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Comment by Johnny555 | Hacker News Reader

Related: some studies have found that opioids are no better than ibuprofen+acetaminophen:

https://arstechnica.com/science/2017/11/as-epidemic-rages-er...

And I believe it.

My wife had somewhat involved oral surgery (1 regular extraction plus removal of 2 impacted molars embedded in her jaw - it was difficult enough that they said a broken jaw during the procedure was a possible complication. The doctor prescribed a week of hydrocodone, and said that she absolutely will need that bottle, and may want a refill.

She didn't want to use the opioids so went with the alternating ibuprofen+acetaminophen route, and though the first couple hours after the Novocain wore off were a little painful, she was pretty comfortable after that.

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Not to put a fine point on it, but you don't know what you're talking about. Have you ever seen someone who is in so much pain that they're projectile vomiting just because of the pain? I have.

There is pain, and there is PAIN. If you can get by with some NSAIDS, then you're just in mild pain. This is not likely to interfere with healing. This is the kind of pain the person is talking about in the article. It's scary for most people because they're not experienced with pain.

I was with a loved one who underwent a very serious surgery. This person has a very high pain theshold and thought that they would ignore the doctor's advise and take something a lot less strong than what was provided.

They ended up back in the hospital on a morphine drip to recover from their pigheadedness. Not taking the prescribed opioids had let their pain get out of control. Severe pain is very serious and can greatly interfere with the healing process.

By way of comparison, this same person had a minor surgery (a couple of years after the very painful one) and the doctor was shocked at how they didn't seem to really be any pain, because their pain threshold was much higher than before.

My point is that the doctor said she she not only needed a week's worth of vicodin to manage the pain for recovery, but she'd likely need more.

Yet she really only needed zero vicodin. Just like the person in the NYTimes article.

But thanks for your illuminating anecdote of someone who had some procedure and ignored some medical advice and took something else than the something that was prescribed.

Why does it surprise you? The doctor is probably basing his/her advice off what they most commonly see.

Are you saying your doctor should have known in advance your wife was an edge case with high pain tolerance?

Well no, I think her doctor is basing his/her advice on what he typically does, and what patients expect (see the original NYTimes article where the author was adamant that she needed stronger painkillers, but turns out she didn't).

The dangers of opioids are well known, and it turns out that the evidence for opioids being the best option to be routinely diagnosed is shaky. From the article I linked to:

The authors of the new trial, led by Andrew Chang of Albany Medical College in New York, note that common medical practice and guidelines, including those championed by the World Health Organization, suggest that opioids are simply more effective at treating acute pain than non-opioid medications—or combinations of them. Yet, the data backing that is shaky.

So maybe, more discretion on when and how many opioids are prescribed would be better for everyone.

> it was difficult enough that they said a broken jaw during the procedure was a possible complication.

This is boilerplate for tooth extraction. I was told the same when I had my wisdom teeth removed.

I agree. In my experience, specifically Vicodin, does almost nothing for inflammation. Ibuprofen has consistently proven more effective when it came to actual pain.

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