March 16, 2018 • 35 mins
When you've got a headache, those bottles of over-the-counter medicines can feel interchangeable. But the truth is, the drugs work in different ways... and each has their own benefits and side-effects. From which drugs work best on toothaches, to which ones are best for hangovers, Will and Mango explore the strange world of painkillers. Plus: why, 5 years from now, you might be replacing your pills with a phone, a pair of goggles and some green apple air freshener.
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Episode Transcript
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Speaker 1 (00:00):
Guess what, mango, what's that will? So I know we
regularly hear these stories about the downsides of texting, you know,
the dangers of texting while driving, or all these stories
about how we're no longer present because we're looking at
our phones when we're around family and friends. But it
was actually a study I was reading recently, and it
was from the journal Pain Medicine, and it showed the
benefits of texting during surgery. So I'm guessing we're not
(00:22):
talking about major surgeries here. Well, yeah, I mean we're
talking about surgeries where the patient is still awake and
and often feeling some kind of discomfort or pain during
that surgery. So the study involved a hundred patients and
they were having these minor surgeries, and they had them
do three different things. So some of the patients were
asked to text, some were playing angry birds, and some
were doing nothing. And they found that of the three groups,
(00:44):
those who were texting actually had the least need for
additional narcotics, and they also experienced the greatest relief from
that pain. But here's what's most weird about it. The
effect was most profound when they were texting with a
complete stranger really not not like someone you know and
someone who cares about you. Well, actually, I'm sure there's
some benefit to that as well, but the greatest benefit
(01:05):
was when they were texting with someone they didn't know.
And they think it has to do with the type
of conversation you'd have with the loved one versus you know,
one with somebody that you don't know. So think about it.
With a loved one, if you're in a lot more pain,
you're you're likely to be talking about what's on your
mind with that or what's bothering you. But with a stranger,
you kind of have to put on a happy face
and be a little bit more positive and your interaction
(01:26):
you want to make a good impression, and that somewhat
forced the positive attitude actually help them withstand a higher
level of pain, and that's really fascinating. It's also kind
of cool to think that your phone's best app is
as a pain killer. That's right, right, And it's a
reminder of that pain itself is such a strange thing,
and while there are multiple ways to manage certain pain,
it feels like most people aren't all that familiar with
(01:48):
the differences among some of the major forms of pain relief.
So on today's episode, we're going to focus on the
science behind the things like ibuprofen, a seda, menafin, aspirin,
as well as some others, and along the way we'll
dive into some of the most surprising forms of pain relief.
So let's get started. Hey there, podcast listeners, welcome to
(02:26):
Part Time Genius. I'm Will Pearson and as always I'm
joined by my good friend man Gesh Ticketer and on
the other side of the soundproof glass sorting his meds
into a massive three hundred and sixty five day pill organizers. Unbelievable.
That's our friend and producer Tristan McNeil. I mean, I've
got to say the sheer level of micromanagement on display
here is both kind of inspiring but also a little
(02:48):
bit unnerving at the same time, So kudos to you, Tristan.
I mean, it's especially interesting because the only pills he
actually takes with those lintstones chewable vitamins, which makes that
giant phil caddy a little like overkill. Well, Tristan refuses
to take shortcuts. You've gotta respect him for that. And
speaking of shortcuts, today we're talking about common pain killers,
you know, which have become many people's go to quick
(03:09):
fix for everything from headaches to hangovers, and most of
us keep at least one of these over the counter
medications on standby and the medicine cabinet or next to us.
But you know whether that's aspirin or hyboprofin or taile
and all. But despite that ubiquity, a few of us
could tell you even the most basic facts about the
pills that we so readily swallow. In fact, according to
(03:30):
a two thousand one survey from the National Council on
Patient Information and Education, only one third of the public
is able to identify the active ingredient in their pain
killer of choice, And with over the counter pain relievers
accounting for over five billion in sales last year, that's
a big chunk of the population that medicates with something
they really don't know that much about. So for today's episode,
(03:52):
we're actually gonna shine some light on the little known
facts behind a few of the world's most commonly taken,
at least understood medications. So we'll try to get an
eye idea of where they come from and what they're
best suited for, as well as what the future of
pain management might look like, alright, ma, go, so where
do you think we should start. So, I mean, this
might sound a little basic, but I thought it'd be
helpful to start with a quick refresher on what pain
(04:13):
really is and how a non prescription painkiller actually works
to relieve it. So for the first part of that,
pain is really just this early warning system. It's our
body's way of letting us know that we're injured or
even though we're doing something that we probably should stop doing. So,
for instance, if you put your hand on the hot stove,
special nerve receptors in your skin will actually respond to
the damage from the heat, and that sensation is then
(04:35):
sent as a chemical message to the spinal cord and
your brain stem, and from there the message travels to
the brain, which is where the sensation is registered and
processed and finally perceived as pain. And that's a helpful description,
but it is kind of weird to take a step
back and think about it, like it almost makes it
sound kind of bureaucratic that like, this pain is this
memo that's got to be passed around from office to office,
(04:56):
gotta get everybody's approval, and then it finally gets to
the big loss upstairs, you know, right, So it obviously
takes more time to describe the experience of feeling the
pain that actually does to feel it, which is pretty
much instantaneous. But it's still helpful to know the ins
and outs of the process because that's ultimately how pain
killers work. Like, they interfere with the body's transmissions of
(05:18):
pain signals. And this is where the difference between pain
killers comes into because each kind targets a different point
in the communication chain. So, for example, aspirin and ibuprofen
our end sets and that's n S a i D,
which stands for a non steroidal anti inflammatory drugs. These
medications cut off the pain signals at the side of
the injury. But something like a set of menafin, which
(05:39):
is a different kind of pain reliever, works much differently.
All right, we'll obviously get to them. Why don't we
stick to the end sets for now? So how does
one of these run interference on these pain signals? Sure? So,
when the nerve receptors in our cells are damaged, they
produce chemicals that perform a variety of functions. Right, Some
lower the pain threshold and the injured cells to make
sure we get the message others produce inflammation and swelling
(06:02):
is a way to cushion the cells from further injury. Alright,
so these chemicals must be what the end SAIDs are targeting,
right since they're anti inflammatories. Right, So and and said like,
aspirin works by halting the production of the chemicals responsible
for the pain and swelling, and the aspirin binds with
the enzymes that produce these chemicals, which basically neutralizes the
enzymes and prevents the chemicals from being made at all.
(06:23):
Oh wow, that's interesting. All right, So the damage that
prompted the pain is still there, but but we no
longer perceive the pain. Is that what's going on exactly?
So the pain killers don't actually heal injuries, and they
don't even kill the pain really, they just kill your
awareness of pain by cutting off that signal out the source.
That sounds pretty deep. So the pain is still there,
we just don't feel the pain. But all right, Well,
speaking of the pain awareness, how does an end said
(06:44):
nowhere to go? Like, how's it able to pinpoint the
part of the body that's injured? So it doesn't really
like the aspirin dissolves in the stomach and it's carried
to all parts of the body through the bloodstream. It's
just that the damage part is the only place it
will actually find pain related enzymes to bind with. Well,
that makes sense. So so what about a sta menaphin
Like it it doesn't reduce inflammation, that it must be
(07:05):
doing something else, right, Yeah, so that's the amazing thing, right, Like,
even though a sida menaphin was discovered in the eighteen
hundreds and it served as the active ingredient tilen al
since I want to say, in the nineteen fifties, we
still really don't know how it works. I mean, just
listen to his physicians note that comes with toilen all
bottles quote. Although the analgesic effects of a sida menaphin
(07:25):
is well established, the site and mode of action have
not been clearly elucidated. And that's stunning. Yeah, so they
feel like it's saying this stuff works, but we have
no idea how. Yeah, it's so weird. But you know,
they do have some theories. So for example, it's possible
that a seda menafin works the same way and SAIDs to,
but it just isn't effective against the chemicals responsible for inflammation.
