WEBVTT - What's the Science of Painkillers? 0:00:00.360 --> 0:00:02.760 Guess what, mango, what's that will? So I know we 0:00:02.840 --> 0:00:06.360 regularly hear these stories about the downsides of texting, you know, 0:00:06.400 --> 0:00:09.480 the dangers of texting while driving, or all these stories 0:00:09.520 --> 0:00:11.520 about how we're no longer present because we're looking at 0:00:11.520 --> 0:00:14.079 our phones when we're around family and friends. But it 0:00:14.200 --> 0:00:16.040 was actually a study I was reading recently, and it 0:00:16.079 --> 0:00:18.840 was from the journal Pain Medicine, and it showed the 0:00:18.840 --> 0:00:22.840 benefits of texting during surgery. So I'm guessing we're not 0:00:22.880 --> 0:00:24.920 talking about major surgeries here. Well, yeah, I mean we're 0:00:24.920 --> 0:00:27.400 talking about surgeries where the patient is still awake and 0:00:27.400 --> 0:00:30.280 and often feeling some kind of discomfort or pain during 0:00:30.320 --> 0:00:33.159 that surgery. So the study involved a hundred patients and 0:00:33.159 --> 0:00:35.800 they were having these minor surgeries, and they had them 0:00:35.840 --> 0:00:37.960 do three different things. So some of the patients were 0:00:38.000 --> 0:00:41.120 asked to text, some were playing angry birds, and some 0:00:41.200 --> 0:00:44.599 were doing nothing. And they found that of the three groups, 0:00:44.680 --> 0:00:47.239 those who were texting actually had the least need for 0:00:47.320 --> 0:00:51.319 additional narcotics, and they also experienced the greatest relief from 0:00:51.320 --> 0:00:54.160 that pain. But here's what's most weird about it. The 0:00:54.240 --> 0:00:56.680 effect was most profound when they were texting with a 0:00:56.720 --> 0:01:00.040 complete stranger really not not like someone you know and 0:01:00.120 --> 0:01:02.720 someone who cares about you. Well, actually, I'm sure there's 0:01:02.760 --> 0:01:05.400 some benefit to that as well, but the greatest benefit 0:01:05.440 --> 0:01:07.560 was when they were texting with someone they didn't know. 0:01:08.040 --> 0:01:09.520 And they think it has to do with the type 0:01:09.520 --> 0:01:12.000 of conversation you'd have with the loved one versus you know, 0:01:12.040 --> 0:01:14.480 one with somebody that you don't know. So think about it. 0:01:14.480 --> 0:01:16.400 With a loved one, if you're in a lot more pain, 0:01:16.480 --> 0:01:19.160 you're you're likely to be talking about what's on your 0:01:19.200 --> 0:01:22.280 mind with that or what's bothering you. But with a stranger, 0:01:22.440 --> 0:01:24.479 you kind of have to put on a happy face 0:01:24.520 --> 0:01:26.680 and be a little bit more positive and your interaction 0:01:26.800 --> 0:01:29.399 you want to make a good impression, and that somewhat 0:01:29.440 --> 0:01:32.679 forced the positive attitude actually help them withstand a higher 0:01:32.760 --> 0:01:34.920 level of pain, and that's really fascinating. It's also kind 0:01:34.920 --> 0:01:37.280 of cool to think that your phone's best app is 0:01:37.319 --> 0:01:40.080 as a pain killer. That's right, right, And it's a 0:01:40.120 --> 0:01:43.199 reminder of that pain itself is such a strange thing, 0:01:43.600 --> 0:01:45.920 and while there are multiple ways to manage certain pain, 0:01:46.200 --> 0:01:48.480 it feels like most people aren't all that familiar with 0:01:48.520 --> 0:01:51.560 the differences among some of the major forms of pain relief. 0:01:51.840 --> 0:01:53.520 So on today's episode, we're going to focus on the 0:01:53.560 --> 0:01:57.560 science behind the things like ibuprofen, a seda, menafin, aspirin, 0:01:57.680 --> 0:02:00.000 as well as some others, and along the way we'll 0:02:00.080 --> 0:02:03.000 dive into some of the most surprising forms of pain relief. 0:02:03.280 --> 0:02:26.600 So let's get started. Hey there, podcast listeners, welcome to 0:02:26.639 --> 0:02:29.120 Part Time Genius. I'm Will Pearson and as always I'm 0:02:29.200 --> 0:02:31.400 joined by my good friend man Gesh Ticketer and on 0:02:31.440 --> 0:02:33.960 the other side of the soundproof glass sorting his meds 0:02:33.960 --> 0:02:39.280 into a massive three hundred and sixty five day pill organizers. Unbelievable. 