I don’t think it’s a coincidence that about the same time vioxx was pulled from market for raising CV risk an equivalent of raising systolic bp two points that opiate substitution took off. Many people couldn’t tolerate naproxen, Tylenol wasn’t effective, and drs feared Celebrex
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AFAIK it is the single largest cause of overdose injury in the western world? And afaik most medical opiate users are already taking significant doses of it AND an anti-inflammatory?
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Here’s a peer reviewed article showing that 800mg of ibuprofen provides pain relief to more patients than any of the opioids. Look at the first Oxford League table. Admittedly, 76 patients is a small sample.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1855338/ …
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Yeah, I think he was cherry picking studies.
End of conversation
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Is anyone else a little unnerved that the official US Surgeon General Twitter account is finding its information on Google?
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Indeed- inability to control pain with more than 4 grams acetaminophen is one of my criteria for moving up on pain control. And I don’t like to use combination like vicodin unless I am sure the acetaminophen dose is not excessive.
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As you undoubtedly know, poor post op pain control is associated w delayed mobilization and attendant complications such as pulmonary embolism. You can’t just tolerate more pain to avoid dependence without other adverse consequences.
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-> Hope this helps! I found them all w 5 minutes on google. Lots of evidence for efficacy/ equivalence/ superiority of non opioids!