(07:46):
And then there's this other theory that a side BeneFin
actually affects our sensation of pain by working on the
endocannabinoid system, which you know, you might guess is the
same system that responds to cannabis or marijuana. So you know,
this is according to researchers at Lund Universe City in Sweden,
and sentimental fin activates two ion channels in the brain
and spinal cord, and these are the two channels that
(08:07):
also respond to cannabinoids. And the weird thing though, is
that these ion channels can actually trigger pain and its responses,
so it's pretty strange that activating them would actually reduce
the pain. But you know, like I said, nobody really
knows for sure how these all work. Well, you know,
you mentioned that a set of menifit has been around
since the eighteen hundreds, So why don't we switch gears
and talk a little bit more about the history behind
(08:28):
a few of the common pain killers. Yeah, So, you know,
I'm always tempted to start from the beginning and dig
into the weird history beyond the topic, but with something
like pain relievers, it feels like it might be a
tad too ambitious. I mean, pain is something that humans
have had to contend with on a daily basis, and
at this point we've actually spent millennia like experimenting with
different kinds of ways to manage it. It's kind of
(08:50):
a lot to cover, you know. Actually, when I was
studying abroaden Tibet, we went to the Kirang Valley, which
hadn't had much contact with western civilization, and our professor
told us that people used to manage their headaches by
putting these pieces of tape on the sides of their heads.
In fact, if you give them aspirin or a town
all or whatever, it would actually really really affect them.
And it was kind of funny because marijuana actually grew
(09:12):
wild in the fields there everywhere, it was all over
the place, but no one smoked as pain release. They
just used these little strips of tape to manage their pain,
and you know, maybe it works. I didn't actually try
didn't try some tape. We could easily devote a whole
episode to bizarre pain management techniques that people have tried
in the past. You look at everything from like boring
holes and people's skulls, the banging gongs, to scare away
(09:34):
painful spirits, which I know you still do sometimes. But
you know what, those ancient remedies that have the most
bearing on pain killers of today, they're actually the botanical ones.
So for instance, you know, you look at the ancient Greeks,
they they chewed bark and the leaves of willow trees
in order to help produce things like fever or relief
pain during childbirth. Ancient Egyptians did something pretty similar with
the leaves from myrtle bushes. You look at the Native
(09:56):
Americans to actually chewed birch bark as their pain relieving
plan of choice, and those all turned out to be
pretty great ideas because actually all three of those plants
contain high levels of salas like acid, which is the
active ingredient, and aspirin, which is awesome, but I always
thought the active ingredient aspirin was aspirin, like, it's not
its own thing. If you want to get technical, the
(10:18):
active ingredient and aspirin is called a setal salacelic acid
or a s A. You know, see that the pain
relieving chemical that's most common to all these plants I
mentioned also had the unfortunate side effect of wreaking havoc
on our digestive systems. So it was a big deal
in when this German scientist who was working for Bear Pharmaceutical,
he was able to synthesize a less harmful and easier
(10:40):
to digest chemical and that was this A S A
that we're talking about. So the Bear company named this
new drug aspirin, and it was the first mass produced
over the counter pain reliever to come to the market.
In fact, the word itself was a trademark term, you know,
kind of like tile and all or some of these
others for about twenty years. But after that aspirin became
a generic word for the A S A based medicine
(11:00):
in most markets. Actually still today, Bear holds the trademark
in some countries. So what about another end said like ibuprofen.
Is that the actual chemical ingredient or is it just
another trademark term that died in went generic. No, Iybroprofen
is its own active ingredient, which you'll find in branded
versions like advil or motrin. And although the chemicals themselves
(11:22):
are different, ibuprofen works pretty similarly to the A S
A and aspirin. In fact, the man who discovered ibuprofen.
His name was Dr Stewart Adams. He did so while
he was looking into how aspirin worked. This was back
in the early nineteen fifties. Adams was working in the
research department at a place called Boots Pure Drug Company,
and this was in England, and his goal at the
time was to find the new way of treating rheumatoid
(11:43):
arthritis that wasn't reliant on steroids and all the side
effects that come along with those. So, I mean at
this time aspirin was already in you. So we've already
said it was non steroidal and and it was great
for inflammation, Like why didn't Arthuris patients just use that?
Well they did, but they were drawbacks to any pain
killer that will be talking about. In the case of aspirin,
it usually has to be given in fairly high doses
(12:05):
and that of course greatly increases the risk of side
effects like allergic reaction or indigestion or in some cases
even internal bleeding. So Adams and his team were after
an alternative that could be better tolerated if if they
were going to be used regularly, and it didn't come easily,
I mean, together with a chemist and a technician. Adams
actually tested the potency of more than six hundred chemical
(12:28):
compounds over the course of about a ten year period.
And I mean you do hear about sort of like
a tenure cycle for drugs coming to come about. But like,
was it just like trial and error until they figured
out this winning compound? Yeah, it was. And I mean
a few of the most promising ones were actually tested
by the team itself, like something you would never see
happening today. And so was the team just knocking back
(12:49):
these experimental pills and like they had no idea what
sort of damage would cause. Well, I mean the handful
of compounds they tested firsthand were ones that had already
passed the toxicity test, but otherwise pretty much I mean.
In fact, Dr Adams later revealed that his discovery of
ibaprof and was due to him ingesting a promising compound
as a way of dealing with a bad hangover. So apparently,
sometime in the early sixties he was scheduled to give
(13:11):
this important speech, but the night before he had spent
some time at the bar wasn't really feeling up to
the task. And here's how he described the event in
an interview he said, I was first up to speak,
and I had a bit of a headache after a
night out with friends, so I took the six hundred
milligram dose just to be sure and found it was
very effective. I love that before he was giving this
(13:31):
big speech, he was like, let me just try a
little bit of this stuff. We've been mixing up one
of the ten thousand different things or six hundred different
chemical compounds. Yeah, and that the night before that he
was just drinking aver Right. It's a good strategy. So,
I mean, obviously it sounds insane, and it does also
sound like a ringing endorsement for iban proof and as
a hangover cure. But uh, what about some other common
(13:51):
pain killers, Like we should probably talk about some of
their striends and weaknesses as well. Yeah, I definitely want to,
but before we do, let's take a quick break. You're
(14:12):
listening to part Time Genius and we're talking about the
science behind the world's most common pain killers. All right, Mango.
So obviously we love a bunch of different products under
the same category of these non prescription pain relievers, and
one of the biggest downside to this is that we
tend to use them all interchangeably. So I know you
were doing some digging into this so too, So tell
me what kind of stuff should we consider when you
know choosing which pill we need to pile. So, I
(14:35):
mean a great place to start is whether or not
you're pain involves any kind of swelling, and if it does,
you should definitely go with an end set. And from
there it really comes down to what kind of pain
you have and if you're dealing with any other conditions.
For example, aspirin works well for headaches and for reducing
inflammation and joints, but like you mentioned earlier, it can
be pretty rough on your stomach. Again, it's also an anticoagulant,
(14:57):
which is why you can reduce the risk of heart
attack or stro can some people, but anybody who's already
on blood thinners should steer clear for the same reason.
All right, So, so going back to iboprof and what's
the deal with that one? So, just like Dr Adams intended,
ibuprofen is less irritating to the stomach than aspirin is,
but it still offers a lot of the same perks.
And for someone with acid reflux or ulcers, hypoprofen is
(15:19):
a good way to go. It's also particularly useful for
dealing with pain, for menstrual cramps or arthritis, toothaches, even sprains.
You know, sometimes it has better results than aspirin. All right,
So what about something like a leave that that's an
inset too, right it is. Yeah, So the active ingredient
in that one is called neoproxin, and it's available in
doses that are much stronger and longer lasting than those
(15:41):
of aspirin and hyperprofen, and that makes it great for
treating inflammation based pain like arthritis or even something like sunburn. However,
there are downsides and aproximate strength, and one of them
is that it can cause gastro intestinal problems and it
can also take a while to kick in, so because
it's not fast acting, it's not actually a great choice
for quick relief from something like a headache. All right.
(16:01):
So there's some nuanced differences between the different end sets
that might make you pick one over another in some cases,
but it feels like for the most part, you know,
any of them would do the trick for common pains
or inflammation. But but that's not really the case with
the seta menaphon though, right, Yeah, So a seta menafant
is really the odd man out among these common pain killers.
It lacks the anti inflammatory properties of its end said counterparts,
(16:23):
but you know, for simple pain relief, a seeda menafin
does have a few things going for it. For one thing,
it's generally very easy on the stomach, so for people
with stomach sensitivities, like a seta menaphin is probably the
first thing they reach for when a headache pops up.
It's also not an anticoagulant like aspirin is, so it's
safer for hemophiliacs or people on bloodending medications as we
talked about, or even for kids. It's interesting that the
(16:46):
seeda menaphon is the safer choice in some cases because
isn't that the one that's supposed to be really bad
for your liver. Yeah, so, taken regularly or to access
seta menafin can actually cause some serious damage to deliver.
