Kris - pain meds, liver and staying sober

[Guest guest]

Hi Kris,

I was struck by your words in a post about the difficulty

not-thinking about taking a drink, especially when you are in a fit

of unrelenting pain.....I gotta say that, even though I was not

much of a drinker ever (maybe a margarita a year) and of course

I am not one now.....I have strong longings for a drink when I am

in so much pain that I am willing to try anything. I read in the

medical journals, articles which state that one theory of how

alcohol causes pancreatitis and this is based on the idea that

alcohol relaxes the sphincter of Oddi and it is thought that the

backflow from the duodenum or common bile duct can now

enter into the pancreas duct. I extrapolate that into thinking:

hmmmm. alcohol = relaxation of the SO = relief of pain from the

spasm of the SO = happiness. Of course, that is a very

dangerous way to think of things but I must say, it is hard to not

try that hypothesis out (to be honest, I mentioned it to a GI once

and he shuddered to even give me one iota of an endorsement).I

guess I just want to say that even non-drinkers have a hard time

not reaching for alcohol when the pain levels are more than we

can bear. I think you are an inspiration for anyone who is looking

for proof that life goes on after a committment is made to

change.

You also were speculating on the association of liver damage

and pain killers....from what I have read, there is no long term

affects of pure narcotic pain relievers on the liver. In fact, as far

as organ damage is concerned (kidneys. liver) narcotics are the

safest medicine there is in the pain reliever category. It is only

when they are coupled with aspirin or tylenol that the trouble

comes in. Obviously we are all familiar with the aspirin link to GI

bleeds (and this is a very real concern!) as well as the effect of

tylenol on our livers. I have read that with long term use of tylenol

(which is more than 5-7 days in a row) that a person should not

exceed 3gms a day of tylenol....some conservative physicians

lower that to 2gms a day. The 4gms that is commonly cited

usually applies to short periods of time only. Tylenol is one of

the harshest meds for the liver. That is why I only take the pure

form of oxycodone - not the percocet or roxicet formulation. I

have problems with my liver function tests normally and I sure

don't want to make things worse by taking the tylenol at the levels

I need for pain control. I am a strong advocate for people get the

pure pills if at all possible.

I also want to wish you well with your ERCP. I hope it all goes

smoothly without any complications. I know you are in good

hands. Dr Lehman (right?) impressed me with his kindness and

the nurses that I briefly met seemed to genuinely care. But I am

sure that you know all of that by now, and so much better than I

do.

Laurie