Gerald E. Markle and Frances B. McCrea
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 About 30 million persons aged 12 or older (13% of the population) have used prescription pain relievers "nonmedically" in their lifetime. The number of drug abusers is increasing—rapidly. Those using prescription pain relievers nonmedically for the first time surged from 600,000 in 1990 to more than two million in 2001. Finally, about 1.5 million persons aged 12 or older were dependent on or abused prescription drug pain relievers in 2002.2
"What exactly do they mean by 'nonmedical?'
"It's Clintonesque," I answered, thinking of our President's defini-tion or is! |
Bottom Line Health
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| Best pain relievers for Headache, Arthritis, Backache and More
Jacob Teitelbaum, MD, director, The Annapolis Center for Effective CFS/Fibromyalgia Therapies, and author of Pain Free 1-2-3! (Deva) and From Fatigued to Fantastic! (Avery), www.endfatigue.com.
Most of us turn to acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) for pain relief—but there can be more effective approaches, including combining conventional and natural pain relievers.
Caution: Check with your doctor before taking any new medication or supplement. |
Ron Garner
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 A headache is not caused by a deficiency of analgesic pain relievers, but is from a stressed body due to emotional pressures, or toxins in the blood that the body is trying to eliminate.
You need to listen to your body and respond in a supportive way. Illness symptoms have causes. They are our friends. They are cries for us to cooperate with the healing process so the underlying causes can be corrected. As uncomfortable reactions manifest, think about what you did or ate recently that provoked the reaction. |
Marshall Editions
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 This can be treated with symptomatic pain relievers, such as children's Tylenol® or Motrin®.
TRADITIONAL CHINESE MEDICINE
Traditional Chinese medicine is based on an ancient system in which, historically, "dentistry" did not exist. However, many classic TCM books have mentioned treatment for problems with the teeth. Traditional Chinese medicine approaches sensitive teeth from the perspective of treating pathogenic heat and wind. The condition is caused by excess stomach heat in the majority of cases due to the special relationship between the stomach and teeth. |
| Additional measures include applying lidocaine gel, taking cool baths, and taking simple pain relievers.
Prevention: Avoid high-risk sexual behavior, fatigue, and stress to help keep herpes in remission. Some studies show that taking lysine supplements is also helpful.
TRADITIONAL CHINESE MEDICINE
Herbs: The herbs listed below are available from Chinese pharmacies or online.
• To treat simplex Type 1 herpes or cold sores: Take Chuang Xin Lian Pian, a Chinese patent herbal pill. It contains the herbs Chuang Xin Lian and Bu Gong Yin, which have antiviral effects to clean heat toxins. |
Bill Sardi
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 To digress for a moment, the FDA continues to ignore the 70,000 confirmed cases of liver toxicity that occur annually from acetaminophen pain relievers. The American Poison Control Centers count about 70-100 deaths per year from acetaminophen poisoning. More than 8 billion acetaminophen pills are sold annually. But the FDA chooses to issue a warning about chaparral, not acetaminophen (Tylenol).
Acetaminophen overdose results in more calls to poison control centers in the United States than does overdose with any other pharmacologic substance. |
Jonathan V. Wright, M.D. and Alan R. Gaby, M.D.
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 When you tried avoiding caffeine strictly, did you eliminate tea, all cola drinks, chocolate, and all pain relievers with caffeine in them?"
"No. I never even thought of the pain relievers—but does caffeine elimination really make any difference?"
"Yes, but only for women who have fibrocystic disease or a tendency towards it. What the negative research found was that caffeine didn't give all women a problem. We can't use that to say caffeine doesn't give anyone a problem."
"I'll give it a try, and be much more careful this time. What else should I do? |
Bottom Line Health
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| Example: Some pain relievers can cause constipation.
Make a follow-up appointment before leaving the office. You may need frequent visits while your medications are being adjusted. Once your pain is controlled, you will probably need to see your doctor less often. Prepare a new pain inventory before each visit.
MEDICATIONS TO CONSIDER
Following are some potent pain-fighting therapies, many of which are underused...
•Anti-inflammatory drugs. |
Herbert Ross, DC with Keri Brenner, L.Ac.
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 In addition, many over-the-counter medications (cold and cough preparations, weight-loss drugs, pain relievers) contain caffeine or caffeine-related substances and can also increase sleep disorders.