It's the top cause of acute liver failure in the
U S. I didn't realize this before this episode, but
you know, a big reason for that is that it's
all too easy to overdose on a seat A menafin
(17:07):
and their recommended dosage for pain relief and the mountain
needed to overdose aren't actually that far apart. So according
to the CDC and FDA, between fifty thou to eighty
thou people in the US head to the emergency room
each year due to seed a menafin overdose. Wow, so
it's just super easy to take too much of it
or what? Yeah, it's probably because the seeda menafin isn't
confined to just tile at all, like it crops up
(17:29):
in over the counter cold and flu remedies, and it's
also in prescription pain killers like percocet, so people who
don't pay close enough attention to the labels might unknowingly
consume more than the recommended doses. And because the drug
can accumulate in your liver and also your bloodstream, even
taking slightly too much a seat a menafin over the
course a few days can lead to an overdose. It's
(17:50):
this phenomena called a staggered overdose, but it can be
every bit as deadly. Well, we're talking about a seeda
menafin being hard on the liver, so so given that,
I'm guessing it's not that helpful when you're trying to
fight something like a hangover, right, oh definitely not. I mean,
tons of people are probably popping a couple of tile
al after a night of drinking in the hopes of
wording off a hangover. But this is one of those
(18:12):
mistakes that comes from using pain killers interchangeably, because taking
a seedominafin with alcohol, even just a little bit, is
actually a terrible idea. Really so so why is that? So?
This is a little tricky and Gabe actually walked me
through it. But basically, because the drug is mostly metabolized
in the liver, where it's joined with something called glutoth ione,
(18:32):
it's then turned into this non toxic compound that can
be removed later through urination. However, alcohol is actually known
to reduce the livers glutothione levels, and when a seeda
menafin is metabolized without it, the drugs turns into this
far more toxic substance, and this is actually bad news
for your kidney. So once study showed that taking the
recommended dose of a seeda menapin with a small to
(18:53):
moderate amount of alcohol can actually increase the risk of
kidney disease by a hundred and twenty All right, well,
so obviously common pain killers aren't as across the board
safe as you know. They're over the counter status might
make you think they are. We talked about insects, you know,
their ability to recapoc on your stomach lining and the
fact that the regular use of the scene menofin can
cause permanent damage to your liver or even your kidneys.
(19:16):
And with those risk in mind, I do think it's
good to point out that these pain relievers they're not
meant to be long term or daily treatments. In fact,
people who regularly take these medications for headaches actually put
themselves at risk for something called rebound headaches, which are
caused by the drugs wearing off. Yeah, so I think
it's a smart idea to occasionally take stock if you're
over the counter drug use, Like if you're taking something
(19:38):
that you use daily for the same reason, then you
should probably consult your doctor about other treatment options, Like
there could be an underlying issue that's just being masked
by these pain killers. Yeah, that's good advice for sure.
And all right, well, if you don't mind, I kind
of want to switch gears a little bit. You know,
we've talked a little bit about the medications that that
are not helpful for drinking alcohol. But there's there's actually
a recent study that suggests alcohol hall itself is a
(20:01):
pretty good way to manage pain, you know, perhaps even
better than some of the pain killers we've talked about. Well,
I mean, you do sometimes hear about alcohol is a
way to dullar numb pain, especially in country music. And
since we've already established that's basically what pain killers do,
I guess it does make sense. Of course, if you
were to regularly use alcohol for pain management, you've run
into similar long term problems as with n sets or
(20:22):
a sid menafine. Absolutely, I mean, it's an interesting study
and it might be good to know on a pinch,
but I've not any medical professional would actually recommend drinking
as a way to treat chronic pain. And I'm pretty
sure that we should not go on the record is
suggesting that, you know, we're not suggesting that. But tell
me what the study said, all right, So, researchers at
the University of Greenwich in London, they gathered volunteers for
(20:42):
a study on pain and alcohol, and they found that
the participants reported to reduce sensitivity to pain with every
drink consumed. And this is actually the interesting part like,
the effect was cumulative, So after three drinks for men
and two for women, the participants pain thresholds rose from
small to moderate lash large. According to the researchers, this
pain relieving effect on alcohol on pain intensity is comparable
(21:06):
to opioids and actually more powerful than a set of
metaphing Wow. So do we know why that's the case?
They really don't know exactly why. I mean, the researchers
suggested that the alcohol may block the transmission of pain signals,
you know, to the spinal cord, but alcohols anxiety relieving
properties could also be a part of this as well.
But either way, it's a little dangerous that alcohol is
(21:27):
as effective as it is in relieving pain. I mean,
swapping chronic pain for alcohol abuse isn't exactly trading up,
and that potential to create a whole new problem is
one of the biggest dangers with self medicating. But you know, amazingly,
we're not even the only animals to try this. I
found a few examples of other species that take their
health into their own paws. But before I tell you
(21:47):
about that, why don't we take a quick break? Okay, So,
what's the drink of choice? For these self medicating animals
that you talked about that like, do they stick to
(22:08):
beer and wine or do they go straight to the
hard stuff or what's their strategy. So there is a
species of monkeys in Uganda that's the leave to self
medicated for pain, but they're not hitting up the bar
to do it. Instead, they consume massive amounts of tree bark,
which is what humans used to do with willow bark. Right, So,
a team of a collegists studied a troop of Colobus monkeys,
some of which were infected with a parasite called whipworm,
(22:31):
and the team noticed that the infected monkeys spent way
less time moving and grooming and even mating than the
other monkeys, but they also ate twice as much tree
bark as them, even though all the monkeys stuck to
the same feeding schedules. All right, so sick monkeys were
purposefully eating more bark than usual, that's what you're saying.
But I mean, couldn't the sickness have just made them hungrier? Yeah,
(22:51):
I mean it could be a coincidence, but it would
have to be a pretty big one. Seven of the
nine species of trees and shrubs that the sick monkeys
ate from are actually known to have armacological properties, and
those are the same plants that local humans actually used
to treat illnesses, including the whipworm illness. All right, so
maybe not a complete coincident. It's just weird to think, though,
that some animals might knowingly take medicine for their illnesses, though,
(23:14):
isn't it. Yeah, And I mean, self medicating monkeys are
one thing, right, Like, they aren't that far removed from
us in terms of evolution. But there's another team of
researchers out at the University of Helsinki that claims to
have found the first evidence of self medicating insects. So
here's how an article in Scientific American broke down this discovery.
When the biologists exposed to hundreds of for Mica fusca
(23:35):
ants to a dangerous fungus, many of the infected insects
chose to consume four to six percent hydrogen peroxide solution
made available for the experiment. Healthy ants avoided the household chemical,
which can quah infections and small doses, but it's otherwise deadly.
The sick ants that partook were less likely to succumb
to the grips of the fungus. I mean, I guess
(23:55):
it is pretty telling that only the sick ants drank
the solution. But what about in the wild. It's pretty different.
It's not like hydrogen peroxide is growing on trees or anything. Yeah,
I mean that's true, but the confound does grow inside
some plants. So researchers theorized that wild dance infected by
the fungus might actually be able to find relief by
eating plants that release hydrogen peroxide in order to fight
off aphids. That is pretty cool, But you know, actually
(24:18):
the animal kingdom isn't just a place for us to
watch to like learn how to manage our pain. It's
actually a place to go as a source of pain
relief in some cases. You know. For instance, I was
reading about a new kind of pain killer that's derived
from the toxic venom of a sea snail. So the
drug is called and I don't know if I'm pronouncing
this correctly. I think it's Zicona tide. But the really
standout name belongs to the snail itself. It's called the
(24:40):
Magician's comb. That is pretty screat And you know, I'm
always curious about this. I know we mentioned it a
little yesterday with that viper from Brazil. But how does
toxic venom make for good medicine? Well, this one works
actually by blocking calcium channels and the specific nerve cells
and that prevents certain pain signals from reaching the brain.
As this makes it super useful for treating patients with
(25:02):
pain that isn't that easily managed by traditional methods. And
we're talking about things people suffering from cancer or AIDS
or you know, several types of neurological disorders that they've
seen positive results with this c snail pain killer. But
if scientists have their way, this won't be the only
venom based pain reliever that's out there. Currently, research is
underway to make use of tarantula venom too, and if
(25:23):
it's successful, we could be looking at a whole new
kind of pain killer no one that can treat severe
pain without the risk of addiction, which is super exciting.
And the animal kingdom isn't even the only place to
find these kinds of breakthrough is because plants are actually
doing their part as well. Both marijuana and salvia are
promising candidates for non addictive pain relief, and even the
pain delling chemical capsation that's found in chili peppers is
(25:46):
on the table as a potential pain killer. Yeah, that's true,
and and really there's a greater need for treatments with
that kind of potential than there ever has been before.
