“As a unit, the kiloton is most often linked to the explosive yield of nuclear weapons in tons of TNT (an explosive). For drugs, we are more comfortable with milligrams, a unit one million million times smaller. With paracetamol, at a population level, the kiloton unit may be more appropriate: in Europe, paracetamol sales range from under 200 tons in Greece and Portugal to 6300 tons in the UK and 10 000 tons in France
The last few years have seen paracetamol and other commonly used drugs subjected to greater scrutiny, particularly the sharp focus of evidence-based medicine; 2015 and 2016 have seen pivotal new evidence appear. The picture is not quite as rosy as the general view would have us think.
Paracetamol at doses between 500 and 1000 mg is in the least effective quartile of drugs for treating acute post-operative pain.
Paracetamol at doses up to 4000 mg daily is ineffective in back pain.
Paracetamol at doses up to 4000 mg daily is practically ineffective in arthritis. Though marginally better than placebo, paracetamol has little chance of achieving clinically meaningful benefit in osteoarthritis.
No review evidence that paracetamol works for dysmenorrhoea, neck pain, rheumatoid arthritis or cancer pain.
We have considerable evidence that as well as not being particularly effective, neither is it particularly safe.
With the (understandable and appropriate) attention on the catastrophic dangers of opioids it might be easy to overlook problems with apparently safe and effective ‘simple analgesics’. This short editorial makes for sobering reading and suggests that a serious rethink is required.
We’re hitting the road and taking our NOI courses right across this great southern land:
Noosa 17 – 19 June Explain Pain and Graded Motor Imagery (Both courses SOLD OUT)
Wagga Wagga 16-17 July Explain Pain
Perth 15 – 17 October Explain Pain and Graded Motor Imagery
EP3 events have sold out three years running in Australia, and we are super excited to be bringing this unique format to the United States in late 2016 with Lorimer Moseley, Mark Jensen, David Butler, and few NOI surprises.
EP3 EAST Philadelphia, December 2, 3, 4 2016
EP3 WEST Seattle, December 9, 10, 11 2016
To register your interest, contact NOI USA:
p (610) 664-4465