WEBVTT - Fan Favorite: What's the Science of Painkillers? 0:00:02.480 --> 0:00:04.800 I guess what, mango, what's that will? So I know 0:00:04.880 --> 0:00:08.400 we regularly hear these stories about the downsides of texting, 0:00:08.440 --> 0:00:11.320 you know, the dangers of texting while driving, or all 0:00:11.360 --> 0:00:13.440 these stories about how we're no longer present because we're 0:00:13.440 --> 0:00:15.880 looking at our phones when we're around family and friends. 0:00:15.920 --> 0:00:18.079 But there was actually a study I was reading recently, 0:00:18.079 --> 0:00:20.680 and it was from the journal Pain Medicine, and it 0:00:20.720 --> 0:00:24.880 showed the benefits of texting during surgery. So I'm guessing 0:00:24.880 --> 0:00:26.920 we're not talking about major surgeries here. Well, yeah, I 0:00:26.920 --> 0:00:28.920 mean we're talking about surgeries where the patient is still 0:00:28.920 --> 0:00:32.080 awake and often feeling some kind of discomfort or pain 0:00:32.200 --> 0:00:35.320 during that surgery. So the study involved a hundred patients 0:00:35.320 --> 0:00:37.879 and they were having these minor surgeries, and they had 0:00:37.880 --> 0:00:40.080 them do three different things. So some of the patients 0:00:40.080 --> 0:00:43.040 were asked to text, some were playing angry birds, and 0:00:43.159 --> 0:00:46.040 some were doing nothing. And they found that of the 0:00:46.120 --> 0:00:49.120 three groups, those who were texting actually had the least 0:00:49.120 --> 0:00:52.960 need for additional narcotics, and they also experienced the greatest 0:00:53.000 --> 0:00:56.120 relief from that pain. But here's what's most weird about it. 0:00:56.360 --> 0:00:58.760 The effect was most profound when they were texting with 0:00:58.840 --> 0:01:02.040 a complete strange, really not not like someone you know 0:01:02.160 --> 0:01:04.720 and someone who cares about you. Well, actually, I'm sure 0:01:04.760 --> 0:01:07.200 there's some benefit to that as well, but the greatest 0:01:07.240 --> 0:01:09.800 benefit was when they were texting with someone they didn't know. 0:01:10.280 --> 0:01:11.759 And they think it has to do with the type 0:01:11.760 --> 0:01:14.240 of conversation you'd have with the loved one versus you know, 0:01:14.280 --> 0:01:16.720 one with somebody that you don't know. So think about it. 0:01:16.720 --> 0:01:18.640 With a loved one, if you're in a lot more pain, 0:01:18.720 --> 0:01:21.399 you're you're likely to be talking about what's on your 0:01:21.440 --> 0:01:23.959 mind with that or what's bothering you. But with a 0:01:24.040 --> 0:01:26.440 stranger you kind of have to put on a happy 0:01:26.480 --> 0:01:28.320 face and be a little bit more positive and your 0:01:28.360 --> 0:01:31.000 interaction you want to make a good impression, and that 0:01:31.200 --> 0:01:34.919 somewhat forced positive attitude actually help them withstand a higher 0:01:35.000 --> 0:01:37.160 level of pain, and that's really fascinating. It's also kind 0:01:37.160 --> 0:01:39.520 of cool to think that your phone's best app is 0:01:39.560 --> 0:01:42.319 as a pain killer. That's right, right, And it's a 0:01:42.360 --> 0:01:45.400 reminder of that pain itself is such a strange thing, 0:01:45.840 --> 0:01:48.160 and while they are multiple ways to manage certain pain, 0:01:48.440 --> 0:01:50.720 it feels like most people aren't all that familiar with 0:01:50.760 --> 0:01:53.800 the differences among some of the major forms of pain relief. 0:01:54.080 --> 0:01:55.760 So in today's episode, we're going to focus on the 0:01:55.800 --> 0:01:59.760 science behind the things like ibuprofen, a seda, menafin, aspirin, 0:02:00.000 --> 0:02:02.280 as well as some others, and along the way we'll 0:02:02.320 --> 0:02:05.240 dive into some of the most surprising forms of pain relief. 0:02:05.520 --> 0:02:28.840 So let's get started. Hey there, podcast listeners, Welcome to 0:02:28.880 --> 0:02:31.360 Part Time Genius. I'm Will Pearson and as always I'm 0:02:31.440 --> 0:02:33.720 joined by my good friend Manesh Ticketer and on the 0:02:33.760 --> 0:02:36.440 other side of the soundproof glass sorting his meds into 0:02:36.480 --> 0:02:41.440 a massive three hundred and sixty five day pill organizers. Unbelievable. 