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(LA Times)   Opioids no better painkillers than Tylenol, et al. Somewhere, Tom Petty is shaking his fist   ( latimes.com) divider line
    More: Asinine, Opioid, average score, Hydrocodone, pain severity, opioid group, Morphine, Codeine, Analgesics Comparative Effectiveness  
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3758 clicks; posted to Main » on 07 Mar 2018 at 3:29 AM (40 weeks ago)   |   Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2018-03-06 08:25:10 PM  
Pot, on the other hand.
 
2018-03-06 08:50:11 PM  
Dilaudid sure makes me tolerate the pain better than sissy-pansy ibuprofen.
 
2018-03-06 09:04:53 PM  
As someone who has been through 4 kidney stones and has arthritis, I can tell you that while OBJECTIVELY opiods may not make the pain lessen more, it sure as hell makes you care about it a farkton less.

When tylenol or aspirin can't do enough to dull the pain, you need the added benefit of not CARING about the rest.

So while objectively you may have the exact same pain number, you care about that pain less, so subjectively it's better at helping you function as a human being.

Not to mention I process opiates strangely and they're better than caffeine at giving me energy and focus. If I can focus on something other than the pain and actually do work or pay attention to a book or tv, I'm not focused on the pain, and feeling much better.

YMMV.
 
2018-03-06 09:26:39 PM  
No shiat, probably because most opioids are mixed with Tylenol.  As a migraine sufferer, there are days when not even Excedrin (Tylenol, aspirin, caffeine) will touch my pain.  On those days, prescription meds would neither dull the pain nor make me stop caring about it.  I really hate having a high constitution score.
 
2018-03-06 09:40:00 PM  
I have a bad back, and I throw it out about 1-2 times a year.  That is why I have a supply of Oxycodone.  I don't give a shiate what the study says, Tylenol won't touch the pack when I throw my back out and the Oxy does.  As far as being addicting, I believe that is true, for certain people.  It makes me fell fuzzy and I don't like it, so I stop immediately after my back mends.
 
2018-03-06 09:45:04 PM  

knbber2: I have a bad back, and I throw it out about 1-2 times a year.  That is why I have a supply of Oxycodone.  I don't give a shiate what the study says, Tylenol won't touch the pack pain when I throw my back out and the Oxy does.  As far as being addicting, I believe that is true, for certain people.  It makes me fell feel fuzzy and I don't like it, so I stop immediately after my back mends.


Damn 2 typos, gotta get more sleep
 
2018-03-06 10:08:52 PM  
IANAMD, but I think that TFA. has a near overdose of spin onboard.
In a study of chronic musculoskeletal pain in older white men-
By some measures,(what exactly were those measures?) the people using non-opioid drugs such as Tylenol, ibuprofen and lidocaine(WTF is up with comparing an injected local anesthetic to oral analgesics, whether they are opioids or not experienced more pain relief than people using medications like morphine, Vicodin and oxycodone - though the differences weren't large enough to be considered statistically significant. (IOW the difference could be due to nothing more than statistical noise) Patients in both groups saw similar improvements in their quality of life.

Lidocaine is sometimes combined with cortisone for injections into painful and inflamed joints, and in epidural injections for sciatica and other spine pain.  But those injections aren't the first line of treatment for chronic pain management because of the limitations on how often cortisone can be used so analgesics (both opioid and non-opioid) and other drugs are usually prescribed in combination with those injections.

I believe that opioids and synthetic opioids are still most often prescribed as initial treatment for acute pain that is moderate to severe, and not as the go to for chronic pain.

If someone with some relevant education or professional qualifications wants to straighten me out on this I'd be happy to hear from them.
 
2018-03-06 11:01:43 PM  

stan unusual: IANAMD, but I think that TFA. has a near overdose of spin onboard.
In a study of chronic musculoskeletal pain in older white men-
By some measures,(what exactly were those measures?) the people using non-opioid drugs such as Tylenol, ibuprofen and lidocaine(WTF is up with comparing an injected local anesthetic to oral analgesics, whether they are opioids or not)  experienced more pain relief than people using medications like morphine, Vicodin and oxycodone - though the differences weren't large enough to be considered statistically significant. (IOW the difference could be due to nothing more than statistical noise) Patients in both groups saw similar improvements in their quality of life.

