June 2017: painkillers: risks and alternatives


Painkillers may often be a blessing, but we should never use them indiscriminately, and it’s well worth checking whether there are other ways to face your pain.

There are basically three kinds of painkillers: paracetamol, opioids, and NSAIDs. They all have their downsides. Here are the reasons why we should try to avoid them as much as we can.

Paracetamol or acetaminophen is an effective painkiller but taxes the liver. It is extremely dangerous if combined with alcohol. For children, there is very poor evidence of fever relief . Giving kids calpol or similar, is not a good idea anyway [1].

Opioid painkillers, like codeine, are addictive, and hard to get off. Only one week of continual use can leave you enslaved.

Anti-inflammatories or NSAIDs (Non-Steroidal Anti-inflammatory Drugs) like aspirin and ibuprofen, damage the gut. Taking too many for too long, can lead to internal bleeding. If you have an ulcer, or any signs of digestive discomfort, the consequences could be serious [2].
Only recently, in March 2017, a Danish study led to calls for restrictions on the sale of ibuprofen, after they found it heightened the risk of cardiac arrest by 31%, with other NSAIDs presenting an even higher risk [3].
And did you know that aspirin and other fever-reducing medications actually suppress the production of antibodies, thus resulting in the infection lasting for up to 50% longer than it should? They inhibit the release of pyrogen, a substance that causes fever. And fever actually helps the body fight infections [4].

So we have to be very careful with painkillers. For 6 reasons, see [5].
For more detail about PARACETAMOL see [6].
More detail about OPIOIDS, and CODEINE more specifically, see [7].
For more detail about NSAIDs, see [8].

There is a marvellous general site about pain, well worth looking at for a start: [9].
You’ll find plenty of non-drug therapies such as heat or cold, acupuncture, (breathing) exercise, yoga, massage etc: see [10]. For a herbal pain approach, see [11].
And did you know that 20 minutes of aerobic exercise is enough to stimulate the body to produce more endorphins – natural painkillers? And that our spit contains a painkiller more powerful than morphine: opiorphin? We have it only in minute quantities, so that we’re not off our heads all the time. Eating, though, releases more of the chemical and this may be a factor in comfort eating.

LAST but not LEAST: when it hurts, there is a reason. If all we can think of is to dull the hurt, we’ll never find the cause and it will persist and get worse. To deal with the cause, preferably in an early stage, we have to feel the pain. We have to respond to the feedback our bodies give us: when does it get better, when does it get worse? Does my food, my posture, stress or things I do, affect it?


“People who view pain as the enemy instinctively respond with vengeance or bitterness–Why me? I don’t deserve this! It’s not fair! – which has the vicious-circle effect of making their pain even worse. “Think of the pain as a speech your body is delivering about a subject of vital importance to you,” I tell my patients. “From the very first twinge, pause and listen to the pain and, yes, try to be grateful. The body is using the language of pain because that’s the most effective way to get your attention.” I call this approach “befriending” pain: to take what is ordinarily seen as an enemy, and to disarm it, and then welcome it.” Pain: The Gift Nobody Wants’ Dr. Paul Brand

veg: broad beans, beet, cabbage, carrots, lettuce, new potatoes, artichokes, asparagus, broccoli, mangetout, peas, cauliflower, radish, spinach, spring onions, spring greens, watercress, kohlrabi, turnips, rhubarb, redcurrants, strawberries, gooseberries.
meat: lamb, wood pigeon.
fish: grey mullet, black bream, gurnard, pollock, whiting, mackerel, lobster, whelks, clams, cockles, coley, crabs, crayfish, flounder, grouper, gurnards, herring, megrim, scallops.

beetroot, calabrese, lettuce, french beans, kale, carrots, cauliflower (mini only), salad onions, (sugar) peas, radish, kohlrabi, mooli, turnip, chicory, Florence fennel, courgettes and pumpkins.
Sow swede and sweetcorn in early June. If the soil is above 25°C, sow crisphead, cos or little Gem only.
plant out: courgettes, cabbage, sprouting broccoli, sprouts, celery, celeriac, ridge cucumbers, runner/french beans, pumpkins, tomatoes, sweet corn.

Radishes bolted? Nothing else in the garden? Don’t despair – this soup is one of the best I’ve made.
Bolted radish green with their (bolted) radishes, onion, 1-2 garlic clove(s), 1 tblsp sour cream, 1 tblsp peanut butter, water/stock, (cayenne) pepper, salt.
Slice onion and garlic, sauté in butter for a min., add plenty of chopped radishes with their leaves, even when bolted. Saute for a few more minutes, add water/stock. Cook till everything is soft. Loosen the peanut butter with the hot liquid, add to the soup along with the sour cream, blitz if you like, season. You can leave out the peanutbutter, or add tomato puree instead.