0:02:41.680 --> 0:02:44.480 That's our friend and producer Tristan McNeil. I mean, I've 0:02:44.520 --> 0:02:47.440 got to say the sheer level of micromanagement on display 0:02:47.480 --> 0:02:50.240 here is both kind of inspiring but also a little 0:02:50.240 --> 0:02:53.680 bit unnerving at the same time, So kudos to you, Tristan. 0:02:53.840 --> 0:02:56.320 I mean, it's especially interesting because the only films he 0:02:56.360 --> 0:02:59.400 actually takes with those flintstones chewable vitamins, which makes that 0:02:59.440 --> 0:03:03.160 giant feel caddy a little like overkill. Well, Tristan refuses 0:03:03.200 --> 0:03:05.920 to take shortcuts. You've gotta respect him for that. And 0:03:05.960 --> 0:03:09.560 speaking of shortcuts, today we're talking about common pain killers, 0:03:09.760 --> 0:03:12.000 you know, which have become many people's go to quick 0:03:12.040 --> 0:03:15.520 fix for everything from headaches to hangovers, and most of 0:03:15.560 --> 0:03:17.400 us keep at least one of these over the counter 0:03:17.440 --> 0:03:20.919 medications on standby and the medicine cabinet or next to us. 0:03:20.919 --> 0:03:22.680 But you know whether that's aspirin or I have a 0:03:22.720 --> 0:03:26.359 profin or tail and all. But despite that ubiquity, a 0:03:26.440 --> 0:03:28.400 few of us could tell you even the most basic 0:03:28.520 --> 0:03:32.160 facts about the pills that we so readily swallow. In fact, 0:03:32.160 --> 0:03:34.520 according to a two thousand one survey from the National 0:03:34.560 --> 0:03:38.280 Council and Patient Information and Education, only one third of 0:03:38.320 --> 0:03:41.160 the public is able to identify the active ingredient in 0:03:41.200 --> 0:03:44.200 their pain killer of choice, And with over the counter 0:03:44.200 --> 0:03:47.920 pain relievers accounting for over five billion in sales last year, 0:03:48.280 --> 0:03:50.760 that's a big chunk of the population that medicates with 0:03:50.800 --> 0:03:53.440 something they really don't know that much about. So for 0:03:53.480 --> 0:03:56.000 today's episode, we're actually gonna shine some light on the 0:03:56.040 --> 0:03:58.200 little known facts behind a few of the world's most 0:03:58.240 --> 0:04:01.880 commonly taken, at least nderstood medications. So we'll try to 0:04:01.880 --> 0:04:03.720 get an idea of where they come from and what 0:04:03.760 --> 0:04:06.240 they're best suited for, as well as what the future 0:04:06.280 --> 0:04:08.960 of pain management might look like, alright, ma, go, so 0:04:08.960 --> 0:04:11.280 where do you think we should start? So, I mean 0:04:11.440 --> 0:04:13.360 this might sound a little basic, but I thought it'd 0:04:13.400 --> 0:04:15.520 be helpful to start with a quick refresher on what 0:04:15.640 --> 0:04:19.080 pain really is and how a non prescription painkiller actually 0:04:19.120 --> 0:04:21.440 works to relieve it. So for the first part of that, 0:04:21.480 --> 0:04:24.320 pain is really just this early warning system. It's our 0:04:24.360 --> 0:04:26.680 body's way of letting us know that we're injured or 0:04:26.960 --> 0:04:29.640 even though we're doing something that we probably should stop doing. So, 0:04:29.760 --> 0:04:31.719 for instance, if you put your hand on the hot stove, 0:04:32.080 --> 0:04:34.520 special nerve receptors in your skin will actually respond to 0:04:34.560 --> 0:04:37.240 the damage from the heat, and that sensation is then 0:04:37.320 --> 0:04:39.599 sent as a chemical message to the spinal cord and 0:04:39.720 --> 0:04:42.400 your brain stem, and from there the message travels to 0:04:42.440 --> 0:04:45.200 the brain, which is where the sensation is registered and 0:04:45.320 --> 0:04:49.520 processed and finally perceived as pain. And that's a helpful description, 0:04:49.560 --> 0:04:51.159 but it is kind of weird to take a step 0:04:51.200 --> 0:04:53.039 back and think about it, like it almost makes it 0:04:53.120 --> 0:04:56.760 sound kind of bureaucratic. Doesn't like this pain is this 0:04:56.800 --> 0:04:59.080 memo that's got to be passed around from office to office, 0:04:59.120 --> 0:05:01.599 