(Unless by 'safe and effective' you mean NEVER have side effects, in which case we probably don't have any 'safe and effective' medications.)
Chronic pain is difficult to deal with and wasn't addressed in this study. Generally opiates are not recommended, but its tough to find other alternatives that are consistently safe. Opiates often end up being used and... epidemic. (... == long complicated story)
Paracetamol/Acetaminophen has an incredible safety profile - in people who use it responsibly and don't have liver disease.
It is, after all and as you are obviously well aware, responsible for the highest number of ED presentations for overdose, and it does kill a number of people each year. But that's a mental health issue, and you can overdose on Water (or food, as I indicate in opening paragraph), and die. For people who take it responsibly and without intent for suicide, it is incredibly safe and effective.
Same with ibuprofen - although with the proviso of Do not take for more than several days. But, the same could also be said of opiates - safe for short periods. it's chronic use that will cause problems in lots of cases (ie. add in benzos as well)
It doesn't just go away like alcohol either. If I drink too much and throw up, I feel better within a few minutes. For cannabis I remain high afterwards, so I've become pretty hesitant about it.
That being said, it is very likely less addictive and has far fewer side-effects for those who it helps. For that reason I am extremely positive about legalizing it and studying it further. :)
Sorry to pick on you, but people should realize that if all they want to do is try cannabis for pain management, they shouldn't let a dislike for the recreational effects deter them because the two can absolutely be separated.
FWIW, I manage my pain with meditation techniques and it's the only form of pain management that I recommend whole-heartedly, so I'm not recommending anyone try CBD. But I know people who take CBD for pain and I think people should, at least, understand how cannabis is used medicinally before saying negative things about it.
Doctors and I were convinced he was not telling the truth or his stuff was laced. Ended up that he was telling the truth and was clean other than pot. Sad thing was he would keep using pot which ended up messing with his health.
I never see why people care to be sedated emotional. Worst thing about pot to me. They miss out on so much emotionally.
PS: Not to defend Cannabis, it can trigger Heart Attacks and is associated with a host of Lung issues. I just never heard of those symptoms.
On the bright side, at dispensaries you can know precisely what you’re getting, so at least I can say “this weed will pleasantly reduce my anxiety and pain, that weed will blast me unwillingly into space” which is an option I never had before.
It's legal where I live and the handful of times I have used during the week, I can't remember what I did the day before as well, or what my tasks for the day are. My performance at work noticeably degrades. I'm also more tired the day after, despite generally getting more sleep.
It's great for the weekend when I can just sleep it off or my only tasks are to go for a hike and get groceries though. Better than alcohol at least.
That being said, I may have exaggerated the memory issues. It isn't like full blown amnesia. More so it just takes longer than usual to remember things. I'd compare it to a cache miss. Smoking clears my brain's cache the next day and I end up feeling like I am pulling short-term thoughts and memories from colder storage.
An uncle and some other older physicians who are on long-term measured acetaminophen usage reported supplementing their regimen with n-acetyl cysteine (NAC) with no apparent diminution in analgesic effect. WebMD has a description of the chemical mechanism:
https://www.webmd.com/vitamins-supplements/ingredientmono-10...
As an aside it's also the primary antitoxin for the treatment of acetaminophen poisoning in veterinary medicine:
http://orrongpharmacy.com/content/s_vet/vet_poisoning.htm
So it might be useful to bring this possibility up with your personal physician.
https://en.wikipedia.org/wiki/NSAID_hypersensitivity_reactio...
NSAIDs-exacerbated respiratory disease
N.E.R.D.
I found out that (scientifically speaking) I am a NERD (or have NERD, whatever)
Digestive problems are so common with long-term use that some doctors think that they should co-prescribed with omeprazole and other agents to head them off. (Long-term omepraloze will give you B-12 deficiency if you don't supplement; it is an unusual side effect, but I can't sleep if I take omeprazole.
Cardiovascular risk from Vioxx was enough to pull the drug from the market; risk is also seen with Celebrex and other COX-2 selective NSAIDS. The risk with non-selective NSAIDS is less understood but still present.
My doc does not want me taking acetaminophen because she thinks it causes me to get elevated liver enzymes.
Like opioids there are problems when people don't "use as directed". My grandmother used to take Bufferin by the handful and one day at the dinner table we saw her throwing up blood like something out of a horror movie and she was subsequently hospitalized..
Acetaminophen overdoses can easily destroy your liver and are one of the most common forms of fatal poisonings.
The verdict is that we don't have truly 'safe and effective' medicines for pain in 2017.