0:02:39.440 --> 0:02:42.280 That's our friend and producer Tristan McNeil. I mean, I've 0:02:42.280 --> 0:02:45.200 got to say the sheer level of micromanagement on display 0:02:45.240 --> 0:02:48.000 here is both kind of inspiring but also a little 0:02:48.000 --> 0:02:51.440 bit unnerving at the same time, So kudos to you, Tristan. 0:02:51.600 --> 0:02:54.079 I mean, it's especially interesting because the only pills he 0:02:54.120 --> 0:02:57.160 actually takes with those lintstones chewable vitamins, which makes that 0:02:57.240 --> 0:03:00.919 giant phil caddy a little like overkill. Well, Tristan refuses 0:03:00.960 --> 0:03:03.680 to take shortcuts. You've gotta respect him for that. And 0:03:03.720 --> 0:03:07.320 speaking of shortcuts, today we're talking about common pain killers, 0:03:07.520 --> 0:03:09.760 you know, which have become many people's go to quick 0:03:09.800 --> 0:03:13.280 fix for everything from headaches to hangovers, and most of 0:03:13.320 --> 0:03:15.160 us keep at least one of these over the counter 0:03:15.200 --> 0:03:18.680 medications on standby and the medicine cabinet or next to us. 0:03:18.680 --> 0:03:21.480 But you know whether that's aspirin or hyboprofin or taile 0:03:21.520 --> 0:03:24.640 and all. But despite that ubiquity, a few of us 0:03:24.639 --> 0:03:27.080 could tell you even the most basic facts about the 0:03:27.080 --> 0:03:30.400 pills that we so readily swallow. In fact, according to 0:03:30.440 --> 0:03:32.800 a two thousand one survey from the National Council on 0:03:32.840 --> 0:03:36.520 Patient Information and Education, only one third of the public 0:03:36.640 --> 0:03:39.440 is able to identify the active ingredient in their pain 0:03:39.520 --> 0:03:42.600 killer of choice, And with over the counter pain relievers 0:03:42.600 --> 0:03:46.240 accounting for over five billion in sales last year, that's 0:03:46.240 --> 0:03:48.840 a big chunk of the population that medicates with something 0:03:48.840 --> 0:03:52.160 they really don't know that much about. So for today's episode, 0:03:52.240 --> 0:03:54.320 we're actually gonna shine some light on the little known 0:03:54.360 --> 0:03:56.880 facts behind a few of the world's most commonly taken, 0:03:57.280 --> 0:03:59.840 at least understood medications. So we'll try to get an 0:03:59.880 --> 0:04:01.720 eye idea of where they come from and what they're 0:04:01.760 --> 0:04:04.120 best suited for, as well as what the future of 0:04:04.120 --> 0:04:06.920 pain management might look like, alright, ma, go, so where 0:04:06.920 --> 0:04:09.280 do you think we should start. So, I mean, this 0:04:09.360 --> 0:04:11.240 might sound a little basic, but I thought it'd be 0:04:11.240 --> 0:04:13.680 helpful to start with a quick refresher on what pain 0:04:13.760 --> 0:04:17.120 really is and how a non prescription painkiller actually works 0:04:17.160 --> 0:04:19.200 to relieve it. So for the first part of that, 0:04:19.240 --> 0:04:22.080 pain is really just this early warning system. It's our 0:04:22.120 --> 0:04:24.440 body's way of letting us know that we're injured or 0:04:24.720 --> 0:04:27.400 even though we're doing something that we probably should stop doing. So, 0:04:27.520 --> 0:04:29.479 for instance, if you put your hand on the hot stove, 0:04:29.839 --> 0:04:32.280 special nerve receptors in your skin will actually respond to 0:04:32.320 --> 0:04:35.039 the damage from the heat, and that sensation is then 0:04:35.080 --> 0:04:37.359 sent as a chemical message to the spinal cord and 0:04:37.480 --> 0:04:40.159 your brain stem, and from there the message travels to 0:04:40.200 --> 0:04:42.880 the brain, which is where the sensation is registered and 0:04:43.080 --> 0:04:47.280 processed and finally perceived as pain. And that's a helpful description, 0:04:47.320 --> 0:04:48.960 but it is kind of weird to take a step 0:04:48.960 --> 0:04:50.800 back and think about it, like it almost makes it 0:04:50.880 --> 0:04:54.560 sound kind of bureaucratic that like, this pain is this 0:04:54.600 --> 0:04:56.839 memo that's got to be passed around from office to office, 0:04:56.920 --> 0:04:59.479 