gotta get everybody's a approval, and then it finally gets 0:05:01.640 --> 0:05:04.880 to the big boss upstairs, you know, right, So it 0:05:05.080 --> 0:05:08.240 obviously takes more time to describe the experience of feeling 0:05:08.240 --> 0:05:10.599 the pain that actually does to feel it, which is 0:05:10.640 --> 0:05:13.840 pretty much instantaneous. But it's still helpful to know the 0:05:13.880 --> 0:05:16.800 ins and outs of the process because that's ultimately how 0:05:16.880 --> 0:05:20.160 pain killers work. Like, they interfere with the body's transmissions 0:05:20.160 --> 0:05:22.520 of pain signals. And this is where the difference between 0:05:22.520 --> 0:05:26.160 pain killers comes into because each kind targets a different 0:05:26.200 --> 0:05:29.240 point in the communication chain. So, for example, aspirin and 0:05:29.240 --> 0:05:32.520 ibuprofen our end sets and that's n S a I D, 0:05:32.760 --> 0:05:37.320 which stands for a non steroidal anti inflammatory drugs. These 0:05:37.320 --> 0:05:39.520 medications cut off the pain signals at the side of 0:05:39.520 --> 0:05:42.160 the injury. But something like a set of menafin, which 0:05:42.160 --> 0:05:45.160 is a different kind of pain reliever, works much differently. 0:05:45.560 --> 0:05:47.200 All right, we'll obviously get to that, But why don't 0:05:47.200 --> 0:05:48.960 we stick to the end sets for now? So how 0:05:48.960 --> 0:05:52.840 does one of these run interference on these pain signals? Sure, so, 0:05:53.080 --> 0:05:55.400 when the nerve receptors in our cells are damaged, they 0:05:55.400 --> 0:05:58.880 produce chemicals that perform a variety of functions, right, some 0:05:59.000 --> 0:06:01.040 lower the pain threshold it in the injured cells, to 0:06:01.080 --> 0:06:03.960 make sure we get the message. Others produce inflammation and 0:06:04.000 --> 0:06:07.240 swelling is a way to cushion the cells from further injury. Alright, 0:06:07.240 --> 0:06:09.920 so these chemicals must be what the end SAIDs are targeting, right, 0:06:10.080 --> 0:06:13.360 since they're anti inflammatories. Right, So and and said, like, 0:06:13.400 --> 0:06:16.400 aspirin works by halting the production of the chemicals responsible 0:06:16.440 --> 0:06:19.039 for the pain and swelling, and the aspirin binds with 0:06:19.080 --> 0:06:22.719 the enzymes that produce these chemicals, which basically neutralizes the 0:06:22.800 --> 0:06:25.280 enzymes and prevents the chemicals from being made at all. 0:06:25.640 --> 0:06:27.560 Oh wow, that's interesting. All right, So the damage that 0:06:27.640 --> 0:06:29.560 prompted the pain is still there, but but we no 0:06:29.640 --> 0:06:32.279 longer perceive the pain. Is that what's going on exactly? 0:06:32.279 --> 0:06:34.839 So pain killers don't actually heal injuries, and they don't 0:06:34.880 --> 0:06:37.400 even kill the pain. Really, they just kill your awareness 0:06:37.400 --> 0:06:39.600 of pain by cutting off that signal out the source. 0:06:40.120 --> 0:06:42.160 That sounds pretty deep. So the pain is still there, 0:06:42.240 --> 0:06:44.600 we just don't feel the pain. But all right, we'll 0:06:44.600 --> 0:06:46.880 speaking of the pain awareness, how does an end said 0:06:46.960 --> 0:06:49.599 nowhere to go? Like, how's it able to pinpoint the 0:06:49.680 --> 0:06:52.800 part of the body that's injured? So it doesn't really 0:06:52.839 --> 0:06:55.520 like the aspirin dissolves in the stomach and it's carried 0:06:55.560 --> 0:06:58.080 to all parts of the body through the bloodstream. It's 0:06:58.120 --> 0:07:00.160 just that the damage part is the only place will 0:07:00.160 --> 0:07:03.080 actually find pain related enzymes to bind with. Well, that 0:07:03.120 --> 0:07:04.840 makes sense. So so what about a seta menaphin like 0:07:04.880 --> 0:07:07.480 it it doesn't reduce inflammation, that it must be doing 0:07:07.760 --> 0:07:11.000 something else, right, Yeah, so that's the amazing thing, right, Like, 0:07:11.080 --> 0:07:13.360 even though a sida menaphin was discovered in the eighteen 0:07:13.400 --> 0:07:16.120 hundreds and it served as the active ingredient tallen al 0:07:16.160 --> 0:07:18.600 since I want to say, the nineteen fifties, we still 0:07:18.720 --> 0:07:21.200 really don't know how it works. I mean, just listen 0:07:21.200 --> 0:07:24.320 to his physicians. Note that comes with toilen ail bottles quote. 