I was looking at some of the statistics from the
Institute of Medicine, and apparently there over a hundred million
Americans currently suffering from some form of chronic pain, which
amounts to as much as six hundred billion dollars a
year in medical bills and lost productivity. And obviously, when
(26:10):
dealing with pain that's that severe, these over the counter
drugs aren't always going to cut it, and that's why
we're currently dealing with things like the opioid crisis in
our country now. So when the best tool for managing
high pain levels is highly addictive and debilitating in its
own right, I mean, you know, it's time to find
a better way. Absolutely, And one of the most promising
alternatives I've actually heard about comes from this really unexpected place, Mango,
(26:34):
even more unexpected than my magical cone sea snails. Yeah,
even more than magical sea snails. But you know, there's
a growing number of hospitals that are out there looking
into how virtual reality could be used for pain management,
like the clunky headsets like video games and stuff like that.
So clinical researchers have already had success using them to
treat panic attacks and other psychosomatic disorders, and now they're
(26:57):
actually starting to explore the text applications for eating pain
brought on from everything from like joint injuries to even cancer,
and so far trials with a pair of the three
D goggles have been proven to produce patients experience of
pain by a full twenty cent. Yeah, I mean there's
also hope that the technology can be extended to chronic
pain sufferers who would typically have to look to those
(27:17):
addictive prescription pain killers for relief. That's pretty incredible. I mean,
can you imagine if someone who had just had surgery
or gotten a car accident, they could just be sent
home with like a VR headset instead of you know,
like a bottle of percoset or something. That might be
a little bit hopeful. But it does sound like this
could really flip the script on pain management definitely. And
and VR treatment actually draws from techniques that have already
(27:39):
proven medically effective, you know, things like mindfulness and meditation.
But you know, most doctors wouldn't prescribe something like meditation
because there's a good chance patience won't go home and
follow through with that treatment. And by comparison, pain pills
have been a more certain and also more lucrative way
to go, but VR, with its promise of fun and escapism,
could actually do away with all that certainty, Like patients
(28:01):
will be far more likely to actually go home and
use it on their own. I mean that kind of
makes sense, but I'm curious, like, how exactly does VR
relief pain? Is it just that it calms people down,
because you know, if that's the case, it seems like
people could just sit there and watch a relaxing video
or something like that. So a major reason why VR
is so effective is that the games and environments that
generates are actually a great way to distract your brain,
(28:23):
and that level of immersion VR provides it actually gives
this distinct advantage over I don't know, just watching a
nature video on your smartphone, and that's because the experience
actually shuts off the neural pathways that typically transfer pain
signals from your peripheral nervous system. It occupies all the
brain's attention so that the sensation of pain is lesson significantly.
That's really interesting, and I admit I was a little
(28:44):
bit skeptical of this, but but it sounds pretty promising.
And I do love the idea of overcoming pain, like
not through just chemical trickery, but simply giving our brains
the freedom to focus on something else. You know, for
way too many people, the physical pain they live with
is just all consuming. You know, pain killers, whether they're
over the counter or even prescription, they're they're pretty limited
in their usefulness because of these side effects and the
(29:06):
high risk of addiction that we talked about. So it
is pretty hardening to hear about these new approaches like
this that make the idea of a pain free future
seem a little more attainable. Yeah, I couldn't agree with
you more. And you know, learning is another great way
to keep your mind off pain. So what do you
say we conduct our own clinical trial using the pain
killing power of facts. I mean, I'm gaining for effect up,
but I do think we should be clear, like, the
(29:27):
health benefits of trivia are not fully proven, So I
think the last thing we need is another lawsuit here, Mango,
that's right, all right, Well I'll kick us off. So
We've talked about a few things that have these surprising
abilities to reduce pain, and here's another one to add
(29:49):
to the list. Now. I know it's common wisdom to
say that money doesn't really lead to happiness, but you know,
there's no denying that our brains love money. In fact,
one study out of China show the just holding onto
it pretty much works like a drug. And the study
participants were asked to put their hands into some really
hot water, now not for long, but still very hot water.
(30:10):
And just before doing this, some of them had been
given a stack of money to handle, and some were
just given blank paper to shuffle through. And sure enough,
those who had handled the money had a higher tolerance
of pain. That's amazing. Well, you know, since you mentioned
hot water, I'm gonna go with the cold water test.
And you know, I have always envious the scientists who
get to conduct studies like the one we heard about
(30:31):
earlier where they were testing to see if swearing actually
reduces pain. And in this study, participants were asked to
put their arm in a bucket of ice water and
then given certain words say or shout out loud and
see how long they could keep their arm in the
ice water, and it turns out that those who were
swearing were able to keep their arms in for longer.
But you know, I was curious as to whether the
(30:52):
specific curse words had different effects, and it turns out
they do. Maybe not surprisingly, they found out that the
F bomb was much more effective than using the word bum.
The word bum. Yeah, I mean, I want to meet
these people who scream out the word bum when they're there.
All right, So we covered handling money and swearing. I
think we're making parents really happy today, So why don't
(31:13):
we do one that's a little bit different. And I
think we should revisit the meditation thing. And I do
know we talked a little bit about it earlier. But
there's this study out of wake Forest that I think
was pretty interesting. And if they found that after just
a few days of meditation training, you know, where they
help participants focus on something soothing instead of their pain,
those in the study actually saw a fifty seven percent
(31:33):
reduction in what they described as unpleasantness. And they reported
that was roughly the equivalent to the effects of morphine.
That's unbelievable. So here's a weird one, and I feel
like you'd have to test this to believe it. But
apparently if you feel a headache coming on, you can
actually eat a bit of green apple or even just
smell one to get some of the relief from a migraine.
And this was a study from the Research Foundation in Chicago,
(31:56):
and the researchers believed it's related to the finding that
the green apples smell does in fact reduced muscle contractions
in the head and neck, which would reduce that pain
from migraine. You know, I think we should do another
study where we test what would happen if you hold
a lot of cash, you scream the F bomb, and
you sniff an apple at the same time, and see
probably feel great. All right? Well, have you ever wondered
(32:18):
why we tend to grab our injuries when we get hurt, like,
you know, imagine you have an ankle's brain, what's the
first thing that you do? You sit down and you
grab your ankle. But apparently there's a reason for this.
So when we touch our injuries, it gives our brains
a chance to map out these injuries and better pinpoint
the location and then more effectively manage the pain. That's fascinating. Okay, Well,
(32:40):
I said my most important fact for last, and that's
the fact that Kenny Loggins and Dean Pitchford actually wrote
the title track for Footloose while under the influence of
pain curs. This is very important. So apparently Loggins had
just recently broken a rib while performing, you know, because
he likes to leave it all out on the stage,
doesn't And Pitchford was dealing with a pretty high fever
and up throat, and the two of them would meet
(33:02):
up to record, and they only had a few days,
so they couldn't let their ailments slow them down. And
as Pitchford said, quote, I think it was two or
three days. We kept up this garade of him showing
up on his pain killers and me and my pain killers,
and us getting the gist of the song. Wow. I mean,
can you imagine the magic that may have never happened
if they hadn't pushed through and worked on this world
(33:23):
changing song Mango. I mean, I may have never had
the opportunity to sing that song in my high school
show choir. I'll pull out the tape sometime to show
you in Tristan, or maybe I'll just leave it at
my parents house. But I'm honestly, I'm not sure I'd
be the man I am today without that experience, though,
So for that, I'm gonna have to give you today's
(33:44):
fact off trophy Mango. And if there was ever a
fact in my fact off windstreak, I'm glad that's the
one of congratulations. Thank you so much, and thank you
guys for listening. If we have forgotten any great facts
that you'd like to share with us about pain killers
or pain management, we'd love to hear those from. You
can always email us part time Genius at how stuff
Works dot com. You can always call our seven fact
(34:06):
hotline that's one eight four four pt Genius, or hit
us up on Facebook or Twitter. We've loved the great
facts that you guys have been sending, the great ideas
that you've been sending, so please keep them coming, and
thanks again for listening, Thanks again for listening. Part Time
(34:33):
Genius is a production of How Stuff Works and wouldn't
be possible without several brilliant people who do the important
things we couldn't even begin to understand. Tristan McNeil does
the editing thing. Noel Brown made the theme song and
does the mixy mixy sound thing. Jerry Rowland does the
exact producer thing Gaveluesier is our lead researcher, with support
from the Research Army including Austin Thompson, Nolan Brown and
Lucas Adams and Eve. Jeff Cook gets the show to
(34:55):
your ears. Good job, Eves. If you like what you heard,
we hope you'll subscribe, And if you really really like
what you've heard, maybe you could leave a good review
for us. Did we? Did we forget Jason? Jason who
Guess what, mango, what's that will? So I know we
regularly hear these stories about the downsides of texting, you know,
the dangers of texting while driving, or all these stories
about how we're no longer present because we're looking at
our phones when we're around family and friends. But it
was actually a study I was reading recently, and it
was from the journal Pain Medicine, and it showed the
benefits of texting during surgery. So I'm guessing we're not
(00:22):
talking about major surgeries here. Well, yeah, I mean we're
talking about surgeries where the patient is still awake and
and often feeling some kind of discomfort or pain during
that surgery. So the study involved a hundred patients and
they were having these minor surgeries, and they had them
do three different things. So some of the patients were
asked to text, some were playing angry birds, and some
were doing nothing. And they found that of the three groups,
(00:44):
those who were texting actually had the least need for
additional narcotics, and they also experienced the greatest relief from
that pain. But here's what's most weird about it. The
effect was most profound when they were texting with a
complete stranger really not not like someone you know and
someone who cares about you. Well, actually, I'm sure there's
some benefit to that as well, but the greatest benefit
(01:05):
was when they were texting with someone they didn't know.