gotta get everybody's approval, and then it finally gets to 0:04:59.520 --> 0:05:03.279 the big loss upstairs, you know, right, So it obviously 0:05:03.320 --> 0:05:06.080 takes more time to describe the experience of feeling the 0:05:06.120 --> 0:05:08.719 pain that actually does to feel it, which is pretty 0:05:08.760 --> 0:05:11.880 much instantaneous. But it's still helpful to know the ins 0:05:11.880 --> 0:05:14.839 and outs of the process because that's ultimately how pain 0:05:14.920 --> 0:05:18.000 killers work. Like, they interfere with the body's transmissions of 0:05:18.000 --> 0:05:20.480 pain signals. And this is where the difference between pain 0:05:20.560 --> 0:05:24.239 killers comes into because each kind targets a different point 0:05:24.240 --> 0:05:27.640 in the communication chain. So, for example, aspirin and ibuprofen 0:05:27.680 --> 0:05:30.320 our end sets and that's n S a i D, 0:05:30.520 --> 0:05:35.080 which stands for a non steroidal anti inflammatory drugs. These 0:05:35.080 --> 0:05:37.279 medications cut off the pain signals at the side of 0:05:37.279 --> 0:05:39.920 the injury. But something like a set of menafin, which 0:05:39.920 --> 0:05:42.920 is a different kind of pain reliever, works much differently. 0:05:43.320 --> 0:05:45.039 All right, we'll obviously get to them. Why don't we 0:05:45.040 --> 0:05:46.920 stick to the end sets for now? So how does 0:05:46.960 --> 0:05:50.640 one of these run interference on these pain signals? Sure? So, 0:05:50.839 --> 0:05:53.160 when the nerve receptors in our cells are damaged, they 0:05:53.160 --> 0:05:56.640 produce chemicals that perform a variety of functions. Right, Some 0:05:56.760 --> 0:05:58.960 lower the pain threshold and the injured cells to make 0:05:59.000 --> 0:06:02.200 sure we get the message others produce inflammation and swelling 0:06:02.320 --> 0:06:05.000 is a way to cushion the cells from further injury. Alright, 0:06:05.000 --> 0:06:07.479 so these chemicals must be what the end SAIDs are targeting, 0:06:07.560 --> 0:06:11.159 right since they're anti inflammatories. Right, So and and said like, 0:06:11.200 --> 0:06:14.160 aspirin works by halting the production of the chemicals responsible 0:06:14.200 --> 0:06:16.800 for the pain and swelling, and the aspirin binds with 0:06:16.839 --> 0:06:20.479 the enzymes that produce these chemicals, which basically neutralizes the 0:06:20.560 --> 0:06:22.960 enzymes and prevents the chemicals from being made at all. 0:06:23.400 --> 0:06:25.320 Oh wow, that's interesting. All right, So the damage that 0:06:25.400 --> 0:06:27.320 prompted the pain is still there, but but we no 0:06:27.400 --> 0:06:30.040 longer perceive the pain. Is that what's going on exactly? 0:06:30.080 --> 0:06:32.400 So the pain killers don't actually heal injuries, and they 0:06:32.440 --> 0:06:34.560 don't even kill the pain really, they just kill your 0:06:34.600 --> 0:06:37.360 awareness of pain by cutting off that signal out the source. 0:06:37.880 --> 0:06:39.960 That sounds pretty deep. So the pain is still there, 0:06:40.000 --> 0:06:42.359 we just don't feel the pain. But all right, Well, 0:06:42.360 --> 0:06:44.680 speaking of the pain awareness, how does an end said 0:06:44.720 --> 0:06:47.400 nowhere to go? Like, how's it able to pinpoint the 0:06:47.440 --> 0:06:50.560 part of the body that's injured? So it doesn't really 0:06:50.600 --> 0:06:53.279 like the aspirin dissolves in the stomach and it's carried 0:06:53.320 --> 0:06:55.840 to all parts of the body through the bloodstream. It's 0:06:55.880 --> 0:06:57.680 just that the damage part is the only place it 0:06:57.720 --> 0:07:00.760 will actually find pain related enzymes to bind with. Well, 0:07:00.760 --> 0:07:02.520 that makes sense. So so what about a sta menaphin 0:07:02.560 --> 0:07:04.919 Like it it doesn't reduce inflammation, that it must be 0:07:05.000 --> 0:07:08.760 doing something else, right, Yeah, so that's the amazing thing, right, Like, 0:07:08.839 --> 0:07:11.120 even though a sida menaphin was discovered in the eighteen 0:07:11.160 --> 0:07:13.920 hundreds and it served as the active ingredient tilen al 0:07:13.960 --> 0:07:15.920 since I want to say, in the nineteen