0:07:25.000 --> 0:07:28.880 Although the analgesic effects of a sida menaphin is well established, 0:07:29.120 --> 0:07:32.840 the site and mode of action have not been clearly elucidated. 0:07:33.320 --> 0:07:35.920 And that's stunning. Yeah. So basically, like it's saying this 0:07:35.920 --> 0:07:38.280 stuff works, but we have no idea how. Yeah, it's 0:07:38.280 --> 0:07:40.720 so weird. But you know, they do have some theories. 0:07:40.720 --> 0:07:43.240 So for example, it's possible that a seda menafin works 0:07:43.280 --> 0:07:45.480 the same way and SAIDs to, but it just isn't 0:07:45.480 --> 0:07:48.920 effective against the chemicals responsible for inflammation. And then there's 0:07:48.960 --> 0:07:51.400 this other theory that a side BeneFin actually affects our 0:07:51.440 --> 0:07:55.160 sensation of pain by working on the endocannabinoid system, which 0:07:55.200 --> 0:07:57.160 you know, you might guess is the same system that 0:07:57.280 --> 0:08:00.640 responds to cannabis or marijuana. So you know, this is 0:08:00.640 --> 0:08:04.360 according to researchers at Lundon University in Sweden, and sentimental 0:08:04.400 --> 0:08:07.960 fin activates two ion channels in the brain and spinal cord, 0:08:08.480 --> 0:08:11.280 and these are the two channels that also respond to cannabinoids. 0:08:11.640 --> 0:08:14.120 And the weird thing though, is that these ion channels 0:08:14.120 --> 0:08:17.760 can actually trigger pain and its responses, so it's pretty 0:08:17.800 --> 0:08:21.320 strange that activating them would actually reduce the pain. But 0:08:21.480 --> 0:08:23.320 you know, like I said, nobody really knows for sure 0:08:23.360 --> 0:08:25.280 how these all work. Well, you know, you mentioned that 0:08:25.280 --> 0:08:27.800 a set of menifit has been around since the eighteen hundreds. 0:08:27.800 --> 0:08:29.480 So why don't we switch gears and talk a little 0:08:29.480 --> 0:08:31.040 bit more about the history behind a few of the 0:08:31.080 --> 0:08:34.360 common pain killers. Yeah, So, you know, I'm always tempted 0:08:34.400 --> 0:08:36.240 to start from the beginning and dig into the weird 0:08:36.320 --> 0:08:39.360 history beyond the topic, but with something like pain relievers, 0:08:39.440 --> 0:08:41.760 it feels like it might be a tad too ambitious. 0:08:41.840 --> 0:08:43.920 I mean, pain is something that humans have had to 0:08:43.920 --> 0:08:46.760 contend with on a daily basis, and at this point 0:08:46.960 --> 0:08:50.320 we've actually spent millennia like experimenting with different kinds of 0:08:50.360 --> 0:08:53.360 ways to manage it. It's kind of a lot to cover, 0:08:54.000 --> 0:08:56.439 you know. Actually, when I was studying abroaden Tibet, we 0:08:56.480 --> 0:08:59.360 went to the Kirang Valley, which hadn't had much contact 0:08:59.400 --> 0:09:02.960 with Western realization, and our professor told us that people 0:09:03.040 --> 0:09:05.080 used to manage their headaches by putting these pieces of 0:09:05.120 --> 0:09:07.040 tape on the sides of their heads. In fact, if 0:09:07.040 --> 0:09:09.840 you give them aspirin or a town all or whatever, 0:09:09.840 --> 0:09:12.880 it would actually really really affect them. And it was 0:09:12.920 --> 0:09:15.640 kind of funny because marijuana actually grew wild in the 0:09:15.760 --> 0:09:18.160 fields there everywhere. It was all over the place, but 0:09:18.200 --> 0:09:20.240 no one smoked as pain release. They just used these 0:09:20.240 --> 0:09:23.200 little strips of tape to manage their pain. And you know, 0:09:23.320 --> 0:09:26.000 maybe it works. I didn't actually try didn't try some tape. 0:09:26.840 --> 0:09:29.480 We could easily devote a whole episode to bizarre pain 0:09:29.520 --> 0:09:32.560 management techniques that people have tried in the past. You 0:09:32.559 --> 0:09:35.200 look at everything from like boring holes and people's skulls, 0:09:35.360 --> 0:09:38.079 the banging gongs to scare away painful spirits, which I 0:09:38.120 --> 0:09:40.520 know you still do sometimes. But you know, but those 0:09:40.559 --> 0:09:43.000 ancient remedies that have the most bearing on pain killers 0:09:43.000 --> 0:09:46.040 of today, they're actually the botanical ones. So for instance, 0:09:46.040 --> 0:09:48.040 you know, you look at the ancient Greeks, they chewed 0:09:48.040 --> 0:09:50.240 bark and the leaves of willow trees in order to 0:09:50.280 --> 0:09:53.960 help produce things like fever or relief pain during childbirth. 