Lidocaine is sometimes combined with cortisone for injections into painful and inflamed joints, and in epidural injections for sciatica and other spine pain.  But those injections aren't the first line of treatment for chronic pain management because of the limitations on how often cortisone can be used so analgesics (both opioid and non-opioid) and other drugs are usually prescribed in combination with those injections.

I believe that opioids and synthetic opioids are still most often prescribed as initial treatment for acute pain that is moderate to severe, and not as the go to for chronic pain.

If someone with some relevant education or professional qualifications wants to straighten me out on this I'd be happy to hear from them.


Lidocaine is used as a topical in Lidoderm patches at 5%. You can get an OTC lidocaine patch with 4% for 1/20th the price.
 
2018-03-07 12:10:46 AM  
My torn meniscus begs to differ with this study
 
2018-03-07 01:48:18 AM  
Bullshiat.
 
Xai [TotalFark] [BareFark]
2018-03-07 03:35:44 AM  
Of course not, but they make you happy too - and that definitely helps a LOT
 
2018-03-07 03:44:35 AM  
Wasn't there another study that said Tylenol is less effective at reducing pain and riskier to your health than alcohol? And it wasn't because alcohol is all that great on either count; Tylenol is just a very lousy painkiller. That makes this seem hard to believe.
 
2018-03-07 03:46:37 AM  
Anecdotally the only thing that dulls pain for me more than opiates is being really drunk. To be fair though you can actually live your life with opiates in your system.
 
2018-03-07 03:47:20 AM  
Covfefe.  Let's see Tylenol do that.
 
TWX [TotalFark]
2018-03-07 03:47:22 AM  
In the past year, between the C-section, the cholecystectomy, the costochondritis, the rounds of mastitis, my wife has been through a lot of pain. She would agree with this study, the over-the-counter meds have been basically as effective as the prescription opioids, at least past the first day or two of use of the opioids. Plus the opioids mess with her digestion, make it hard to keep-down food.

Perhaps it's time for doctors to prescribe only a day or two's course of those meds, and then switch the patient to something less risky, so that the patient doesn't keep taking them if they don't need them. In a worst-case scenario the patient contacts the clinic and the doctor sends a second script over to the pharmacy if the original short script was inadequate.
 
2018-03-07 03:49:08 AM  
If you're having pain flare-ups try first:
Anything that relaxes you. Stress makes it way worse.
Anti-inflammatories. A lot of pain is due to inflammation. This includes food that has anti-inflammatoiry properties.
Also, move. It will help in the long run. Yoga, Tai Chi, or just go run errands. If you sit too long muscular , back and joint pain will get worse. Just moving around some will make it better in the long run. And you might as well.
 
2018-03-07 03:50:32 AM  

brax33: As someone who has been through 4 kidney stones and has arthritis, I can tell you that while OBJECTIVELY opiods may not make the pain lessen more, it sure as hell makes you care about it a farkton less.

When tylenol or aspirin can't do enough to dull the pain, you need the added benefit of not CARING about the rest.

So while objectively you may have the exact same pain number, you care about that pain less, so subjectively it's better at helping you function as a human being.

Not to mention I process opiates strangely and they're better than caffeine at giving me energy and focus. If I can focus on something other than the pain and actually do work or pay attention to a book or tv, I'm not focused on the pain, and feeling much better.

YMMV.


Yeah....THIS^^^^
Shattered my elbow about a month ago.
Percocets work. Tylenol not so much.
 
2018-03-07 03:52:48 AM  

TWX: In the past year, between the C-section, the cholecystectomy, the costochondritis, the rounds of mastitis, my wife has been through a lot of pain. She would agree with this study, the over-the-counter meds have been basically as effective as the prescription opioids, at least past the first day or two of use of the opioids. Plus the opioids mess with her digestion, make it hard to keep-down food.

Perhaps it's time for doctors to prescribe only a day or two's course of those meds, and then switch the patient to something less risky, so that the patient doesn't keep taking them if they don't need them. In a worst-case scenario the patient contacts the clinic and the doctor sends a second script over to the pharmacy if the original short script was inadequate.