200g shredded spring greens, 3 sliced garlic cloves, 200 grams diced bacon, 100g peas, 200g cream cheese, handful of basil, black pepper, 480g pasta.
Cook greens in water for 5 mins until slightly wilted and tender. Saute garlic for 1-2 mins, then add drained spring greens. Fry for 5 mins, add peas and cream cheese and stir until melted. Add a teensie bit of water, cover and cook for 7-10 min until peas are done. Add torn basil and pepper. In another pan prepare pasta in the usual way. Drain and mix in the cheesey sauce.

450g spinach or chard, some leaves of sorrel, garlic clove, 900g thin fish fillets, salt, pepper, nice bread (onion, thyme, ginger).
Split the leaves from the stalks if using perennial spinach, and cut them. Season the fish. Boil a little bit of water, add the cut stalks if any, cook for 3-5 minutes. Then add the rest of the greens and chopped garlic, put the fish on top, cover. Cook for about 15 minutes, no longer.
Place bread on a plate and add fish, greens and liquid, which shouldn’t be too much by now.
This is surprisingly nice, but to improve on it even  more, fry plenty of onions with some ginger and thyme, and add that to the mass.

2 small, young kohlrabi, 6 radishes, 4 tblsp extra-virgin olive oil, 4 tsp cider vinegar, a pinch of English mustard powder, blue cheese, flaky sea salt, pepper.
Strip leaves off the kohlrabi and cut off tops and bottoms. Using a mandolin, cut into paper-thin slices. Do the same with the radishes. Arrange kohlrabi and radish on a platter. Whisk oil, cider vinegar and mustard powder together, drizzle over the slices. Season and sprinkle with crumbled blue cheese. Serve immediately.

A lovely cheap and easy dish, as long as you do some preparation beforehand.
Every lamb has a heart, so if you ask your butcher he may well come up with one, if only from the freezer.
450g lamb or beef hearts. For the marinade: 2 tblsp balsamic vinegar, 1 tsp salt, 1/2 tsp ground black pepper and 1tsp thyme.
Trim the heart(s) and cut in 1.5 – 2cm cubes. Marinate for at for least 8 hrs. Grill, spreading out into a single layer, and let brown for a minute or two. Toss and brown on the other sides for another minute; remove. Delicious!

BRAISED LETTUCE and PEAS for 1 or 2.
2 tblsp butter, shallot thinly sliced, half a head of (cos) lettuce, ab. 150ml stock, 100g (frozen) peas.
Chop lettuce into small pieces. Saute shallot for a minute, add lettuce, saute for another minute. Add stock, bring to a simmer.  Add peas, cook covered for a short while.. Season if necessary. Garnish with for instance heavy cream, mint, grated carrots or lemon juice.

BROAD BEANS with ONIONS and BACON, serves 2 as a side dish.
250g shelled broad beans, 1 butter, 1/2 chopped onion, 175ml water, 75g smoked bacon, plenty of lemon juice, salt, pepper.
Chop bacon. Sauté onion in butter for a few mins. Add beans and bacon and sauté for a further 5 mins. Add water, bring to a boil. Simmer slowly for 15 mins, or until beans are tender. Add lemon juice and season. Serve warm or at room temperature.

Mackerel and broccoli for 2; 3 anchovy fillets, 2 garlic cloves, 1 chilli (or powder), olive oil, (rosemary).
Chop three anchovy fillets, two cloves of garlic and one red chilli. Mash to a near-paste. Melt the paste in a small frying pan with 2 tblsp of butter. Meanwhile, grill or sauté the mackerel in oil. Top with rosemary if you have it. Don’t add salt, because the sauce will supply that. Steam the broccoli, drain, then stir it into the anchovy sauce. Serve next to the mackerel.
Best with plain cooked potatoes, methinks.


The old days were not necessarily better ……

[1] http://www.theecologist.org/green_green_living/behind_the_label/346400/behind_the_label_calpol.html
[2] (From https://www.patrickholford.com/blog/the-dangers-of-painkillers)
[3] https://www.theguardian.com/society/2017/mar/15/ibuprofen-sale-restrictions-study-increased-cardiac-arrest-risk
[5] http://www.thehealthsite.com/diseases-conditions/6-reasons-you-should-stop-taking-too-many-painkillers/. See also http://www.theguardian.com/society/2008/feb/10/health.drugsandalcohol and https://health.clevelandclinic.org/2016/04/6-myths-about-painkillers/
[6] http://www.evidentlycochrane.net/paracetamol-widely-used-ineffective/
OPIOIDS in general:
One of which is CODEINE :
[8] https://tv.greenmedinfo.com/dangers-painkillers-infographic/
[9] https://www.painscience.com. See also http://www.paintoolkit.org.
[10] http://www.health.harvard.edu/special-health-reports/pain-relief-without-drugs-and-surgery?utm_source=HHPBlog&utm_medium=link&utm_content=related-text&utm_campaign=referral (click on contents and excerpt)
Though just because it’s herbal, that doesn’t mean it’s safe: see https://www.theguardian.com/society/2016/jul/11/heart-failure-patients-warned-off-over-the-counter-medications.