0:09:54.400 --> 0:09:56.959 Ancient Egypsians did something pretty similar with the leaves from 0:09:56.960 --> 0:09:59.839 myrtle bushes. You look at the Native Americans to actually 0:10:00.000 --> 0:10:02.760 you birch bark as their pain relieving plan of choice, 0:10:03.240 --> 0:10:05.959 and those all turned out to be pretty great ideas 0:10:06.000 --> 0:10:09.160 because actually all three of those plants contain high levels 0:10:09.160 --> 0:10:12.160 of salasilic acid, which is the active ingredient, and aspirin, 0:10:12.800 --> 0:10:15.600 which is awesome, but I always thought the active ingredient 0:10:15.720 --> 0:10:19.520 aspirin was aspirin, Like, it's not its own thing. If 0:10:19.559 --> 0:10:22.240 you want to get technical, the active ingredient and aspirin 0:10:22.320 --> 0:10:24.960 is called a setal salasilic acid or a s A. 0:10:25.520 --> 0:10:27.920 You know, see that the pain relieving chemical that's most 0:10:27.920 --> 0:10:30.560 common to all these plants I mentioned also had the 0:10:30.600 --> 0:10:34.200 unfortunate side effect of wreaking havoc on our digestive systems. 0:10:34.520 --> 0:10:37.160 So it was a big deal in when this German 0:10:37.240 --> 0:10:40.160 scientist who was working for Bear Pharmaceutical, he was able 0:10:40.160 --> 0:10:43.680 to synthesize a less harmful and easier to digest chemical 0:10:43.679 --> 0:10:45.760 and that was this A S A that we're talking about. 0:10:46.080 --> 0:10:49.040 So the Bear company named this new drug aspirin, and 0:10:49.080 --> 0:10:51.600 it was the first mass produced over the counter pain 0:10:51.640 --> 0:10:53.800 reliever to come to the market. In fact, the word 0:10:53.840 --> 0:10:55.760 itself was a trademark term, you know, kind of like 0:10:55.800 --> 0:10:57.439 tile and all or some of these others for about 0:10:57.480 --> 0:11:00.720 twenty years. But after that aspirin became i a generic 0:11:00.800 --> 0:11:03.920 word for the A S A based medicine in most markets. 0:11:03.920 --> 0:11:07.240 Actually still today Bear holds the trademark in some countries. 0:11:07.840 --> 0:11:11.600 So what about another end said like ibuprofen. Is that 0:11:11.720 --> 0:11:15.240 the actual chemical ingredient or is it just another trademark 0:11:15.360 --> 0:11:18.240 term that died in went generic. No, Hyperprofen is its 0:11:18.280 --> 0:11:21.280 own active ingredient, which you'll find in branded versions like 0:11:21.360 --> 0:11:24.839 advil or motrin. And although the chemicals themselves are different, 0:11:24.880 --> 0:11:28.200 ibuprofen works pretty similarly to the A S A and aspirin. 0:11:28.559 --> 0:11:30.640 In fact, the man who discovered ibuprof and his name 0:11:30.679 --> 0:11:32.840 was Dr Stewart Adams. He did so while he was 0:11:32.920 --> 0:11:35.880 looking into how aspirin worked. This was back in the 0:11:35.920 --> 0:11:39.400 early nineteen fifties. Adams was working in the research department 0:11:39.400 --> 0:11:41.480 at a place called Boots Pure Drug Company, and this 0:11:41.600 --> 0:11:43.800 was in England, and his goal at the time was 0:11:43.840 --> 0:11:46.640 to find a new way of treating rheumatoid arthritis that 0:11:46.840 --> 0:11:49.720 wasn't reliant on steroids and all the side effects that 0:11:49.760 --> 0:11:52.199 come along with those. So, I mean at this time 0:11:52.240 --> 0:11:55.080 aspirin was already in you. So we've already said it 0:11:55.120 --> 0:11:57.720 was non steroidal and and it was great for inflammation, 0:11:57.760 --> 0:12:01.120 Like why didn't arthritis patients just use Well, they did, 0:12:01.200 --> 0:12:03.600 but there were drawbacks to any pain killer that we'll 0:12:03.640 --> 0:12:05.920 be talking about. In the case of aspirin, it usually 0:12:05.920 --> 0:12:08.480 has to be given in fairly high doses and that 0:12:08.559 --> 0:12:11.080 of course greatly increases the risk of side effects like 0:12:11.120 --> 0:12:15.559 allergic reaction or indigestion or in some cases even internal bleeding. 