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Pain is unavoidable. Suffering is optional. Credit: artem evdokimov / Shuttestock.com
Chronic Pain and the Search for Effective Treatment
The management of pain has been a central part of medical practice for many years. The effects of chronic pain on individuals can be serious and wide-ranging, affecting their quality of living. Chronic pain is not an exaggeration. The search for an ideal pain reliever is ongoing.
Medical science has made some advances, but they have not been as significant as one might think. Although personalised medicine is often discussed as the future of effective pain management – and it likely holds significant promise – it is not a solution that will become widely available in the immediate future. We must for now rely on treatments that are currently available.
Paracetamol, the most widely used painkiller worldwide
The majority of people have used paracetamol. Since around 1900, it has been an effective and inexpensive pain reliever. However, it was not widely available in pharmacies before the 1950s. It has since become one of most widely used medicines in the world.
Spain is a bit unusual, as it restricts the sale of over-the counter medicines to pharmacies. In most other countries, paracetamol and similar products can be purchased in supermarkets, convenience stores or motorway service stations.
It is easy to get the impression, due to their availability, that these medicines are no different than everyday products such as cough sweets. The difference between the two is significant.
How doctors determine safe medication dosages
When producing drugs for wide-spread use, drug manufacturers are faced with a unique challenge.
A small dog will require a higher dose to calm it down than an elephant. Veterinarians are faced with this problem regularly and adjust dosages according to the animal’s weight and species.
Manufacturers must take a middle ground approach when a product such as paracetamol, is marketed to the general public as a suitable medication. Standard dosages usually are based upon a “typical adult” weighing 70 kilograms.
Individuals who are under this weight limit should not be concerned about accidentally overdosing on the recommended doses. Over-the-counter medicines are designed to have a large safety margin.
Is paracetamol safe? Understanding the risks
Paracetamol can be so familiar, it’s often taken for given. In rare cases, it can cause severe damage to the kidneys and liver, which could be fatal.
In order to limit this, many countries have set a maximum number of tablets per transaction. Retail systems with barcode-based inventory control prevent customers exceeding these limits automatically at the checkout.
It is not possible to prevent people from buying more medication in another shop. However, it would be better to remove the drug from the over-the-counter market.
In hospitals, intravenous paracetamol
Paracetamol can also be found in many hospitals.
When pain relief is needed quickly, the drug can be administered intravenously.
When administered intravenously, the dosage is carefully calculated according to the patient’s body weight – much like veterinary dosing – ensuring that the medication effectively relieves pain while minimising the risk of harm to vital organs.
Medical errors and the culture that blames in healthcare
A patient was treated intravenously with paracetamol for a rare medical problem that caused an abnormally low weight.
The patient received a dose that was not weight-adjusted, for reasons which have never been completely clarified. This led to fatal organ failure.
This type of incident is extremely rare. It appears that the larger concern was the attempts to cover up the mistake by several individuals. Sometimes, the fear of lawsuits can overshadow transparency and create a culture where It is difficult to find the truth.
Aviation safety can teach us a lot about healthcare
In contrast, the aviation industry is often cited by organisations as an example of how to respond when something goes wrong.
In order to determine the root causes of an incident, a well-established and structured process is used.
Even when pilots are at fault, investigators will examine whether other factors like confusing warning systems or control layouts may have played a role in the error. All findings that can improve safety are shared with the entire industry.
Any complex field is bound to make mistakes. However, when a culture of blame dominates – as it often does in healthcare – identifying the truth and learning from errors becomes far more difficult.
The Opioid Crisis & the Sackler Family
You can also find out more about the following: Sackler family It has again been in news following controversy over a large donation that was accepted by the charity affiliated with Chelsea and Westminster Hospital NHS Foundation Trust In the UK.
The criticism is based on the fact that the family owned the pharmaceutical company which developed and marketed opioid pain medications. OxyContin.
When OxyContin was introduced, it was aggressively promoted as a “silver bullet” for pain management – offering powerful pain relief without the addictive properties traditionally associated with opioid medications.
The reality was quite different. It was widely prescribed and thousands of people became dependent.
Addiction can lead to overdoses and death in many cases. It is one of the biggest public health problems that has ever occurred in American history.
Why opioid painkillers should be strictly controlled
Opioids, precisely because of the high risk for addiction, are strictly controlled.
When prescribed by a doctor, they usually require strict monitoring.
In the United States there were problems when new drugs, which were heavily promoted by financial incentives and luxury hospitality to doctors and General Practitioners, caused problems.
A further controversy was sparked when the pharmaceutical company accused of misrepresenting or adjusting data from clinical trials.
Alternative therapies can help relieve pain.
Are there other methods to relieve pain besides pharmaceuticals?
I was always sceptical about anything that wasn’t conventional medicine. I was forced to seek out other options after my medication became a major part of my life due to a chronic condition that required pain control.
I went to a clinic where a doctor who was also a traditional Chinese acupuncturist practiced.
Initially, I had a lot of doubts. Within minutes of being injected with small, completely non-painful needles at specific points, i fell asleep. My pain significantly decreased after a few sessions.
Process Pain
Pain is a complex phenomenon – it is ultimately processed in the brain.
Referred pain can occur when we feel discomfort in a certain area but it actually originated elsewhere on the body.
This neural processing helps explain why pain can be such a subjective feeling, and how it varies from person-to-person.
As the famous Buddhist saying says: “Pain will always be there.” “Suffering can be optional.”
Information provided in this column should only be used for informational and educational purposes. It does not constitute any medical advice. This is not meant to be a replacement for professional medical advice, diagnosis, and treatment. If you have any questions about a medical condition, always seek out the advice of a qualified physician.
Dr Marcus Stephan