Recently, coffee and chocolate have both been touted for their high levels of antioxidants, and in fact, caffeine itself is an antioxidant. A 2005 study found that coffee is actually the top source of antioxidants in the U.S. diet. |
Lester A. Mitscher and Victoria Toews
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 Contrary to popular belief, there is no clear evidence that stress or overindulgent eating habits lead to ulcers of the stomach, esophagus, or small intestine, but research suggests that smoking and the use of certain medications, such as aspirin and other pain relievers, increase the likelihood of ulcers.
The catechins in tea may help prevent ulcers. In tests conducted on animals, catechins showed an 80-percent success rate in preventing stomach ulcers. |
Jonny Bowden, Ph.D., C.N.S.
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 For relief from the pain, many reach for remedies like the prescription drugs in the category known as COX-2 inhibitors (Celebrex and Vioxx are famous examples), or pain relievers such as acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (Aleve). These drugs do offer immediate relief, but they're hardly without problems (witness the class-action suits over Vioxx). O
Keep in mind that none of them address 03 the underlying cause of the joint pa.n. |
| NSAIDs, which also include pain relievers such as aspirin and aspirin-like compounds like ibuprofen and naproxen sodium, aren't as innocuous as they seem. They come with their own set of potential side effects, one of which is that they can increase what's called gut permeability—essentially a weakening of the lining in the gut that serves as a protective barrier for the bloodstream, keeping out things that don't belong. When those "borders" are weakened, i.e., when the gut becomes more permeable, all manner of digestive "riffraff can get in, causing myriad health problems. |
Gerald E. Markle and Frances B. McCrea
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| Taken together, pain relievers accounted for one-third of all medications. The next most category of drugs (15%) were antibiotics, the overprescription of which, documented in the preceding chapter, is a significant public health problem.
Only one in twenty patients arrive at the emergency room with that most fearsome symptom—chest pain—as their primary symptom, though heart problems are the most common ED physician diagnosis among those over age 45. Although the number of patients is relatively small, the potential consequences of chest pain are life or death. |
Herbert Ross, DC with Keri Brenner, L.Ac.
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| Short-term use of over-the-counter pain relievers, heart medications, antianxiety drugs, and even sleeping pills has been shown to interfere with nocturnal secretion of melatonin. Although avoiding these medications is the only definite way to reverse or avoid their effects on melatonin, taking these drugs earlier in the day may minimize their impacts on sleep. Statistics regarding sleep deprivation in older people rarely take into account the use of multiple medications and their effects on sleep patterns. |
Melody Petersen
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 Reicin proposed that people with a high risk of cardiovascular problems be kept out of a proposed study in the hope that by the trial's conclusion the difference in the rate of heart complications between the Vioxx patients and those taking other pain relievers "would not be evident."
The fear that Vioxx could harm the heart continued to roil Merck's executives, scientists, and marketers in the following years, as the FDA approved the drug in May 1999, and the company began spending tens of millions of dollars a month to promote it. |
Brenda Watson and Leonard Smith
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 Researchers have also found that people share a concern today for side effects associated with over-the-counter pain relievers, but at the same time those same people admit to taking more than the recommended dose.
If you are like most people, you throw away the original box and any paper that comes with your over-the-counter medicine. Very few people save leaflets or packaging with important warning information. But even conscientious people who read the fine print may not get the crucial information they need. That's because many nonprescription drug labels are woefully inadequate. |
Bill Sardi
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| Just the use of non-steroidal pain relievers like aspirin and ibuprofen cause an estimated 16,000 deaths annually. Side effects from properly used prescription drugs, administered by nurses in hospitals, result in over 100,000 deaths annually. The FDA approval process does not guarantee safety.
Does sugar cause cancer to grow?
According to the American Cancer Society, sugar doesn't make cancer grow faster. It is true that all cells depend upon sugar for energy, and that cancer cells produce their own form of sugar via fermentation. |
Bottom Line Health
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| Most of us turn to acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) for pain relief—but there can be more effective approaches, including combining conventional and natural pain relievers.
Caution: Check with your doctor before taking any new medication or supplement.
ARTHRITIS
There are two types of arthritis—osteoarthritis, in which cartilage between bones wears away... and rheumatoid arthritis, an autoimmune disease that inflames joints. |
| Women often do better with ibuprofen (Advil) or another nonsteroidal anti-inflammatory drug (NSAID), such as naproxen (Aleve), than with pain relievers, such as acetaminophen (Tylenol), that do not treat inflammation.