fifties, we 0:07:16.040 --> 0:07:18.640 still really don't know how it works. I mean, just 0:07:18.720 --> 0:07:20.960 listen to his physicians note that comes with toilen all 0:07:21.000 --> 0:07:25.480 bottles quote. Although the analgesic effects of a sida menaphin 0:07:25.600 --> 0:07:28.880 is well established, the site and mode of action have 0:07:29.040 --> 0:07:32.640 not been clearly elucidated. And that's stunning. Yeah, so they 0:07:32.720 --> 0:07:34.800 feel like it's saying this stuff works, but we have 0:07:34.840 --> 0:07:37.280 no idea how. Yeah, it's so weird. But you know, 0:07:37.360 --> 0:07:39.920 they do have some theories. So for example, it's possible 0:07:39.960 --> 0:07:42.040 that a seda menafin works the same way and SAIDs to, 0:07:42.480 --> 0:07:45.800 but it just isn't effective against the chemicals responsible for inflammation. 0:07:46.240 --> 0:07:48.320 And then there's this other theory that a side BeneFin 0:07:48.400 --> 0:07:50.760 actually affects our sensation of pain by working on the 0:07:50.960 --> 0:07:54.120 endocannabinoid system, which you know, you might guess is the 0:07:54.160 --> 0:07:58.120 same system that responds to cannabis or marijuana. So you know, 0:07:58.200 --> 0:08:00.920 this is according to researchers at Lund Universe City in Sweden, 0:08:01.200 --> 0:08:04.840 and sentimental fin activates two ion channels in the brain 0:08:04.920 --> 0:08:07.480 and spinal cord, and these are the two channels that 0:08:07.520 --> 0:08:10.600 also respond to cannabinoids. And the weird thing though, is 0:08:10.640 --> 0:08:14.440 that these ion channels can actually trigger pain and its responses, 0:08:14.480 --> 0:08:17.880 so it's pretty strange that activating them would actually reduce 0:08:17.920 --> 0:08:20.520 the pain. But you know, like I said, nobody really 0:08:20.520 --> 0:08:22.560 knows for sure how these all work. Well, you know, 0:08:22.600 --> 0:08:24.240 you mentioned that a set of menifit has been around 0:08:24.280 --> 0:08:26.720 since the eighteen hundreds, So why don't we switch gears 0:08:26.720 --> 0:08:28.280 and talk a little bit more about the history behind 0:08:28.320 --> 0:08:30.920 a few of the common pain killers. Yeah, So, you know, 0:08:31.000 --> 0:08:33.440 I'm always tempted to start from the beginning and dig 0:08:33.440 --> 0:08:36.079 into the weird history beyond the topic, but with something 0:08:36.160 --> 0:08:38.360 like pain relievers, it feels like it might be a 0:08:38.400 --> 0:08:41.320 tad too ambitious. I mean, pain is something that humans 0:08:41.320 --> 0:08:43.720 have had to contend with on a daily basis, and 0:08:43.840 --> 0:08:47.360 at this point we've actually spent millennia like experimenting with 0:08:47.360 --> 0:08:50.240 different kinds of ways to manage it. It's kind of 0:08:50.280 --> 0:08:53.120 a lot to cover, you know. Actually, when I was 0:08:53.120 --> 0:08:55.680 studying abroaden Tibet, we went to the Kirang Valley, which 0:08:55.880 --> 0:08:59.920 hadn't had much contact with western civilization, and our professor 0:09:00.000 --> 0:09:02.000 told us that people used to manage their headaches by 0:09:02.000 --> 0:09:04.079 putting these pieces of tape on the sides of their heads. 0:09:04.360 --> 0:09:07.040 In fact, if you give them aspirin or a town 0:09:07.080 --> 0:09:09.920 all or whatever, it would actually really really affect them. 0:09:10.000 --> 0:09:12.839 And it was kind of funny because marijuana actually grew 0:09:12.880 --> 0:09:15.480 wild in the fields there everywhere, it was all over 0:09:15.480 --> 0:09:17.400 the place, but no one smoked as pain release. They 0:09:17.440 --> 0:09:20.040 just used these little strips of tape to manage their pain, 0:09:20.520 --> 0:09:22.840 and you know, maybe it works. I didn't actually try 0:09:22.880 --> 0:09:26.000 didn't try some tape. We could easily devote a whole 0:09:26.000 --> 0:09:29.040 episode to bizarre pain management techniques that people have tried 0:09:29.080 --> 0:09:31.560 in the past. You look at everything from like boring 0:09:31.640 --> 0:09:34.720 holes and people's skulls, the banging gongs, to scare away 0:09:34.760 --> 0:09:37.360 painful spirits, which I