And they think it has to do with the type
of conversation you'd have with the loved one versus you know,
one with somebody that you don't know. So think about it.
With a loved one, if you're in a lot more pain,
you're you're likely to be talking about what's on your
mind with that or what's bothering you. But with a stranger,
you kind of have to put on a happy face
and be a little bit more positive and your interaction
(01:26):
you want to make a good impression, and that somewhat
forced the positive attitude actually help them withstand a higher
level of pain, and that's really fascinating. It's also kind
of cool to think that your phone's best app is
as a pain killer. That's right, right, And it's a
reminder of that pain itself is such a strange thing,
and while there are multiple ways to manage certain pain,
it feels like most people aren't all that familiar with
(01:48):
the differences among some of the major forms of pain relief.
So on today's episode, we're going to focus on the
science behind the things like ibuprofen, a seda, menafin, aspirin,
as well as some others, and along the way we'll
dive into some of the most surprising forms of pain relief.
So let's get started. Hey there, podcast listeners, welcome to
(02:26):
Part Time Genius. I'm Will Pearson and as always I'm
joined by my good friend man Gesh Ticketer and on
the other side of the soundproof glass sorting his meds
into a massive three hundred and sixty five day pill organizers. Unbelievable.
That's our friend and producer Tristan McNeil. I mean, I've
got to say the sheer level of micromanagement on display
here is both kind of inspiring but also a little
(02:48):
bit unnerving at the same time, So kudos to you, Tristan.
I mean, it's especially interesting because the only pills he
actually takes with those lintstones chewable vitamins, which makes that
giant phil caddy a little like overkill. Well, Tristan refuses
to take shortcuts. You've gotta respect him for that. And
speaking of shortcuts, today we're talking about common pain killers,
you know, which have become many people's go to quick
(03:09):
fix for everything from headaches to hangovers, and most of
us keep at least one of these over the counter
medications on standby and the medicine cabinet or next to us.
But you know whether that's aspirin or hyboprofin or taile
and all. But despite that ubiquity, a few of us
could tell you even the most basic facts about the
pills that we so readily swallow. In fact, according to
(03:30):
a two thousand one survey from the National Council on
Patient Information and Education, only one third of the public
is able to identify the active ingredient in their pain
killer of choice, And with over the counter pain relievers
accounting for over five billion in sales last year, that's
a big chunk of the population that medicates with something
they really don't know that much about. So for today's episode,
(03:52):
we're actually gonna shine some light on the little known
facts behind a few of the world's most commonly taken,
at least understood medications. So we'll try to get an
eye idea of where they come from and what they're
best suited for, as well as what the future of
pain management might look like, alright, ma, go, so where
do you think we should start. So, I mean, this
might sound a little basic, but I thought it'd be
helpful to start with a quick refresher on what pain
(04:13):
really is and how a non prescription painkiller actually works
to relieve it. So for the first part of that,
pain is really just this early warning system. It's our
body's way of letting us know that we're injured or
even though we're doing something that we probably should stop doing. So,
for instance, if you put your hand on the hot stove,
special nerve receptors in your skin will actually respond to
the damage from the heat, and that sensation is then
(04:35):
sent as a chemical message to the spinal cord and
your brain stem, and from there the message travels to
the brain, which is where the sensation is registered and
processed and finally perceived as pain. And that's a helpful description,
but it is kind of weird to take a step
back and think about it, like it almost makes it
sound kind of bureaucratic that like, this pain is this
memo that's got to be passed around from office to office,
(04:56):
gotta get everybody's approval, and then it finally gets to
the big loss upstairs, you know, right, So it obviously
takes more time to describe the experience of feeling the
pain that actually does to feel it, which is pretty
much instantaneous. But it's still helpful to know the ins
and outs of the process because that's ultimately how pain
killers work. Like, they interfere with the body's transmissions of
(05:18):
pain signals. And this is where the difference between pain
killers comes into because each kind targets a different point
in the communication chain. So, for example, aspirin and ibuprofen
our end sets and that's n S a i D,
which stands for a non steroidal anti inflammatory drugs. These
medications cut off the pain signals at the side of
the injury. But something like a set of menafin, which
(05:39):
is a different kind of pain reliever, works much differently.
All right, we'll obviously get to them. Why don't we
stick to the end sets for now? So how does
one of these run interference on these pain signals? Sure? So,
when the nerve receptors in our cells are damaged, they
produce chemicals that perform a variety of functions. Right, Some
lower the pain threshold and the injured cells to make
sure we get the message others produce inflammation and swelling
(06:02):
is a way to cushion the cells from further injury. Alright,
so these chemicals must be what the end SAIDs are targeting,
right since they're anti inflammatories. Right, So and and said like,
aspirin works by halting the production of the chemicals responsible
for the pain and swelling, and the aspirin binds with
the enzymes that produce these chemicals, which basically neutralizes the
enzymes and prevents the chemicals from being made at all.
(06:23):
Oh wow, that's interesting. All right, So the damage that
prompted the pain is still there, but but we no
longer perceive the pain. Is that what's going on exactly?
So the pain killers don't actually heal injuries, and they
don't even kill the pain really, they just kill your
awareness of pain by cutting off that signal out the source.
That sounds pretty deep. So the pain is still there,
we just don't feel the pain. But all right, Well,
speaking of the pain awareness, how does an end said
(06:44):
nowhere to go? Like, how's it able to pinpoint the
part of the body that's injured? So it doesn't really
like the aspirin dissolves in the stomach and it's carried
to all parts of the body through the bloodstream. It's
just that the damage part is the only place it
will actually find pain related enzymes to bind with. Well,
that makes sense. So so what about a sta menaphin
Like it it doesn't reduce inflammation, that it must be
(07:05):
doing something else, right, Yeah, so that's the amazing thing, right, Like,
even though a sida menaphin was discovered in the eighteen
hundreds and it served as the active ingredient tilen al
since I want to say, in the nineteen fifties, we
still really don't know how it works. I mean, just
listen to his physicians note that comes with toilen all
bottles quote. Although the analgesic effects of a sida menaphin
(07:25):
is well established, the site and mode of action have
not been clearly elucidated. And that's stunning. Yeah, so they
feel like it's saying this stuff works, but we have
no idea how. Yeah, it's so weird. But you know,
they do have some theories. So for example, it's possible
that a seda menafin works the same way and SAIDs to,
but it just isn't effective against the chemicals responsible for inflammation.
(07:46):
And then there's this other theory that a side BeneFin
actually affects our sensation of pain by working on the
endocannabinoid system, which you know, you might guess is the
same system that responds to cannabis or marijuana. So you know,
this is according to researchers at Lund Universe City in Sweden,
and sentimental fin activates two ion channels in the brain
and spinal cord, and these are the two channels that
(08:07):
also respond to cannabinoids. And the weird thing though, is
that these ion channels can actually trigger pain and its responses,
so it's pretty strange that activating them would actually reduce
the pain. But you know, like I said, nobody really
knows for sure how these all work. Well, you know,
you mentioned that a set of menifit has been around
since the eighteen hundreds, So why don't we switch gears
and talk a little bit more about the history behind
(08:28):
a few of the common pain killers. Yeah, So, you know,
I'm always tempted to start from the beginning and dig
into the weird history beyond the topic, but with something
like pain relievers, it feels like it might be a
tad too ambitious. I mean, pain is something that humans
have had to contend with on a daily basis, and
at this point we've actually spent millennia like experimenting with
different kinds of ways to manage it. It's kind of
(08:50):
a lot to cover, you know. Actually, when I was
studying abroaden Tibet, we went to the Kirang Valley, which
hadn't had much contact with western civilization, and our professor
told us that people used to manage their headaches by
putting these pieces of tape on the sides of their heads.