No
 
TWX [TotalFark]
2018-03-07 03:53:18 AM  

pineapplesherbet: If you're having pain flare-ups try first:
Anything that relaxes you. Stress makes it way worse.
Anti-inflammatories. A lot of pain is due to inflammation. This includes food that has anti-inflammatoiry properties.
Also, move. It will help in the long run. Yoga, Tai Chi, or just go run errands. If you sit too long muscular , back and joint pain will get worse. Just moving around some will make it better in the long run. And you might as well.


Sometimes I find that I feel worse when I have nothing else to focus my attention on besides that which ails me. Unfortunately if I wake up feeling lousy (damn sinus cavities, why can't I have them teflon-coated and be done with it?!) it's difficult to overcome the inertia to sit on my butt and do nothing, but if I actually shower, groom, and go find something to do I usually feel better than if I wallow in my own self-pity.
 
2018-03-07 03:53:38 AM  
The rest of the world already knows this. It's only America which thinks opioids are the answer and that is only - see comments above and below - because patients use pain as an excuse for getting high.
 
2018-03-07 03:56:35 AM  

TWX: pineapplesherbet: If you're having pain flare-ups try first:
Anything that relaxes you. Stress makes it way worse.
Anti-inflammatories. A lot of pain is due to inflammation. This includes food that has anti-inflammatoiry properties.
Also, move. It will help in the long run. Yoga, Tai Chi, or just go run errands. If you sit too long muscular , back and joint pain will get worse. Just moving around some will make it better in the long run. And you might as well.

Sometimes I find that I feel worse when I have nothing else to focus my attention on besides that which ails me. Unfortunately if I wake up feeling lousy (damn sinus cavities, why can't I have them teflon-coated and be done with it?!) it's difficult to overcome the inertia to sit on my butt and do nothing, but if I actually shower, groom, and go find something to do I usually feel better than if I wallow in my own self-pity.


Yeah, that's kind of what I meant. I get them same thing. As long as I'm not literally having a migraine it's always better to get up, hydrate and move. Do something. Anything, really.
 
2018-03-07 03:57:32 AM  

brax33: As someone who has been through 4 kidney stones and has arthritis, I can tell you that while OBJECTIVELY opiods may not make the pain lessen more, it sure as hell makes you care about it a farkton less.....


So while objectively you may have the exact same pain number, you care about that pain less, so subjectively it's better at helping you function as a human being.......


YMMV.


I believe it, and I think it's clear  the ability to make people not care is why opioids are also so often used for emotional pain as well.
 
2018-03-07 03:58:48 AM  

fusillade762: Bullshiat.


theinfosphere.orgView Full Size
 
2018-03-07 04:00:52 AM  
Chronic pain patient here suffering from FBSS (Failed Back Surgery Syndrome). I can tell you from personal experience this article is full of it.

  Why am I commenting in this thread at 4am? Because I don't sleep much anymore as I am in literal agony nightly.  Why?  Because asshat opiod abusers have made it all but impossible for legitimate pain patients to get pain killers.

  I've been on an opiod regiment for nearly 15 years until my doctor one day told me he can no longer write opiod scripts long term as the DEA in Florida is coming down hard on doctors.  Even if I could get the script,  good luck finding a pharmacy willing to fill it.  Medical professionals are running scared of the DEA and it is chronic pain patient's who suffer.

  I used to pity addicts,  but no more.  Screw them,  because of their need for a high I and others must suffer day in and day out.

 No matter what this study says,  when you have truly serious pain levels,  Tylenol and ibprophen don't even touch it.  They do compliment the opiods, but by themselves they're useless.
 
2018-03-07 04:03:00 AM  
Fentanyl is the problem.
 
2018-03-07 04:05:08 AM  

OBBN: Chronic pain patient here suffering from FBSS (Failed Back Surgery Syndrome). I can tell you from personal experience this article is full of it.

  Why am I commenting in this thread at 4am? Because I don't sleep much anymore as I am in literal agony nightly.  Why?  Because asshat opiod abusers have made it all but impossible for legitimate pain patients to get pain killers.

  I've been on an opiod regiment for nearly 15 years until my doctor one day told me he can no longer write opiod scripts long term as the DEA in Florida is coming down hard on doctors.  Even if I could get the script,  good luck finding a pharmacy willing to fill it.  Medical professionals are running scared of the DEA and it is chronic pain patient's who suffer.