know you still do sometimes. But 0:09:37.760 --> 0:09:39.760 you know what, those ancient remedies that have the most 0:09:39.760 --> 0:09:42.760 bearing on pain killers of today, they're actually the botanical ones. 0:09:43.200 --> 0:09:45.080 So for instance, you know, you look at the ancient Greeks, 0:09:45.080 --> 0:09:47.560 they they chewed bark and the leaves of willow trees 0:09:47.600 --> 0:09:50.440 in order to help produce things like fever or relief 0:09:50.480 --> 0:09:54.160 pain during childbirth. Ancient Egyptians did something pretty similar with 0:09:54.160 --> 0:09:56.720 the leaves from myrtle bushes. You look at the Native 0:09:56.760 --> 0:09:59.679 Americans to actually chewed birch bark as their pain relieving 0:09:59.679 --> 0:10:02.280 plan of choice, and those all turned out to be 0:10:02.400 --> 0:10:05.960 pretty great ideas because actually all three of those plants 0:10:05.960 --> 0:10:08.400 contain high levels of salas like acid, which is the 0:10:08.440 --> 0:10:12.360 active ingredient, and aspirin, which is awesome, but I always 0:10:12.360 --> 0:10:16.040 thought the active ingredient aspirin was aspirin, like, it's not 0:10:16.120 --> 0:10:18.640 its own thing. If you want to get technical, the 0:10:18.679 --> 0:10:21.920 active ingredient and aspirin is called a setal salacelic acid 0:10:22.040 --> 0:10:24.320 or a s A. You know, see that the pain 0:10:24.360 --> 0:10:27.040 relieving chemical that's most common to all these plants I 0:10:27.080 --> 0:10:30.559 mentioned also had the unfortunate side effect of wreaking havoc 0:10:30.600 --> 0:10:33.160 on our digestive systems. So it was a big deal 0:10:33.200 --> 0:10:37.160 in when this German scientist who was working for Bear Pharmaceutical, 0:10:37.360 --> 0:10:40.360 he was able to synthesize a less harmful and easier 0:10:40.400 --> 0:10:42.480 to digest chemical and that was this A S A 0:10:42.640 --> 0:10:45.120 that we're talking about. So the Bear company named this 0:10:45.200 --> 0:10:48.440 new drug aspirin, and it was the first mass produced 0:10:48.520 --> 0:10:50.720 over the counter pain reliever to come to the market. 0:10:51.000 --> 0:10:53.120 In fact, the word itself was a trademark term, you know, 0:10:53.200 --> 0:10:54.600 kind of like tile and all or some of these 0:10:54.640 --> 0:10:57.839 others for about twenty years. But after that aspirin became 0:10:57.880 --> 0:11:00.480 a generic word for the A S A based medicine 0:11:00.520 --> 0:11:03.960 in most markets. Actually still today, Bear holds the trademark 0:11:04.000 --> 0:11:08.720 in some countries. So what about another end said like ibuprofen. 0:11:08.920 --> 0:11:12.240 Is that the actual chemical ingredient or is it just 0:11:12.280 --> 0:11:15.680 another trademark term that died in went generic. No, Iybroprofen 0:11:15.760 --> 0:11:18.400 is its own active ingredient, which you'll find in branded 0:11:18.480 --> 0:11:22.120 versions like advil or motrin. And although the chemicals themselves 0:11:22.160 --> 0:11:25.080 are different, ibuprofen works pretty similarly to the A S 0:11:25.160 --> 0:11:28.119 A and aspirin. In fact, the man who discovered ibuprofen. 0:11:28.160 --> 0:11:30.400 His name was Dr Stewart Adams. He did so while 0:11:30.400 --> 0:11:33.439 he was looking into how aspirin worked. This was back 0:11:33.480 --> 0:11:36.320 in the early nineteen fifties. Adams was working in the 0:11:36.320 --> 0:11:39.080 research department at a place called Boots Pure Drug Company, 0:11:39.080 --> 0:11:41.240 and this was in England, and his goal at the 0:11:41.240 --> 0:11:43.599 time was to find the new way of treating rheumatoid 0:11:43.720 --> 0:11:47.000 arthritis that wasn't reliant on steroids and all the side 0:11:47.000 --> 0:11:49.640 effects that come along with those. So, I mean at 0:11:49.640 --> 0:11:52.520 this time aspirin was already in you. So we've already 0:11:52.559 --> 0:11:54.800 said it was non steroidal and and it was great 0:11:54.840 --> 0:11:57.959 for inflammation, Like why didn't Arthuris patients just use that? 0:11:58.240 --> 0:12:00.679 Well they did, but they were drawbacks to any pain 0:12:00.760 --> 0:12:03.160 killer that will be talking about. In