In fact, if you give them aspirin or a town
all or whatever, it would actually really really affect them.
And it was kind of funny because marijuana actually grew
(09:12):
wild in the fields there everywhere, it was all over
the place, but no one smoked as pain release. They
just used these little strips of tape to manage their pain,
and you know, maybe it works. I didn't actually try
didn't try some tape. We could easily devote a whole
episode to bizarre pain management techniques that people have tried
in the past. You look at everything from like boring
holes and people's skulls, the banging gongs, to scare away
(09:34):
painful spirits, which I know you still do sometimes. But
you know what, those ancient remedies that have the most
bearing on pain killers of today, they're actually the botanical ones.
So for instance, you know, you look at the ancient Greeks,
they they chewed bark and the leaves of willow trees
in order to help produce things like fever or relief
pain during childbirth. Ancient Egyptians did something pretty similar with
the leaves from myrtle bushes. You look at the Native
(09:56):
Americans to actually chewed birch bark as their pain relieving
plan of choice, and those all turned out to be
pretty great ideas because actually all three of those plants
contain high levels of salas like acid, which is the
active ingredient, and aspirin, which is awesome, but I always
thought the active ingredient aspirin was aspirin, like, it's not
its own thing. If you want to get technical, the
(10:18):
active ingredient and aspirin is called a setal salacelic acid
or a s A. You know, see that the pain
relieving chemical that's most common to all these plants I
mentioned also had the unfortunate side effect of wreaking havoc
on our digestive systems. So it was a big deal
in when this German scientist who was working for Bear Pharmaceutical,
he was able to synthesize a less harmful and easier
(10:40):
to digest chemical and that was this A S A
that we're talking about. So the Bear company named this
new drug aspirin, and it was the first mass produced
over the counter pain reliever to come to the market.
In fact, the word itself was a trademark term, you know,
kind of like tile and all or some of these
others for about twenty years. But after that aspirin became
a generic word for the A S A based medicine
(11:00):
in most markets. Actually still today, Bear holds the trademark
in some countries. So what about another end said like ibuprofen.
Is that the actual chemical ingredient or is it just
another trademark term that died in went generic. No, Iybroprofen
is its own active ingredient, which you'll find in branded
versions like advil or motrin. And although the chemicals themselves
(11:22):
are different, ibuprofen works pretty similarly to the A S
A and aspirin. In fact, the man who discovered ibuprofen.
His name was Dr Stewart Adams. He did so while
he was looking into how aspirin worked. This was back
in the early nineteen fifties. Adams was working in the
research department at a place called Boots Pure Drug Company,
and this was in England, and his goal at the
time was to find the new way of treating rheumatoid
(11:43):
arthritis that wasn't reliant on steroids and all the side
effects that come along with those. So, I mean at
this time aspirin was already in you. So we've already
said it was non steroidal and and it was great
for inflammation, Like why didn't Arthuris patients just use that?
Well they did, but they were drawbacks to any pain
killer that will be talking about. In the case of aspirin,
it usually has to be given in fairly high doses
(12:05):
and that of course greatly increases the risk of side
effects like allergic reaction or indigestion or in some cases
even internal bleeding. So Adams and his team were after
an alternative that could be better tolerated if if they
were going to be used regularly, and it didn't come easily,
I mean, together with a chemist and a technician. Adams
actually tested the potency of more than six hundred chemical
(12:28):
compounds over the course of about a ten year period.
And I mean you do hear about sort of like
a tenure cycle for drugs coming to come about. But like,
was it just like trial and error until they figured
out this winning compound? Yeah, it was. And I mean
a few of the most promising ones were actually tested
by the team itself, like something you would never see
happening today. And so was the team just knocking back
(12:49):
these experimental pills and like they had no idea what
sort of damage would cause. Well, I mean the handful
of compounds they tested firsthand were ones that had already
passed the toxicity test, but otherwise pretty much I mean.
In fact, Dr Adams later revealed that his discovery of
ibaprof and was due to him ingesting a promising compound
as a way of dealing with a bad hangover. So apparently,
sometime in the early sixties he was scheduled to give
(13:11):
this important speech, but the night before he had spent
some time at the bar wasn't really feeling up to
the task. And here's how he described the event in
an interview he said, I was first up to speak,
and I had a bit of a headache after a
night out with friends, so I took the six hundred
milligram dose just to be sure and found it was
very effective. I love that before he was giving this
(13:31):
big speech, he was like, let me just try a
little bit of this stuff. We've been mixing up one
of the ten thousand different things or six hundred different
chemical compounds. Yeah, and that the night before that he
was just drinking aver Right. It's a good strategy. So,
I mean, obviously it sounds insane, and it does also
sound like a ringing endorsement for iban proof and as
a hangover cure. But uh, what about some other common
(13:51):
pain killers, Like we should probably talk about some of
their striends and weaknesses as well. Yeah, I definitely want to,
but before we do, let's take a quick break. You're
(14:12):
listening to part Time Genius and we're talking about the
science behind the world's most common pain killers. All right, Mango.
So obviously we love a bunch of different products under
the same category of these non prescription pain relievers, and
one of the biggest downside to this is that we
tend to use them all interchangeably. So I know you
were doing some digging into this so too, So tell
me what kind of stuff should we consider when you
know choosing which pill we need to pile. So, I
(14:35):
mean a great place to start is whether or not
you're pain involves any kind of swelling, and if it does,
you should definitely go with an end set. And from
there it really comes down to what kind of pain
you have and if you're dealing with any other conditions.
For example, aspirin works well for headaches and for reducing
inflammation and joints, but like you mentioned earlier, it can
be pretty rough on your stomach. Again, it's also an anticoagulant,
(14:57):
which is why you can reduce the risk of heart
attack or stro can some people, but anybody who's already
on blood thinners should steer clear for the same reason.
All right, So, so going back to iboprof and what's
the deal with that one? So, just like Dr Adams intended,
ibuprofen is less irritating to the stomach than aspirin is,
but it still offers a lot of the same perks.
And for someone with acid reflux or ulcers, hypoprofen is
(15:19):
a good way to go. It's also particularly useful for
dealing with pain, for menstrual cramps or arthritis, toothaches, even sprains.
You know, sometimes it has better results than aspirin. All right,
So what about something like a leave that that's an
inset too, right it is. Yeah, So the active ingredient
in that one is called neoproxin, and it's available in
doses that are much stronger and longer lasting than those
(15:41):
of aspirin and hyperprofen, and that makes it great for
treating inflammation based pain like arthritis or even something like sunburn. However,
there are downsides and aproximate strength, and one of them
is that it can cause gastro intestinal problems and it
can also take a while to kick in, so because
it's not fast acting, it's not actually a great choice
for quick relief from something like a headache. All right.
(16:01):
So there's some nuanced differences between the different end sets
that might make you pick one over another in some cases,
but it feels like for the most part, you know,
any of them would do the trick for common pains
or inflammation. But but that's not really the case with
the seta menaphon though, right, Yeah, So a seta menafant
is really the odd man out among these common pain killers.
It lacks the anti inflammatory properties of its end said counterparts,
(16:23):
but you know, for simple pain relief, a seeda menafin
does have a few things going for it. For one thing,
it's generally very easy on the stomach, so for people
with stomach sensitivities, like a seta menaphin is probably the
first thing they reach for when a headache pops up.
It's also not an anticoagulant like aspirin is, so it's
safer for hemophiliacs or people on bloodending medications as we
talked about, or even for kids. It's interesting that the
(16:46):
seeda menaphon is the safer choice in some cases because
isn't that the one that's supposed to be really bad
for your liver. Yeah, so, taken regularly or to access
seta menafin can actually cause some serious damage to deliver.