  I used to pity addicts,  but no more.  Screw them,  because of their need for a high I and others must suffer day in and day out.

 No matter what this study says,  when you have truly serious pain levels,  Tylenol and ibprophen don't even touch it.  They do compliment the opiods, but by themselves they're useless.


I know people in very serious pain are having a very hard time right now. The DEA has gone insane on cracking down and people can't get a legit prescription filled.
All the people I know who have had back surgery have told me they wouldn't do it if they could go back  and make  different choice.
 
2018-03-07 04:07:37 AM  
This is why, even though I don't smoke it, I fully support full legalization of pot.
Those who want a high can get it and those who need other types of pain pills can get theirs.
 
2018-03-07 04:12:33 AM  
I support the abolishment of the drug scheduling system entirely.
 
2018-03-07 04:16:35 AM  

ecmoRandomNumbers: Dilaudid sure makes me tolerate the pain better than sissy-pansy ibuprofen.


After my last spine surgery with a titanium plate screwed into my cervical vertebrae, I woke up with a morphine pump and it did nothing for the pain. Dilaudid was the answer. Even then I couldn't push the button fast enough!
/I've never been so high!
 
2018-03-07 04:28:49 AM  
This is very specifically for musculo-skeletal pain (which opioids aren't great for) and over 12 months (which opioids aren't great for)

So not surprising, but also not exactly journalism or interesting.
 
2018-03-07 04:42:18 AM  

orbister: The rest of the world already knows this. It's only America which thinks opioids are the answer and that is only - see comments above and below - because patients use pain as an excuse for getting high.


That's why I got my spine fused, I figured 3 weeks of post-op pain killers would be easier then scoring heroin.
 
2018-03-07 04:43:24 AM  
Take an Anacin.
 
2018-03-07 04:54:11 AM  
My L3-L4 disc has degenerated. I can't get a fusion until after I move closer to family. The partial laminectomy that I underwent was hard enough to recover from, so without help, it just isn't going to happen. Thing is, I would have lost the use of my left leg if I hadn't had the original surgery. Massive quantities of ibuprofen help somewhat, but Oxycodone lets me function somewhat.
 
2018-03-07 05:05:41 AM  
As you can see from the comments, this test is Bull. This is how the Anti Vaxers got started. One study that screwed it's results, but the news takes it as Gospel. Anyone that suffers from severe pain will tell you that opioids work best. When my pain started I took Tylenol, nothing. I took ibuprofen, it helped a little. My doctor kept telling me to take more, it worked better. It also ate my. stomach. I found a new doctor that prescribed opioids. I cried with joy. The pain was still there,but it was so much less, I felt so much better. Take from someone who has had 9 surgeries, it is a great thing if used correctly. Of course, I would like to try pot. Not only do I have neck, lower back and knee problems, I also have Glaucoma and cataracts.
Yes, I now, just call me Lucky.
 
2018-03-07 05:12:12 AM  

orbister: The rest of the world already knows this. It's only America which thinks opioids are the answer and that is only - see comments above and below - because patients use pain as an excuse for getting high.


So you're telling me the reason I took e everything from Vicodin too Fentynal for over a decade was so I could get high?  Spoken like a true moran who's not experiencing debilitating chronic pain.

  News Flash for you,  I didn't get high from any of it I take that back,  I did get I high three very first time I was given an opiod injection,  demerol. Since then,  not a single time,  even when taking 90mg of morphine with 30mg of oxycodone. In fact you would be hard pressed to even notice I was talking anything.

I truly hope you never experience agonizing chronic pain.  But if you do,  don't be a hypocrite and make sure you take nothing stronger than Tylenol.
 
2018-03-07 05:16:42 AM  

daffy: As you can see from the comments, this test is Bull. This is how the Anti Vaxers got started. One study that screwed it's results, but the news takes it as Gospel. Anyone that suffers from severe pain will tell you that opioids work best. When my pain started I took Tylenol, nothing. I took ibuprofen, it helped a little. My doctor kept telling me to take more, it worked better. It also ate my. stomach. I found a new doctor that prescribed opioids. I cried with joy. The pain was still there,but it was so much less, I felt so much better. Take from someone who has had 9 surgeries, it is a great thing if used correctly. Of course, I would like to try pot. Not only do I have neck, lower back and knee problems, I also have Glaucoma and cataracts.
Yes, I now, just call me Lucky.