the case of aspirin, 0:12:03.240 --> 0:12:05.680 it usually has to be given in fairly high doses 0:12:05.720 --> 0:12:08.280 and that of course greatly increases the risk of side 0:12:08.280 --> 0:12:12.120 effects like allergic reaction or indigestion or in some cases 0:12:12.160 --> 0:12:15.160 even internal bleeding. So Adams and his team were after 0:12:15.200 --> 0:12:17.839 an alternative that could be better tolerated if if they 0:12:17.840 --> 0:12:21.360 were going to be used regularly, and it didn't come easily, 0:12:21.640 --> 0:12:24.880 I mean, together with a chemist and a technician. Adams 0:12:24.880 --> 0:12:27.959 actually tested the potency of more than six hundred chemical 0:12:28.040 --> 0:12:30.560 compounds over the course of about a ten year period. 0:12:31.240 --> 0:12:33.000 And I mean you do hear about sort of like 0:12:33.040 --> 0:12:35.679 a tenure cycle for drugs coming to come about. But like, 0:12:36.280 --> 0:12:38.400 was it just like trial and error until they figured 0:12:38.440 --> 0:12:40.559 out this winning compound? Yeah, it was. And I mean 0:12:40.559 --> 0:12:42.920 a few of the most promising ones were actually tested 0:12:42.960 --> 0:12:45.640 by the team itself, like something you would never see 0:12:45.720 --> 0:12:49.240 happening today. And so was the team just knocking back 0:12:49.240 --> 0:12:51.559 these experimental pills and like they had no idea what 0:12:51.679 --> 0:12:53.520 sort of damage would cause. Well, I mean the handful 0:12:53.520 --> 0:12:56.240 of compounds they tested firsthand were ones that had already 0:12:56.240 --> 0:12:59.679 passed the toxicity test, but otherwise pretty much I mean. 0:12:59.840 --> 0:13:02.440 In fact, Dr Adams later revealed that his discovery of 0:13:02.440 --> 0:13:05.719 ibaprof and was due to him ingesting a promising compound 0:13:06.040 --> 0:13:09.120 as a way of dealing with a bad hangover. So apparently, 0:13:09.160 --> 0:13:11.120 sometime in the early sixties he was scheduled to give 0:13:11.160 --> 0:13:14.160 this important speech, but the night before he had spent 0:13:14.240 --> 0:13:16.440 some time at the bar wasn't really feeling up to 0:13:16.480 --> 0:13:18.880 the task. And here's how he described the event in 0:13:18.920 --> 0:13:21.640 an interview he said, I was first up to speak, 0:13:21.720 --> 0:13:23.320 and I had a bit of a headache after a 0:13:23.440 --> 0:13:25.960 night out with friends, so I took the six hundred 0:13:25.960 --> 0:13:28.320 milligram dose just to be sure and found it was 0:13:28.400 --> 0:13:31.160 very effective. I love that before he was giving this 0:13:31.200 --> 0:13:32.880 big speech, he was like, let me just try a 0:13:32.920 --> 0:13:34.640 little bit of this stuff. We've been mixing up one 0:13:34.679 --> 0:13:37.319 of the ten thousand different things or six hundred different 0:13:37.360 --> 0:13:40.520 chemical compounds. Yeah, and that the night before that he 0:13:40.600 --> 0:13:43.600 was just drinking aver Right. It's a good strategy. So, 0:13:43.840 --> 0:13:46.480 I mean, obviously it sounds insane, and it does also 0:13:46.480 --> 0:13:48.920 sound like a ringing endorsement for iban proof and as 0:13:48.960 --> 0:13:51.679 a hangover cure. But uh, what about some other common 0:13:51.720 --> 0:13:54.120 pain killers, Like we should probably talk about some of 0:13:54.160 --> 0:13:56.600 their striends and weaknesses as well. Yeah, I definitely want to, 0:13:56.640 --> 0:14:12.000 but before we do, let's take a quick break. You're 0:14:12.040 --> 0:14:13.840 listening to part Time Genius and we're talking about the 0:14:13.840 --> 0:14:17.320 science behind the world's most common pain killers. All right, Mango. 0:14:17.400 --> 0:14:19.920 So obviously we love a bunch of different products under 0:14:19.920 --> 0:14:23.000 the same category of these non prescription pain relievers, and 0:14:23.360 --> 0:14:25.280 one of the biggest downside to this is that we 0:14:25.320 --> 0:14:28.160 tend to use them all interchangeably. So I know you 0:14:28.200 --> 0:14:29.800 were doing some digging into this so too, So tell 0:14:29.840 --> 0:14:31.920 me what kind of stuff should we consider when you 0:14:31.920 --> 0:14:35.200 know choosing which pill we need to pile. So, I 0:14:35.240 --> 0:14:37.600 mean a great place to start is whether or not 0:14:37.640 --> 0:14:40.400 you're pain involves any kind of swelling, and if it does, 0:14:40.480 --> 0:14:43.280 you should definitely go with an end set. And from 0:14:43.320 --> 0:14:45.000 there it really comes down to what kind of pain 0:14:45.080 --> 0:14:47.280 you have and if you're dealing with any other conditions. 