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Comment by txsh | Hacker News Reader

As someone who has had frequent kidney stones, I have found that many painkiller prescriptions are unnecessary. Kidney stones are more painful than childbirth and I’ve been hospitalized for then before. But prescription painkillers rarely get rid of the pain.

People seem to be reluctant to mix medications for fear of drug interactions. They want a strong dose of one substance.

But nothing has worked for me better than mixing acetaminophen with ibuprofen or with naproxen. All are cheap, available over the counter, and have fewer side effects than prescription pain killers.

I also find that, after the initial pain subsides, I can more quickly reduce the dosage of these drugs than I could with prescription painkillers.

By all means, use oxy if you need it. But please consider trying alternatives first so you can avoid addiction.

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> mixing acetaminophen with ibuprofen

It's a well-documented (in scientific literature) phenomenon that the mix of a standard dose of both acetaminophen and ibuprofen provides the same or better pain relief as opioids. This is what medical schools currently teach. You can read Maxigesic sales forecasts if you'd like a glowing review.

> use [OxyContin] if you need it

As far as I know, no one "needs" it (for pain relief, unless already addicted). By suggesting so, you're creating a placebo effect.

> [@Kenji] it depends on the person

Responding to a dead sibling comment: There are some differences observed for anesthetic response. The "red head rule" is interesting and suggests that different people might have different responses to various drugs. However, I'm not aware of any differentiation known for acetaminophen or ibuprofen response.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1362956/

There are useful cases for opioids, but it's a tiny percentage of the cases where they are being prescribed today. think treating traumatic amputation, for example.

mixing acetaminophen with ibuprofen It's a well-documented (in scientific literature) phenomenon that the mix of a standard dose of both acetaminophen and ibuprofen provides the same or better pain relief as opioids

If you had said some types of pain, I would agree, but your statement as-is is not accurate.

If just had a leg amputated or some other major surgery, I doubt you'd be ok with just Tylenol and ibuprofen.

The only info could find concluded it better for dental pain.

True. Interestingly, from what I've read, people often rate dental pain worse than other kinds when asked "How much pain are you in, from 1 to 10?" Nasty toothaches and kidney stones are just about the worst pain someone can experience. Maybe the data on losing limbs isn't good because the question gets asked at the wrong time.

Also, a large portion of the opioids prescribed are for dental pain. At least historically.

The reason that ibuprofen works for kidney stones is that it actually treats the cause, which is swelling in the ureter caused by a sharp rock ripping it up from the inside. For many types of severe pain, ibuprofen won't do much.

Strong pain killers are still somewhat useful for kidney stones however; When I had one a few years ago I was unable to keep any larger dose in my stomach long enough to metabolize it before the pain made me vomit. I got prescribed dilauded which was able to act fast enough to give the ibuprofen time to kick in.

But definitely consider destroying your opioids if you no longer need them, I think there are some common household chemicals which will break them down to a non-potent form, so we don't end up with them in places like puget sound.

Ibuprofen decreases inflamation which passes the stone faster which increases the pain. Ibuprofen alone makes the pain worse. But, even with stones too large to pass, ibuprofen and acetaminophen works better than prescription pain medicine. I can’t say it works better for everyone. But it would for most if they tried it.

Or take them back to a pharmacy - when I have asked I’ve been provided a receipt too.

Too late for some! When trying to kick opiods, I recommend cannabis. Any narcotic works wonders through opioid withdrawal, and cannabis is so safe.

Although you might become 'addicted', it's easier than controlling opioid intake.

By all means, use oxy if you need it. But please consider trying alternatives first so you can avoid addiction.

An amusing anecdote that I hope doesn't make light of your suffering... I once had some severe pain from a pinched nerve, and my doctor prescribed Oxy. I tried one pill at bedtime to help me get to sleep. It was when we were just beginning to hear about how dangerous that stuff is, and I was worried about it.

Then my wife said to me: "You're not having any alcohol with that stuff, are you?" Shit. I realized that a good stiff drink would probably have put me to sleep too. So I asked her to get me a bottle of whisky, and I flushed the Oxy. My pain went away about the same time I ran out of whisky.

Considering the respective risks of addiction, overdose, withdrawal symptoms and dangers, health deterioration, and general functional impairments, I think you may have been safer with the Oxy.

To be honest, I think alcohol is the strongest painkiller that's readily available. When I was in pain for weeks, none of the pain killers did anything but when I drank one large beer, the pain was pretty much gone for the next couple of hours. Of course you cannot stay drunk forever but you also cannot stay on painkillers forever, and both are taking a toll on your liver.

I don't know, maybe it depends on the person, how your body reacts to different substances.

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