 I'm sorry about your pain.  Three surgeries here.  In fused L3-S1 and people cannot understand chronic pain if you've not experienced it.  You are right,  bull studies like this can lead to others assuming we only take opiods you get high.  It's frustrating to see the ignorance in some people when it comes to pain.
 
2018-03-07 05:31:53 AM  

orbister: The rest of the world already knows this. It's only America which thinks opioids are the answer and that is only - see comments above and below - because patients use pain as an excuse for getting high.


I can't say what it is like for other countries but the point of pain management in Britain is not to comletly remove the pain (as it can have a useful function to stop you from doing too much) but to make the pain livable.

The first point of call for heavy duty painkillers in Britain is paracetimal (or ibuprofin) and codine mixes unless you are in hosipital. Only after these don't work is morphine used, usually perscribed as a patch to prevent misuse. In hospitals its mostly intravenous morphine as a start.

Needless to say we have a much smaller problem with painkiller abuse
 
2018-03-07 05:32:41 AM  

dweigert: My L3-L4 disc has degenerated. I can't get a fusion until after I move closer to family. The partial laminectomy that I underwent was hard enough to recover from, so without help, it just isn't going to happen. Thing is, I would have lost the use of my left leg if I hadn't had the original surgery. Massive quantities of ibuprofen help somewhat, but Oxycodone lets me function somewhat.


FYI my recovery was only a few weeks, I was driving (after abstaining from my pain medication for a few extra hours) within week. it was a C-5/C-6 so that might be different, but it was surprisingly quick to get back to somewhat normal, and the non surgical pain was gone almost immediately, first time in 18 mos without feeling like I had an ice pick in my lower neck.
 
2018-03-07 05:32:56 AM  
After years of dealing with joint pain caused by psoriatic arthritis, I have finally reached the point where I'm throwing caution to the winds and trying a CBD treatment. Due to kidney issues i can't take acetaminophen, and tylenol doesn't do much. I've been on a minimal dose of hydrocodone, but it's been pretty much completely worthless. And the hoops I have to jump thru just to get that are a royal pain in the patootski. So, here's hoping my employer continues to let me do my thing as long as it is not affecting my work. The final straw was when I started developing bursitis. I can really empathize with people who suffer debilitating pain and have to deal with the current, very broken, system.
 
2018-03-07 05:37:30 AM  
OBBN

Most people that have never had real pain don't understand. the pain scale not a good way to judge. I know one woman that said her hang nail was a 10 on the scale. Just hours after Abdominal  surgery, I told them my IV was blown. By the time they did any thing, my hand was twice it's normal size. Then the resident decided that I should sit up after they took it out. It took them a half hour to get a new one in me. After all that time in severe pain, I started to pass out. My husband was screaming at them to get me some morphine. He later told me I had turned deathly gray. That pain was the worst I ever suffered. I tell my doctors that was a 20.
 
2018-03-07 05:39:02 AM  
Whole lotta addicts-in-denial up in this thread... If you use smack for chronic pain, you are going to end up in just as much pain, but addicted too. This is not even the first time this sort of result has been published. Get some counseling and a bottle of Aleve, and start tapering off.
 
2018-03-07 05:43:42 AM  
The part of this study that grinds my gears is that it was limited to older white men.  Why not younger men and different races?  Why not women at all?  Oh, I forgot, if it ain't for old guard, it ain't for anybody.

If certain diseases, such as sickle cell are more prevalent in some groups and less in others, maybe there is something to the idea that each body type processes pain differently.  There was a study sometime in the last year or so about redheads processing pain much differently than the rest of us.  Men who've been in the obstetrics suites will tell you they couldn't deal with what their women went through to become parents.

I realize this study was funded by or run through the VA, so the population to draw from is already biased, but damn, there are veterans of all races and genders available.  Study them all.
 
2018-03-07 05:44:48 AM  
Tell that to my brother who has trigeminal neuralgia. They call it the suicide disease for a reason. Imagine the pain of an abscessed tooth 24/7 and thinking Tylenol would be just as effective as Dilauded or Fentanyl.