0:14:47.360 --> 0:14:50.720 For example, aspirin works well for headaches and for reducing 0:14:50.720 --> 0:14:53.640 inflammation and joints, but like you mentioned earlier, it can 0:14:53.680 --> 0:14:57.320 be pretty rough on your stomach. Again, it's also an anticoagulant, 0:14:57.480 --> 0:14:59.280 which is why you can reduce the risk of heart 0:14:59.320 --> 0:15:02.320 attack or stro can some people, but anybody who's already 0:15:02.320 --> 0:15:04.680 on blood thinners should steer clear for the same reason. 0:15:05.080 --> 0:15:07.360 All right, So, so going back to iboprof and what's 0:15:07.400 --> 0:15:10.600 the deal with that one? So, just like Dr Adams intended, 0:15:10.640 --> 0:15:13.480 ibuprofen is less irritating to the stomach than aspirin is, 0:15:13.760 --> 0:15:15.640 but it still offers a lot of the same perks. 0:15:15.880 --> 0:15:19.360 And for someone with acid reflux or ulcers, hypoprofen is 0:15:19.360 --> 0:15:22.200 a good way to go. It's also particularly useful for 0:15:22.320 --> 0:15:26.960 dealing with pain, for menstrual cramps or arthritis, toothaches, even sprains. 0:15:27.040 --> 0:15:29.920 You know, sometimes it has better results than aspirin. All right, 0:15:29.960 --> 0:15:31.880 So what about something like a leave that that's an 0:15:31.880 --> 0:15:35.200 inset too, right it is. Yeah, So the active ingredient 0:15:35.240 --> 0:15:38.240 in that one is called neoproxin, and it's available in 0:15:38.280 --> 0:15:40.960 doses that are much stronger and longer lasting than those 0:15:41.040 --> 0:15:43.760 of aspirin and hyperprofen, and that makes it great for 0:15:43.840 --> 0:15:48.240 treating inflammation based pain like arthritis or even something like sunburn. However, 0:15:48.280 --> 0:15:51.360 there are downsides and aproximate strength, and one of them 0:15:51.400 --> 0:15:54.240 is that it can cause gastro intestinal problems and it 0:15:54.280 --> 0:15:56.720 can also take a while to kick in, so because 0:15:56.720 --> 0:15:59.160 it's not fast acting, it's not actually a great choice 0:15:59.160 --> 0:16:01.680 for quick relief from something like a headache. All right. 0:16:01.720 --> 0:16:04.360 So there's some nuanced differences between the different end sets 0:16:04.440 --> 0:16:06.880 that might make you pick one over another in some cases, 0:16:06.920 --> 0:16:09.040 but it feels like for the most part, you know, 0:16:09.080 --> 0:16:11.240 any of them would do the trick for common pains 0:16:11.360 --> 0:16:13.840 or inflammation. But but that's not really the case with 0:16:13.880 --> 0:16:16.760 the seta menaphon though, right, Yeah, So a seta menafant 0:16:16.800 --> 0:16:19.680 is really the odd man out among these common pain killers. 0:16:20.000 --> 0:16:23.520 It lacks the anti inflammatory properties of its end said counterparts, 0:16:23.520 --> 0:16:26.200 but you know, for simple pain relief, a seeda menafin 0:16:26.280 --> 0:16:28.480 does have a few things going for it. For one thing, 0:16:28.520 --> 0:16:31.040 it's generally very easy on the stomach, so for people 0:16:31.080 --> 0:16:34.080 with stomach sensitivities, like a seta menaphin is probably the 0:16:34.120 --> 0:16:36.080 first thing they reach for when a headache pops up. 0:16:36.560 --> 0:16:39.680 It's also not an anticoagulant like aspirin is, so it's 0:16:39.720 --> 0:16:43.360 safer for hemophiliacs or people on bloodending medications as we 0:16:43.440 --> 0:16:46.600 talked about, or even for kids. It's interesting that the 0:16:46.640 --> 0:16:49.560 seeda menaphon is the safer choice in some cases because 0:16:49.840 --> 0:16:51.520 isn't that the one that's supposed to be really bad 0:16:51.560 --> 0:16:54.920 for your liver. Yeah, so, taken regularly or to access 0:16:55.240 --> 0:16:57.920 seta menafin can actually cause some serious damage to deliver. 