It's the top cause of acute liver failure in the
U S. I didn't realize this before this episode, but
you know, a big reason for that is that it's
all too easy to overdose on a seat A menafin
(17:07):
and their recommended dosage for pain relief and the mountain
needed to overdose aren't actually that far apart. So according
to the CDC and FDA, between fifty thou to eighty
thou people in the US head to the emergency room
each year due to seed a menafin overdose. Wow, so
it's just super easy to take too much of it
or what? Yeah, it's probably because the seeda menafin isn't
confined to just tile at all, like it crops up
(17:29):
in over the counter cold and flu remedies, and it's
also in prescription pain killers like percocet, so people who
don't pay close enough attention to the labels might unknowingly
consume more than the recommended doses. And because the drug
can accumulate in your liver and also your bloodstream, even
taking slightly too much a seat a menafin over the
course a few days can lead to an overdose. It's
(17:50):
this phenomena called a staggered overdose, but it can be
every bit as deadly. Well, we're talking about a seeda
menafin being hard on the liver, so so given that,
I'm guessing it's not that helpful when you're trying to
fight something like a hangover, right, oh definitely not. I mean,
tons of people are probably popping a couple of tile
al after a night of drinking in the hopes of
wording off a hangover. But this is one of those
(18:12):
mistakes that comes from using pain killers interchangeably, because taking
a seedominafin with alcohol, even just a little bit, is
actually a terrible idea. Really so so why is that? So?
This is a little tricky and Gabe actually walked me
through it. But basically, because the drug is mostly metabolized
in the liver, where it's joined with something called glutoth ione,
(18:32):
it's then turned into this non toxic compound that can
be removed later through urination. However, alcohol is actually known
to reduce the livers glutothione levels, and when a seeda
menafin is metabolized without it, the drugs turns into this
far more toxic substance, and this is actually bad news
for your kidney. So once study showed that taking the
recommended dose of a seeda menapin with a small to
(18:53):
moderate amount of alcohol can actually increase the risk of
kidney disease by a hundred and twenty All right, well,
so obviously common pain killers aren't as across the board
safe as you know. They're over the counter status might
make you think they are. We talked about insects, you know,
their ability to recapoc on your stomach lining and the
fact that the regular use of the scene menofin can
cause permanent damage to your liver or even your kidneys.
(19:16):
And with those risk in mind, I do think it's
good to point out that these pain relievers they're not
meant to be long term or daily treatments. In fact,
people who regularly take these medications for headaches actually put
themselves at risk for something called rebound headaches, which are
caused by the drugs wearing off. Yeah, so I think
it's a smart idea to occasionally take stock if you're
over the counter drug use, Like if you're taking something
(19:38):
that you use daily for the same reason, then you
should probably consult your doctor about other treatment options, Like
there could be an underlying issue that's just being masked
by these pain killers. Yeah, that's good advice for sure.
And all right, well, if you don't mind, I kind
of want to switch gears a little bit. You know,
we've talked a little bit about the medications that that
are not helpful for drinking alcohol. But there's there's actually
a recent study that suggests alcohol hall itself is a
(20:01):
pretty good way to manage pain, you know, perhaps even
better than some of the pain killers we've talked about. Well,
I mean, you do sometimes hear about alcohol is a
way to dullar numb pain, especially in country music. And
since we've already established that's basically what pain killers do,
I guess it does make sense. Of course, if you
were to regularly use alcohol for pain management, you've run
into similar long term problems as with n sets or
(20:22):
a sid menafine. Absolutely, I mean, it's an interesting study
and it might be good to know on a pinch,
but I've not any medical professional would actually recommend drinking
as a way to treat chronic pain. And I'm pretty
sure that we should not go on the record is
suggesting that, you know, we're not suggesting that. But tell
me what the study said, all right, So, researchers at
the University of Greenwich in London, they gathered volunteers for
(20:42):
a study on pain and alcohol, and they found that
the participants reported to reduce sensitivity to pain with every
drink consumed. And this is actually the interesting part like,
the effect was cumulative, So after three drinks for men
and two for women, the participants pain thresholds rose from
small to moderate lash large. According to the researchers, this
pain relieving effect on alcohol on pain intensity is comparable
(21:06):
to opioids and actually more powerful than a set of
metaphing Wow. So do we know why that's the case?
They really don't know exactly why. I mean, the researchers
suggested that the alcohol may block the transmission of pain signals,
you know, to the spinal cord, but alcohols anxiety relieving
properties could also be a part of this as well.
But either way, it's a little dangerous that alcohol is
(21:27):
as effective as it is in relieving pain. I mean,
swapping chronic pain for alcohol abuse isn't exactly trading up,
and that potential to create a whole new problem is
one of the biggest dangers with self medicating. But you know, amazingly,
we're not even the only animals to try this. I
found a few examples of other species that take their
health into their own paws. But before I tell you
(21:47):
about that, why don't we take a quick break? Okay, So,
what's the drink of choice? For these self medicating animals
that you talked about that like, do they stick to
(22:08):
beer and wine or do they go straight to the
hard stuff or what's their strategy. So there is a
species of monkeys in Uganda that's the leave to self
medicated for pain, but they're not hitting up the bar
to do it. Instead, they consume massive amounts of tree bark,
which is what humans used to do with willow bark. Right, So,
a team of a collegists studied a troop of Colobus monkeys,
some of which were infected with a parasite called whipworm,
(22:31):
and the team noticed that the infected monkeys spent way
less time moving and grooming and even mating than the
other monkeys, but they also ate twice as much tree
bark as them, even though all the monkeys stuck to
the same feeding schedules. All right, so sick monkeys were
purposefully eating more bark than usual, that's what you're saying.
But I mean, couldn't the sickness have just made them hungrier? Yeah,
(22:51):
I mean it could be a coincidence, but it would
have to be a pretty big one. Seven of the
nine species of trees and shrubs that the sick monkeys
ate from are actually known to have armacological properties, and
those are the same plants that local humans actually used
to treat illnesses, including the whipworm illness. All right, so
maybe not a complete coincident. It's just weird to think, though,
that some animals might knowingly take medicine for their illnesses, though,
(23:14):
isn't it. Yeah, And I mean, self medicating monkeys are
one thing, right, Like, they aren't that far removed from
us in terms of evolution. But there's another team of
researchers out at the University of Helsinki that claims to
have found the first evidence of self medicating insects. So
here's how an article in Scientific American broke down this discovery.
When the biologists exposed to hundreds of for Mica fusca
(23:35):
ants to a dangerous fungus, many of the infected insects
chose to consume four to six percent hydrogen peroxide solution
made available for the experiment. Healthy ants avoided the household chemical,
which can quah infections and small doses, but it's otherwise deadly.
The sick ants that partook were less likely to succumb
to the grips of the fungus. I mean, I guess
(23:55):
it is pretty telling that only the sick ants drank
the solution. But what about in the wild. It's pretty different.
It's not like hydrogen peroxide is growing on trees or anything. Yeah,
I mean that's true, but the confound does grow inside
some plants. So researchers theorized that wild dance infected by
the fungus might actually be able to find relief by
eating plants that release hydrogen peroxide in order to fight
off aphids. That is pretty cool, But you know, actually
(24:18):
the animal kingdom isn't just a place for us to
watch to like learn how to manage our pain. It's
actually a place to go as a source of pain
relief in some cases. You know. For instance, I was
reading about a new kind of pain killer that's derived
from the toxic venom of a sea snail. So the
drug is called and I don't know if I'm pronouncing
this correctly. I think it's Zicona tide. But the really
standout name belongs to the snail itself. It's called the
(24:40):
Magician's comb. That is pretty screat And you know, I'm
always curious about this. I know we mentioned it a
little yesterday with that viper from Brazil. But how does
toxic venom make for good medicine? Well, this one works
actually by blocking calcium channels and the specific nerve cells
and that prevents certain pain signals from reaching the brain.
As this makes it super useful for treating patients with
(25:02):
pain that isn't that easily managed by traditional methods. And
we're talking about things people suffering from cancer or AIDS
or you know, several types of neurological disorders that they've
seen positive results with this c snail pain killer. But
if scientists have their way, this won't be the only
venom based pain reliever that's out there. Currently, research is
underway to make use of tarantula venom too, and if
(25:23):
it's successful, we could be looking at a whole new
kind of pain killer no one that can treat severe
pain without the risk of addiction, which is super exciting.
And the animal kingdom isn't even the only place to
find these kinds of breakthrough is because plants are actually
doing their part as well. Both marijuana and salvia are
promising candidates for non addictive pain relief, and even the
pain delling chemical capsation that's found in chili peppers is
(25:46):
on the table as a potential pain killer. Yeah, that's true,
and and really there's a greater need for treatments with
that kind of potential than there ever has been before.
