> His doctor just decided to not prescribe opoids for any reason.

From my unerstanding, you can only take them for about a week before they become addictive, and that in itself is fine, but they become less and less effective as time goes on as well. You've got to take more and more to get the same effect.

Opioids are really only good for short-term pain. Also, doctors are really under the gun right now because they have been overprescribing opioids for years and a non-trivial segment of the population (at least in the US) is addicted to them.

This is absolutely not true for everyone. I took oxycodone for three years without ever getting addicted, and it never stopped working. Thankfully, eventually enough surgeries and physical therapy finally worked to where I don't really need pharmaceutical pain management beyond normal OTC stuff, but for a while, there was no way I could have handled life without a whole lot of schedule II help, and I'm glad as hell this was before the addiction problem really took off in these economically depressed places among people who are jobless with terrible lives and no prospects and everyone blaming the drugs, so my doctors were never pressured into not prescribing them for people they clearly worked for.

It’s a shockingly common outcome though. Long term opioid use occurs in about 4% of people following their use for trauma or surgery related pain.. The odds get much worse when prescribed for long periods.

I hope your friend can seek another doctor if this is debilitating. Empathy doesn’t always get a fair voice in prescribing guidelines / decisions

Any reason for ibuprofen instead of paracetamol? Ibuprofen can damage your gastrointestinal tract.

For me, I choose ibuprofen more often than paracetamol because 1) paracetamol carries a fairly serious overdose risk and is one of the common drugs people accidentally kill themselves with, and 2) paracetamol is not a true anti-inflammatory and doesn't help nearly as much with arthritis. Ibuprofen doesn't just relieve pain but actively reduces inflammation.

Paracetamol can damage your liver. Neither are great options to take too much of.

As I understand it, paracetamol was discovered as the active metabolite of a much more damaging drug (acetanilide); and that most of paracetamol's effects is due to a metabolite of paracetamol in turn, namely AM404.

Why the pharmaceutical companies haven't done to paracetamol what they did to acetanilide, I don't understand. Providing AM404 directly would avoid the production of NAPQI in the body.

More research is being done nowadays on various terpenes for pain relief. Unfortunately, because it’s strongly associated the cannabis industry, it’s hard to get past all the noise to the good information like research papers.

Most of the terpenes in cannabis strains are also found in other plants to varying degrees. Pure extracts are available and legal without question.

I can’t say much about their efficacy though, because I haven’t done a deep dive. Id love to hear from anyone who has done the research or has personal experience, especially without THC or CBD along for the ride.

I had a similar thought, but in the other direction. I would be very curious to see how controlled doses of cannabinoids / cannabis oils compare to common opioid prescriptions for severe chronic and acute pain.

As far as terpenes specifically, I've been hearing some recent positive buzz about linalool.