Painkillers and alcohol – can they be tolerated?
Painkillers are considered very safe when taken safely and correctly. However, painkillers and alcohol are not a recommended combination, as they involve many dangers and risks, some of which can even be life-threatening, for example, if highly effective opiates are taken with alcohol. With other active substances, however, it is only necessary to weigh up the risks and possibly only reduce the amount of alcohol to the minimum necessary.
Problems with the combination of alcohol and painkillers often involve similar points of attack in the brain or a similar breakdown pathway via the liver and kidneys. Here mutual interactions lead to poisoning with one or the other combination partner. By competing for precisely those points of attack, the effects of the two opponents reinforce each other.
Opiates, even in much lower doses, can cause extreme side effects such as respiratory paralysis, which under normal circumstances would not be expected under any circumstances at the dosage used. Non-steroidal painkillers (NSAIDs = Ibuprofen, Voltaren, Diclofenac etc.) develop the interactions mainly in the stomach, where the balance is shifted by the drugs in favor of the harmful stomach acid.
Alcohol shifts this balance further in the direction of gastric acid and the risk of stomach or duodenal ulcers or even life-threatening gastric perforation increases. Also with non-steroidal painkillers, the joint breakdown with the alcohol in the liver continues to be the main focus and here too the effect can be mutually enhanced or weakened. For the treatment of pain after alcohol consumption, the analgesic Aspirin® and a sufficient supply of fluid are particularly suitable.
Painkillers after surgery
The treatment of pain after an operation depends on the type of operation, because different operations cause very different levels of pain. For example, greater pain can be expected after operations on the chest or abdomen than after minor operations on arms or legs. While a single painkiller tablet may be sufficient to relieve pain during minor operations, major abdominal operations require a multi-faceted pain therapy consisting of several components.
However, the goal of every therapy is always the freedom from pain of the patient. This is often achieved by a combination of different procedures. Pain is demonstrably bad for recovery and unnecessary stress for the patient.
The therapy of pain after surgery is individually tailored to each patient and thus, in addition to the type of operation, underlying diseases, pre-medications or even age and the previous “pain history” play an important role in the selection of the right pain therapy. During the operation, the patient is protected from pain by the strong painkillers that are part of every anaesthetic. After the operation, however, the pain would arise quickly due to the procedure.
Therefore, pain therapy usually begins during the operation, where the patient already receives the first dose of a painkiller in order to wake up from the anesthesia as painlessly as possible. Higher doses of metamizole or paracetamol from the non-opiates group are often used. The pain therapy is then continued in the recovery room by the regular administration of painkillers.
Opiates are often used here. For the days after the operation and in order to treat post-operative pain, the doctors, in consultation with the patient, have ideally developed a scheme before the operation, which, through the optimal combination of drugs, provides the patient with freedom from pain. If severe pain or prolonged pain is to be expected, the insertion of a pain catheter into the vein or spinal cord (as a so-called peridual catheter) has also proven to be effective.
The catheter and a connected pump permanently deliver small amounts of pain medication to keep the patient pain-free. If so-called “pain peaks” nevertheless occur at certain points, the patient can request an extra dose of the medication via a button on the pump. An overdose is excluded by a preset maximum dose.
Pain after operations on arms or legs can be achieved by nerve blocks. For example, a pain catheter can be placed directly on the nerve of the arm and thus block the transmission from the nerve to the brain.
