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Pain killers – the good, the bad and the ugly.

I was very fortunate to attend and listen to a very interesting topic about pain killers recently.  During our work at Bodylogics we have clients regularly see us who have spent some time taking medication to control their symptoms and it amazes me that so many actually do not follow the guidelines stated.  Education on this topic is therefore vital to ensure we all know what is happening when we take these drugs and what good or harm they are actually doing.

Let’s start with paracetamol.  This is the most widely used over the counter analgesic form of medication available to the general public.  You do not need a prescription for it and you can buy it from pretty much any supermarket now.  But what does it do and how does it work?  The simplistic way to explain it is that paracetamol, when broken down, attaches itself to nerve receptors in the body but these nerve receptors are pretty much associated with every possible discomfort that the body can feel.  It works by making us feel a little more relaxed and comfortable and is usually used alongside other medicines simply because of this effect.

On the other hand, paracetamol can be very toxic.  The body can only absorb about 1 gram 3-4 times per day.  As soon as you start going above this it can become very toxic.  This is prevalent when you think that in all suicides that involve medication, 60-70% have  paracetamol as the primary drug involved. The issue lies within the liver. When paracetamol is metabolised in the liver it is then passed out to the blood stream which has the calming effect on the nerve receptors.  The issue lies though in paracetamol which is only part metabolised.  This causes high toxins within the liver and by adding more paracetamol to be broken down, the liver cannot cope and you create a funnel effect into the liver which it cannot cope with.  This then results in a build up of toxins which can result in catastrophic liver damage when people overdose.  Paracetamol also competes with enzymes in the liver that is used for breaking down alcohol and unfortunately people often use paracetamol to deal with the effects of alcohol and are therefore creating a more toxic effect in the liver area without even knowing it.

If we just took the ‘average’ healthy person, people ask what is the minimum dosage that they have to take to avoid danger.  Paracetamol has a half life of around 1-2 hours.  After this time it starts to die off.  This is why we have the recommendation of taking 1 tablet 3-4 times per day.  This coupled with the fact that for the paracetamol to actually kick in and start working so you are in a ‘steady state’ where the effects of the drug are playing out but in a safe way, usually takes at least 7-8 cycles of taking it.  It is really important here to ensure you take these in line with the guidelines.  I have experienced clients who when asked how long they took the paracetamol for they respond with having taken 2 rounds of pills and then felt no difference, so they then increase the dosage of go straight to their GP and ask for something stronger without having allowed the medication to actually work.

When we look at Tramadol and Codeine there is a slightly different approach to how the drug works.  Codeine itself has absolutely no analgesic effect on its own.  However, when taken and metabolised by the liver it changes the molecular make up of the drug and creates something very similar to morphine.  It is also important to remember that around 10-15% of the population are unable to break this down and will therefore have no impact.  There is also 5% of the population that break these drugs down rapidly and then experience adverse side effects as their body is unable to deal with the ‘morphine hit’ it is experiencing.

There is also the fear that both these drugs can become addictive and people are worried about this and will therefore avoid taking them.  If we take the figures that are available, true addictive of pain killer drugs when taken in the presence of pain, is around 2-3% of all people which is relatively low.  It is important to be aware that there is no physiological part of drugs that have any addictive component within them.  Addiction comes from beliefs within the individual that they require them so educating our clients is very important to ensure that this can be managed.

To conclude, pain killers are not a bad thing.  It is vital to ensure they are taken whilst following the guidelines and  hopefully by understanding them a little more from this blog you will be better informed of how they can help you.


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