Anyone who seriously believes that Tylenol is as effective has probably never talked a sibling out of suicide because of *serious* chronic pain.
 
2018-03-07 05:44:57 AM  

orbister: because patients use pain as an excuse for getting high.


Serious question, what is your precise objection to people getting high? Do you object to people getting drunk? What about using coffee?

I just see the objection to people getting high quite a lot, but no one has ever actually explained why they find it so offensive.

/count me in as one who is annoyed that junkies have ruined things for pain sufferers
//wouldn't have to be that way if we could just accept that some people do want to get high, and let them
 
2018-03-07 05:51:32 AM  

Xai: Of course not, but they make you happy too - and that definitely helps a LOT


I have a pinched nerve in my neck that has left me with chronic pain that is sometimes severe. When it's not severe, it's still there - I've literally not had a single pain-free day in over 5 years. No OTC painkillers are capable of managing the pain - not remotely - even at high doses.

Vicodin didn't make the pain go away; it only made me not care about it.

Percocet, OTOH, not only made the pain go away, but also was the only thing that managed to make me feel *good* in all those years of pain. Even though it only lasted a couple hours at a time, I can't tell you how great a relief that was.

I often say I never used to understand how anyone could get hooked on pills, but now I get it. If I could, I would take Percocet every day to feel that way, even if only for a while. I'm in the middle of a flare up right now and I really wish I had some on hand, but the way things are now it's harder to coax my doctor to prescribe it than it once was, and the current social stigma is starting to make me feel like a junkie to ask for refills.

Tylenol and Ibuprofen are woefully inadequate substitutes for opiates in my experience. Plus, I'm not excited about the prospect of long-term liver damage with extended high doses of Tylenol. When I took it in Percocet, I took a lot less of it than I do now. Ugh.
 
2018-03-07 05:52:34 AM  

brax33: As someone who has been through 4 kidney stones and has arthritis, I can tell you that while OBJECTIVELY opiods may not make the pain lessen more, it sure as hell makes you care about it a farkton less.

When tylenol or aspirin can't do enough to dull the pain, you need the added benefit of not CARING about the rest.

So while objectively you may have the exact same pain number, you care about that pain less, so subjectively it's better at helping you function as a human being.

Not to mention I process opiates strangely and they're better than caffeine at giving me energy and focus. If I can focus on something other than the pain and actually do work or pay attention to a book or tv, I'm not focused on the pain, and feeling much better.

YMMV.


They're talking about long term use, and moderate amounts.

Ofcourse a highdose of opiod works better than an Asperin, noone is claiming otherwise.

But for chronic backpain, you won't be given dosages that leaves you permanently high as a kite.
 
2018-03-07 05:57:57 AM  
Anecdotally, that article sucks balls.
I had a complete hip replacement last week.
When I came out of the operating room last week, my blood pressure was abnormally low (70/50)
The "50" number meant I was at risk of coma if given narcotic pain relief (Opioids).
Sooo....extra strength Tylenol after having the top of my femur sawed off and replaced with a titanium joint.
Hurt like a son-of-a-biatch.
After eight hellish hours, my blood pressure recovered and I got some Percocet.
"No difference" my ass.
 
2018-03-07 06:00:41 AM  
This sounds like it was originally a conclusion in search of a study.
 
2018-03-07 06:12:16 AM  

axeeugene: Percocet, OTOH, not only made the pain go away, but also was the only thing that managed to make me feel *good* in all those years of pain. Even though it only lasted a couple hours at a time, I can't tell you how great a relief that was.

I often say I never used to understand how anyone could get hooked on pills, but now I get it. If I could, I would take Percocet every day to feel that way, even if only for a while. I'm in the middle of a flare up right now and I really wish I had some on hand, but the way things are now it's harder to coax my doctor to prescribe it than it once was, and the current social stigma is starting to make me feel like a junkie to ask for refills.


Granted, my pain IS reducing, which is to be expected and welcomed, however sleep sucks right now. Today, I just had my first 4 continuous hours of sleep since late Jan. The perc's work. And they have allowed me to somewhat function in the day. (btw, I only take one a day right in the morning)
 
2018-03-07 06:15:51 AM  
Wouldn't want to stress the delicate geniuses by asking them to honor their responsibility to manage pain for the patient.
 
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