0:12:15.920 --> 0:12:18.320 So Adams and his team were after an alternative that 0:12:18.320 --> 0:12:20.360 could be better tolerated if if they were going to 0:12:20.440 --> 0:12:24.120 be used regularly, and it didn't come easily. I mean, 0:12:24.120 --> 0:12:27.760 together with a chemist and a technician, Adams actually tested 0:12:27.800 --> 0:12:31.000 the potency of more than six hundred chemical compounds over 0:12:31.040 --> 0:12:33.839 the course of about a ten year period. And I 0:12:33.920 --> 0:12:35.640 mean you do hear about sort of like a tenure 0:12:35.720 --> 0:12:38.600 cycle for drugs coming to come about, But like, was 0:12:38.600 --> 0:12:40.840 it just like trial and error until they figured out 0:12:40.840 --> 0:12:42.880 this winning compound? Yeah, it was, And I mean a 0:12:42.920 --> 0:12:45.280 few of the most promising ones were actually tested by 0:12:45.360 --> 0:12:48.760 the team itself, like something you would never see happening today. 0:12:49.679 --> 0:12:52.199 And so was the team just knocking back these experimental 0:12:52.240 --> 0:12:54.079 pills and like they had no idea what sort of 0:12:54.160 --> 0:12:56.320 damage would cause. Well, I mean the handful of compounds 0:12:56.320 --> 0:12:58.839 they tested firsthand were ones that had already passed the 0:12:58.880 --> 0:13:02.400 toxicity test, but otherwise pretty much I mean. In fact, 0:13:02.480 --> 0:13:05.319 Dr Adams later revealed that his discovery of ibaprof and 0:13:05.400 --> 0:13:08.480 was due to him ingesting a promising compound as a 0:13:08.480 --> 0:13:11.640 way of dealing with a bad hangover. So apparently, sometime 0:13:11.640 --> 0:13:13.480 in the early sixties he was scheduled to give this 0:13:13.520 --> 0:13:16.560 important speech, but the night before he has spent some 0:13:16.600 --> 0:13:19.160 time at the bar, wasn't really feeling up to the task. 0:13:19.240 --> 0:13:21.720 And here's how he described the event in an interview. 0:13:21.720 --> 0:13:24.120 He said, I was first up to speak, and I 0:13:24.200 --> 0:13:26.000 had a bit of a headache after a night out 0:13:26.000 --> 0:13:29.000 with friends, so I took the six hundred milligram dose 0:13:29.160 --> 0:13:31.360 just to be sure and found it was very effective. 0:13:31.960 --> 0:13:33.960 I love that before he was giving this big speech, 0:13:33.960 --> 0:13:35.520 he was like, let me just try a little bit 0:13:35.520 --> 0:13:37.080 of this stuff. We've been mixing up one of the 0:13:37.400 --> 0:13:41.360 ten thousand different things or six hundred different chemical compounds. Yeah, 0:13:41.400 --> 0:13:43.440 and that the night before that he was just drinking 0:13:43.440 --> 0:13:46.840 over right, It's a good strategy. So, I mean, obviously 0:13:46.840 --> 0:13:49.240 it sounds insane, and it does also sound like a 0:13:49.360 --> 0:13:52.480 ringing endorsement for ibanprofen as a hangover cure. But h 0:13:52.720 --> 0:13:55.240 what about some other common pain killers, Like we should 0:13:55.240 --> 0:13:58.120 probably talk about some of their striends and weaknesses as well. Yeah, 0:13:58.160 --> 0:13:59.959 I definitely want to, But before we do, let's take 0:14:00.000 --> 0:14:15.360 a quick break. You're listening to Part Time Genius and 0:14:15.400 --> 0:14:17.880 we're talking about the science behind the world's most common 0:14:17.960 --> 0:14:20.760 pain killers, all right, Mango. So obviously we lump a 0:14:20.800 --> 0:14:23.520 bunch of different products into the same category of these 0:14:23.560 --> 0:14:26.840 non prescription pain relievers, and one of the biggest downside 0:14:26.880 --> 0:14:29.600 to this is that we tend to use them all interchangeably. 