I was looking at some of the statistics from the
Institute of Medicine, and apparently there over a hundred million
Americans currently suffering from some form of chronic pain, which
amounts to as much as six hundred billion dollars a
year in medical bills and lost productivity. And obviously, when
(26:10):
dealing with pain that's that severe, these over the counter
drugs aren't always going to cut it, and that's why
we're currently dealing with things like the opioid crisis in
our country now. So when the best tool for managing
high pain levels is highly addictive and debilitating in its
own right, I mean, you know, it's time to find
a better way. Absolutely, And one of the most promising
alternatives I've actually heard about comes from this really unexpected place, Mango,
(26:34):
even more unexpected than my magical cone sea snails. Yeah,
even more than magical sea snails. But you know, there's
a growing number of hospitals that are out there looking
into how virtual reality could be used for pain management,
like the clunky headsets like video games and stuff like that.
So clinical researchers have already had success using them to
treat panic attacks and other psychosomatic disorders, and now they're
(26:57):
actually starting to explore the text applications for eating pain
brought on from everything from like joint injuries to even cancer,
and so far trials with a pair of the three
D goggles have been proven to produce patients experience of
pain by a full twenty cent. Yeah, I mean there's
also hope that the technology can be extended to chronic
pain sufferers who would typically have to look to those
(27:17):
addictive prescription pain killers for relief. That's pretty incredible. I mean,
can you imagine if someone who had just had surgery
or gotten a car accident, they could just be sent
home with like a VR headset instead of you know,
like a bottle of percoset or something. That might be
a little bit hopeful. But it does sound like this
could really flip the script on pain management definitely. And
and VR treatment actually draws from techniques that have already
(27:39):
proven medically effective, you know, things like mindfulness and meditation.
But you know, most doctors wouldn't prescribe something like meditation
because there's a good chance patience won't go home and
follow through with that treatment. And by comparison, pain pills
have been a more certain and also more lucrative way
to go, but VR, with its promise of fun and escapism,
could actually do away with all that certainty, Like patients
(28:01):
will be far more likely to actually go home and
use it on their own. I mean that kind of
makes sense, but I'm curious, like, how exactly does VR
relief pain? Is it just that it calms people down,
because you know, if that's the case, it seems like
people could just sit there and watch a relaxing video
or something like that. So a major reason why VR
is so effective is that the games and environments that
generates are actually a great way to distract your brain,
(28:23):
and that level of immersion VR provides it actually gives
this distinct advantage over I don't know, just watching a
nature video on your smartphone, and that's because the experience
actually shuts off the neural pathways that typically transfer pain
signals from your peripheral nervous system. It occupies all the
brain's attention so that the sensation of pain is lesson significantly.
That's really interesting, and I admit I was a little
(28:44):
bit skeptical of this, but but it sounds pretty promising.
And I do love the idea of overcoming pain, like
not through just chemical trickery, but simply giving our brains
the freedom to focus on something else. You know, for
way too many people, the physical pain they live with
is just all consuming. You know, pain killers, whether they're
over the counter or even prescription, they're they're pretty limited
in their usefulness because of these side effects and the
(29:06):
high risk of addiction that we talked about. So it
is pretty hardening to hear about these new approaches like
this that make the idea of a pain free future
seem a little more attainable. Yeah, I couldn't agree with
you more. And you know, learning is another great way
to keep your mind off pain. So what do you
say we conduct our own clinical trial using the pain
killing power of facts. I mean, I'm gaining for effect up,
but I do think we should be clear, like, the
(29:27):
health benefits of trivia are not fully proven, So I
think the last thing we need is another lawsuit here, Mango,
that's right, all right, Well I'll kick us off. So
We've talked about a few things that have these surprising
abilities to reduce pain, and here's another one to add
(29:49):
to the list. Now. I know it's common wisdom to
say that money doesn't really lead to happiness, but you know,
there's no denying that our brains love money. In fact,
one study out of China show the just holding onto
it pretty much works like a drug. And the study
participants were asked to put their hands into some really
hot water, now not for long, but still very hot water.
(30:10):
And just before doing this, some of them had been
given a stack of money to handle, and some were
just given blank paper to shuffle through. And sure enough,
those who had handled the money had a higher tolerance
of pain. That's amazing. Well, you know, since you mentioned
hot water, I'm gonna go with the cold water test.
And you know, I have always envious the scientists who
get to conduct studies like the one we heard about
(30:31):
earlier where they were testing to see if swearing actually
reduces pain. And in this study, participants were asked to
put their arm in a bucket of ice water and
then given certain words say or shout out loud and
see how long they could keep their arm in the
ice water, and it turns out that those who were
swearing were able to keep their arms in for longer.
But you know, I was curious as to whether the
(30:52):
specific curse words had different effects, and it turns out
they do. Maybe not surprisingly, they found out that the
F bomb was much more effective than using the word bum.
The word bum. Yeah, I mean, I want to meet
these people who scream out the word bum when they're there.
All right, So we covered handling money and swearing. I
think we're making parents really happy today, So why don't
(31:13):
we do one that's a little bit different. And I
think we should revisit the meditation thing. And I do
know we talked a little bit about it earlier. But
there's this study out of wake Forest that I think
was pretty interesting. And if they found that after just
a few days of meditation training, you know, where they
help participants focus on something soothing instead of their pain,
those in the study actually saw a fifty seven percent
(31:33):
reduction in what they described as unpleasantness. And they reported
that was roughly the equivalent to the effects of morphine.
That's unbelievable. So here's a weird one, and I feel
like you'd have to test this to believe it. But
apparently if you feel a headache coming on, you can
actually eat a bit of green apple or even just
smell one to get some of the relief from a migraine.
And this was a study from the Research Foundation in Chicago,
(31:56):
and the researchers believed it's related to the finding that
the green apples smell does in fact reduced muscle contractions
in the head and neck, which would reduce that pain
from migraine. You know, I think we should do another
study where we test what would happen if you hold
a lot of cash, you scream the F bomb, and
you sniff an apple at the same time, and see
probably feel great. All right? Well, have you ever wondered
(32:18):
why we tend to grab our injuries when we get hurt, like,
you know, imagine you have an ankle's brain, what's the
first thing that you do? You sit down and you
grab your ankle. But apparently there's a reason for this.
So when we touch our injuries, it gives our brains
a chance to map out these injuries and better pinpoint
the location and then more effectively manage the pain. That's fascinating. Okay, Well,
(32:40):
I said my most important fact for last, and that's
the fact that Kenny Loggins and Dean Pitchford actually wrote
the title track for Footloose while under the influence of
pain curs. This is very important. So apparently Loggins had
just recently broken a rib while performing, you know, because
he likes to leave it all out on the stage,
doesn't And Pitchford was dealing with a pretty high fever
and up throat, and the two of them would meet
(33:02):
up to record, and they only had a few days,
so they couldn't let their ailments slow them down. And
as Pitchford said, quote, I think it was two or
three days. We kept up this garade of him showing
up on his pain killers and me and my pain killers,
and us getting the gist of the song. Wow. I mean,
can you imagine the magic that may have never happened
if they hadn't pushed through and worked on this world
(33:23):
changing song Mango. I mean, I may have never had
the opportunity to sing that song in my high school
show choir. I'll pull out the tape sometime to show
you in Tristan, or maybe I'll just leave it at
my parents house. But I'm honestly, I'm not sure I'd
be the man I am today without that experience, though,
So for that, I'm gonna have to give you today's
(33:44):
fact off trophy Mango. And if there was ever a
fact in my fact off windstreak, I'm glad that's the
one of congratulations. Thank you so much, and thank you
guys for listening. If we have forgotten any great facts
that you'd like to share with us about pain killers
or pain management, we'd love to hear those from. You
can always email us part time Genius at how stuff
Works dot com. You can always call our seven fact
(34:06):
hotline that's one eight four four pt Genius, or hit
us up on Facebook or Twitter. We've loved the great
facts that you guys have been sending, the great ideas
that you've been sending, so please keep them coming, and
thanks again for listening, Thanks again for listening. Part Time
(34:33):
Genius is a production of How Stuff Works and wouldn't
be possible without several brilliant people who do the important
things we couldn't even begin to understand. Tristan McNeil does
the editing thing. Noel Brown made the theme song and
does the mixy mixy sound thing. Jerry Rowland does the
exact producer thing Gaveluesier is our lead researcher, with support
from the Research Army including Austin Thompson, Nolan Brown and
Lucas Adams and Eve. Jeff Cook gets the show to
(34:55):
your ears. Good job, Eves. If you like what you heard,
we hope you'll subscribe, And if you really really like
what you've heard, maybe you could leave a good review
for us. Did we? Did we forget Jason? Jason who
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