0:16:58.440 --> 0:17:00.760 It's the top cause of acute liver failure in the 0:17:00.840 --> 0:17:02.840 U S. I didn't realize this before this episode, but 0:17:03.080 --> 0:17:04.840 you know, a big reason for that is that it's 0:17:04.840 --> 0:17:07.040 all too easy to overdose on a seat A menafin 0:17:07.440 --> 0:17:10.399 and their recommended dosage for pain relief and the mountain 0:17:10.400 --> 0:17:13.399 needed to overdose aren't actually that far apart. So according 0:17:13.400 --> 0:17:17.040 to the CDC and FDA, between fifty thou to eighty 0:17:17.080 --> 0:17:19.400 thou people in the US head to the emergency room 0:17:19.480 --> 0:17:22.399 each year due to seed a menafin overdose. Wow, so 0:17:22.440 --> 0:17:24.639 it's just super easy to take too much of it 0:17:24.720 --> 0:17:27.359 or what? Yeah, it's probably because the seeda menafin isn't 0:17:27.400 --> 0:17:29.719 confined to just tile at all, like it crops up 0:17:29.720 --> 0:17:32.520 in over the counter cold and flu remedies, and it's 0:17:32.560 --> 0:17:35.840 also in prescription pain killers like percocet, so people who 0:17:35.840 --> 0:17:38.679 don't pay close enough attention to the labels might unknowingly 0:17:38.720 --> 0:17:42.200 consume more than the recommended doses. And because the drug 0:17:42.240 --> 0:17:45.720 can accumulate in your liver and also your bloodstream, even 0:17:45.720 --> 0:17:48.159 taking slightly too much a seat a menafin over the 0:17:48.160 --> 0:17:50.680 course a few days can lead to an overdose. It's 0:17:50.720 --> 0:17:53.480 this phenomena called a staggered overdose, but it can be 0:17:53.560 --> 0:17:56.119 every bit as deadly. Well, we're talking about a seeda 0:17:56.119 --> 0:17:58.840 menafin being hard on the liver, so so given that, 0:17:58.880 --> 0:18:01.399 I'm guessing it's not that helpful when you're trying to 0:18:01.440 --> 0:18:04.680 fight something like a hangover, right, oh definitely not. I mean, 0:18:05.000 --> 0:18:07.480 tons of people are probably popping a couple of tile 0:18:07.600 --> 0:18:09.560 al after a night of drinking in the hopes of 0:18:09.640 --> 0:18:12.280 wording off a hangover. But this is one of those 0:18:12.320 --> 0:18:15.680 mistakes that comes from using pain killers interchangeably, because taking 0:18:15.680 --> 0:18:18.879 a seedominafin with alcohol, even just a little bit, is 0:18:18.880 --> 0:18:22.440 actually a terrible idea. Really so so why is that? So? 0:18:22.600 --> 0:18:24.879 This is a little tricky and Gabe actually walked me 0:18:24.920 --> 0:18:28.440 through it. But basically, because the drug is mostly metabolized 0:18:28.440 --> 0:18:31.840 in the liver, where it's joined with something called glutoth ione, 0:18:32.520 --> 0:18:35.239 it's then turned into this non toxic compound that can 0:18:35.240 --> 0:18:39.120 be removed later through urination. However, alcohol is actually known 0:18:39.119 --> 0:18:42.280 to reduce the livers glutothione levels, and when a seeda 0:18:42.320 --> 0:18:45.439 menafin is metabolized without it, the drugs turns into this 0:18:45.520 --> 0:18:48.760 far more toxic substance, and this is actually bad news 0:18:48.840 --> 0:18:51.240 for your kidney. So once study showed that taking the 0:18:51.240 --> 0:18:53.800 recommended dose of a seeda menapin with a small to 0:18:53.920 --> 0:18:56.760 moderate amount of alcohol can actually increase the risk of 0:18:56.840 --> 0:19:00.439 kidney disease by a hundred and twenty All right, well, 0:19:00.480 --> 0:19:02.960 so obviously common pain killers aren't as across the board 0:19:03.040 --> 0:19:05.120 safe as you know. They're over the counter status might 0:19:05.119 --> 0:19:07.840 make you think they are. We talked about insects, you know, 0:19:07.960 --> 0:19:10.960 their ability to recapoc on your stomach lining and the 0:19:11.000 --> 0:19:12.919 fact that the regular use of the scene menofin can 0:19:12.960 --> 0:19:16.200 cause permanent damage to your liver or even your kidneys. 0:19:16.200 --> 0:19:18.160 And with those risk in mind, I do think it's 0:19:18.160 --> 0:19:20.239