0:14:30.000 --> 0:14:31.440 So I know, you were doing some digging into this 0:14:31.480 --> 0:14:33.280 so too, So tell me what kind of stuff should 0:14:33.320 --> 0:14:35.320 we consider when you know choosing which pill we need 0:14:35.360 --> 0:14:38.920 to pop. So, I mean, a great place to start 0:14:39.120 --> 0:14:41.440 is whether or not your pain involves any kind of swelling, 0:14:41.640 --> 0:14:44.120 and if it does, you should definitely go with an 0:14:44.200 --> 0:14:46.640 end set. And from there it really comes down to 0:14:46.640 --> 0:14:48.360 what kind of pain you have and if you're dealing 0:14:48.440 --> 0:14:51.640 with any other conditions. For example, aspirin works well for 0:14:51.720 --> 0:14:55.000 headaches and for reducing inflammation in joints, but like you 0:14:55.040 --> 0:14:57.640 mentioned earlier, it can be pretty rough on your stomach. Again, 0:14:57.960 --> 0:15:00.880 it's also an anticoagulant, which is why you can reduce 0:15:00.920 --> 0:15:02.880 the risk of heart attack or stroke in some people. 0:15:03.240 --> 0:15:06.160 But anybody who's already on blood thinners should steer clear 0:15:06.160 --> 0:15:08.560 for the same reason. All right, So, so going back 0:15:08.600 --> 0:15:11.160 to iboprof and what's the deal with that one? So, 0:15:11.320 --> 0:15:14.360 just like Dr Adams intended, ibuprofen is less irritating to 0:15:14.400 --> 0:15:17.000 the stomach than aspirin is, but it still offers a 0:15:17.000 --> 0:15:19.480 lot of the same perks, and for someone with acid 0:15:19.520 --> 0:15:22.320 reflux or ulcers, hyperprofen is a good way to go. 0:15:22.760 --> 0:15:26.040 It's also particularly useful for dealing with pain from menstrual 0:15:26.040 --> 0:15:30.040 cramps or arthritis, toothaches, even sprains. You know, sometimes it 0:15:30.080 --> 0:15:33.000 has better results than aspirin. Alright, So what about something 0:15:33.040 --> 0:15:36.040 like a leave that that's an inset too, right it is. Yeah, 0:15:36.200 --> 0:15:39.360 So the active ingredient in that one is called anoproxin, 0:15:39.680 --> 0:15:42.040 and it's available in doses that are much stronger and 0:15:42.120 --> 0:15:45.320 longer lasting than those of aspirin and hyperprofen, and that 0:15:45.400 --> 0:15:48.200 makes it great for treating inflammation based pain like arthritis 0:15:48.360 --> 0:15:51.760 or even something like sunburn. However, there are downsides and 0:15:51.840 --> 0:15:54.080 aproxism strength, and one of them is that it can 0:15:54.120 --> 0:15:57.080 cause gastro intestinal problems and it can also take a 0:15:57.080 --> 0:15:59.960 while to kick in, so because it's not fast active, 0:16:00.120 --> 0:16:02.240 it's not actually a great choice for quick relief from 0:16:02.240 --> 0:16:04.800 something like a headache. All right. So there's some nuanced 0:16:04.840 --> 0:16:07.240 differences between the different end sets that might make you 0:16:07.280 --> 0:16:09.840 pick one over another in some cases, but it feels 0:16:09.840 --> 0:16:11.800 like for the most part, you know, any of them 0:16:11.800 --> 0:16:14.920 would do the trick for common pains or inflammation. But 0:16:14.920 --> 0:16:17.800 but that's not really the case with the seta menaphon though, right, Yeah, 0:16:17.920 --> 0:16:20.200 so a seta menfant is really the odd man out 0:16:20.240 --> 0:16:23.760 among these common pain killers. It lacks the anti inflammatory 0:16:23.760 --> 0:16:26.640 properties of its end said counterparts, but you know, for 0:16:26.760 --> 0:16:29.080 simple pain relief, a seta menafin does have a few 0:16:29.120 --> 0:16:31.640 things going for it. For one thing, it's generally very 0:16:31.720 --> 0:16:34.680 easy on the stomach, so for people with stomach sensitivities, 0:16:34.680 --> 0:16:36.880 like a seta menaphin is probably the first thing they 0:16:36.880 --> 0:16:39.360 reach for when a headache pops up. It's also not 0:16:39.400 --> 0:16:43.320 an anticoagulant like aspirin is, so it's safer for hemophiliacs 0:16:43.480 --> 0:16:46.360 or people on bloodening medications as we talked about, or 0:16:46.480 --> 0:16:49.640 even for kids. It's interesting that the Seeda menapin is 0:16:49.680 --> 0:16:52.480 the safer choice in some cases, because isn't that the 0:16:52.480 --> 0:16:55.320 one that's supposed to be really bad for your liver. Yeah, so, 0:16:55.480 --> 0:16:58.760 taken regularly or to access seta menafin can actually cause 