Best advice: For severe pain—following surgery, for example—women should ask their doctors for a "kappa opioid," such as butorpha-nol tartrate (Stadol), a morphine-like painkiller. This class of drugs is much more effective for women than other analgesics. In men, kappa opioids are not as effective as other drugs. |
Melody Petersen
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| Graber, a professor at the University of Iowa and an emergency room physician at the university's hospital in Iowa City, said he sees patients whose stomachs are bleeding because of pain relievers and others whose hearts are failing because their diabetes meds or pain pills have caused dangerous buildups of fluids. Other patients, he said, have suffered severe and sudden allergic reactions to antibiotics.
The university does not keep track of the numbers of patients rushed to the emergency room because of injuries caused by their medications, Dr. Graber said. |
Marshall Editions
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| These pain relievers can usually be taken safely, however, unless extremely large amounts of alcohol have been consumed.
TRADITIONAL CHINESE MEDICINE
Herbs: Mix 5 g of Ye Ju Hua (wild chrysanthemum flower) and 3 g of Shen Gan Cao (raw licorice) in a teapot. Add boiling water and let the herbs steep for a few minutes. Drink the tea three to four times a day. The herbs are available from Chinese pharmacies or online.
Acupuncture: Treatment can be useful for a hangover. Consult a practitioner who wil recommend a certain number of sessions and advise on the frequency of treatments. |
Melody Petersen
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| Scientists at Merck and at Searle, a company later bought by Pharmacia, developed the medicines on the basis of research into cyclooxygenase, an enzyme in the body that is often referred to as Cox. pain relievers like aspirin and ibuprofen inhibit the Cox enzymes as they reduce pain. At the same time, these drugs often wreak havoc in the stomach and, in the worst cases, cause bleeding ulcers that kill. Merck and Searle scientists developed the new drugs on the theory that there were two kinds of Cox enzymes, Cox-1 and Cox-2. |
Marshall Editions
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| T
Medication to treat pain: Drugs used to treat rheumatoid arthritis are pain relievers such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs have the added benefit of reducing inflammation as well as pain. Corticosteroids are given orally to treat severe or aggressive disease. Local infections of the joint can be used when there is swelling and loss of motion.
Medication to control the disease: Other classes of drugs are used to modify and control the disease. |
Melody Petersen
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| Before the introduction of Vioxx and Celebrex, sales of such antiinflammatory pain relievers had been in decline. It was not a market that excited analysts on Wall Street. Patients with arthritis could buy a variety of cheap and effective over-the-counter medicines like aspirin or ibuprofen and ease their pain for just pennies a day.
But in 1998 news stories began to appear about the new "super-aspirins" that were coming soon. The media reports said the new drugs would offer great pain relief without the dangerous side effects of standard anti-inflammatory pain pills. |
| In the following months more articles raising questions about the safety of the new pain relievers were published. Most of them singled out Vioxx.
A group of doctors at Vanderbilt University reported in October 2002 that they had found that poor patients in Tennessee who were taking high doses of Vioxx had significantly more heart attacks and strokes than patients not using such high amounts.
Merck kept selling.
SIX
Ghostwriters and Secret Studies
Complete honesty is of course imperative in scientific work.
—W.I.B. |
Mark Sircus
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 William Lee, a liver specialist at the University of Texas Southwestern Medical Center in Dallas said he was disturbed by a pattern: "that acetaminophen is always billed as the one to reach to for safety, probably even more so now, with other pain relievers pulled from the market." "It's extremely frustrating to see people come into the hospital who felt fine several days ago, but now need a new liver," said Dr. Tim Davern, a gastroenterologist with the liver transplant program of the University of California at San Francisco. |
The Editors of FC&A
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| Unfortunately, not all pain relievers bring relief to your heart. A new study links high blood pressure to frequent use of common over-the-counter pain relievers. These include acetaminophen (Tylenol) and NSAIDs, like ibuprofen (Advil, Motrin) or naproxen (Aleve).
People who took acetaminophen 22 days a month or more doubled their chances of developing high blood pressure. Those who took NSAIDs that often were 86 percent more likely to have high blood pressure.
This is the first study to find such a link, and more research is needed. |
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