unit
I've never even heard of those. How to obtain? Surprisingly my bs isn't the result of an injury (that I know of) but that sounds cool.
Ask your doctor, esp since they aren't necessarily a good option for all types of chronic pain. There's OTC units but they aren't as good as what you can get with a prescription. Also, with a scrip they're covered by insurance and might be able to do a try-before-you-buy thing with doctor supervision.
I have an OTC unit for nerve pain and it goes WAYYYYY too strong if I turn it up at half or more, just a heads up!
It’s fascinating though, it’s the size of an… iPod nano? 2004 Motorola Razr. The battery lasts forever and it’s so small and light!
Tramadol is a shit drug imo, compared to other opioids its pain relief is questionable at best. I would talk to your doctor about trying meloxicam and gabapentin.
No problem, also 75mg of tramadol isn't much. I see people on 250mg/day. Not that you want to get to that point but yeah.
Everyone always says tramadol is shit. I've been on 150mg/day for 3 years with no tolerance increase. It sucks when the pharmacy fucks something up and I'm out for a couple of days, but it's not nearly as bad as missing a dose of gabapentin was.
I'm sure it works fine for you, but drugs are judged based on their efficacy and safety across 10s of thousands of people.
https://rebelem.com/tramadol-or-tramadont/
"The big issue is that CYP2D6 activity varies among patients and this is important because you don’t know how much opiate the patient is actually receiving (i.e. the same dose of tramadol will have widely different effects from patient to patient). Not only is tramadol potentially not giving pain relief, but patients often return to the ED for common side effects of tramadol including nausea/vomiting, dizziness, constipation, etc. Because of it’s multiple mechanisms of action, potential drug-drug interactions, and lowering of the seizure threshold, the safety of tramadol has been brought to question."
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I would like for the solution to this to be that easy.