0:16:58.800 --> 0:17:01.800 some serious damage to ever. It's the top cause of 0:17:01.840 --> 0:17:04.159 acute liver failure in the US. I didn't realize this 0:17:04.200 --> 0:17:06.320 before this episode, but you know, a big reason for 0:17:06.359 --> 0:17:08.399 that is that it's all too easy to overdose on 0:17:08.480 --> 0:17:11.919 a seat a menafin and their recommended dosage for pain relief, 0:17:12.080 --> 0:17:15.240 and the mountain needed to overdose aren't actually that far apart. So, 0:17:15.280 --> 0:17:18.760 according to the CDC and FDA, between fifty thousand to 0:17:18.960 --> 0:17:21.359 eighty thou people in the US head to the emergency 0:17:21.440 --> 0:17:24.639 room each year due to seeda menafin overdose. Wow, so 0:17:24.680 --> 0:17:26.840 it's just super easy to take too much of it 0:17:26.960 --> 0:17:29.600 or what? Yeah, it's probably because the seeda menafin isn't 0:17:29.640 --> 0:17:31.960 confined to just tile at all, like it crops up 0:17:31.960 --> 0:17:34.760 in over the counter cold and flu remedies, and it's 0:17:34.760 --> 0:17:38.040 also in prescription pain killers like percocet, so people who 0:17:38.080 --> 0:17:40.919 don't pay close enough attention to the labels might unknowingly 0:17:40.960 --> 0:17:44.440 consume more than the recommended doses. And because the drug 0:17:44.480 --> 0:17:47.960 can accumulate in your liver and also your bloodstream, even 0:17:47.960 --> 0:17:50.399 taking slightly too much a seat a menafin over the 0:17:50.400 --> 0:17:52.920 course a few days can lead to an overdose. It's 0:17:52.920 --> 0:17:55.720 this phenomena called a staggered overdose, but it can be 0:17:55.800 --> 0:17:58.359 every bit as deadly. What we're talking about a seta 0:17:58.359 --> 0:18:01.080 menafin being hard on the liver. So so given that, 0:18:01.119 --> 0:18:03.639 I'm guessing it's not that helpful when you're trying to 0:18:03.680 --> 0:18:06.480 fight something like a hangover, right, Oh, definitely not. I 0:18:06.720 --> 0:18:09.520 mean tons of people are probably popping a couple of 0:18:09.520 --> 0:18:11.680 tile al after a night of drinking in the hopes 0:18:11.720 --> 0:18:14.280 of wording off a hangover. But this is one of 0:18:14.320 --> 0:18:17.639 those mistakes that comes from using pain killers interchangeably, because 0:18:17.680 --> 0:18:20.720 taking a seedominafin with alcohol, even just a little bit, 0:18:21.080 --> 0:18:24.680 is actually a terrible idea. Really so, so why is that? So? 0:18:24.840 --> 0:18:27.080 This is a little tricky and Gabe actually walked me 0:18:27.119 --> 0:18:30.680 through it. But basically, because the drug is mostly metabolized 0:18:30.680 --> 0:18:34.080 in the liver, where it's joined with something called glutoth ione, 0:18:34.760 --> 0:18:37.479 it's then turned into this non toxic compound that can 0:18:37.480 --> 0:18:41.360 be removed later through urination. However, alcohol is actually known 0:18:41.359 --> 0:18:44.520 to reduce the livers glutothione levels, and when a seeda 0:18:44.560 --> 0:18:47.639 menafin is metabolized without it, the drugs turns into this 0:18:47.760 --> 0:18:51.000 far more toxic substance, and this is actually bad news 0:18:51.040 --> 0:18:53.440 for your kidney. So once studies showed that taking the 0:18:53.480 --> 0:18:56.040 recommended dose of a seeda menapin with a small to 0:18:56.160 --> 0:18:59.000 moderate amount of alcohol can actually increase the risk of 0:18:59.080 --> 0:19:03.280 kidney disease by a hundred All right, well, so obviously 0:19:03.320 --> 0:19:05.680 common pain killers aren't as across the board safe as 0:19:05.760 --> 0:19:07.639 you know. They're over the counter status might make you 0:19:07.720 --> 0:19:10.320 think they are. We talked about insects, you know, their 0:19:10.359 --> 0:19:13.400 ability to recavoc on your stomach lining and the fact 0:19:13.480 --> 0:19:15.840 that the regular use of a sneamenefin can cause permanent 0:19:15.920 --> 0:19:18.840 damage to your liver or even your kidneys. And with 0:19:18.880 --> 0:19:20.639 those risk in mind, I do think it's good to 0:19:20.640 --> 0:19:22.919 point out that these pain relievers they're not meant to 0:19:22.920 --> 0:19:26.440