# Are these painkillers I bought a placebo? **URL:** \ **Category:** Factual Questions\ **Created:** [September 15, 2024, 9:45pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318 "2024-09-15T21:45:47Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 16, 2024, 4:04pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/21 "2024-09-16T16:04:28Z")
I knew a guy nicknamed ‘Dexter McThorphan’ for his habit of robo-tripping (chugging robitussin). Dextromethorphan is a potent dissociative at higher doses, as it binds with the same receptors that PCP does. DM reportedly gives some folks the same kind of long, loud buzz one can get from smoking a handful of couch stuffing material. Definitely don’t recommend for recreational use. Glad it worked for you for cough suppression though. Most folks find it pretty ineffective compared to codeine, it’s nice to know it works for some. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [September 16, 2024, 8:33pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/22 "2024-09-16T20:33:04Z")
My MIL swore by it for cough suppression, and didn’t have any weird side effects, fwiw. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 16, 2024, 9:10pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/23 "2024-09-16T21:10:41Z")
Yeah, one must chug a bottle or six of that stuff to get those effects. Which are usually accompanied by diarrhea, walking into walls, and chewing on fingernails (one’s own or other people’s) in those dose ranges. Along with potential arrhythmias and just a TON of other nasty stuff. But safe when taken as directed in nice lower doses. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [September 22, 2024, 2:47am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/24 "2024-09-22T02:47:42Z")
An alternative to strychnine and sniffing glue? [![](https://img.youtube.com/vi/ANSXbyuhvlQ/hqdefault.jpg "The Fuzztones-Romilar D.wmv") ](https://www.youtube.com/watch?v=ANSXbyuhvlQ) ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [September 22, 2024, 5:29am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/25 "2024-09-22T05:29:10Z")
> [@WalterBishop](#): > > My hunch is that these tablets are BS, and they just put a nominal amount of codeine in them to trick you into thinking that they’re stronger than they are. 500mg paracetamol aka acetaminophen is a solid proven pain reliever. Not a placebo in any way shape or form. Also what Qadgop\_the\_Mercotan said. ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [September 22, 2024, 8:01am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/26 "2024-09-22T08:01:00Z")
It’s a shame people can’t get the cough relief and help with pain they need due to others. It’s also a shame you have to be nervous a doctor thinks you are drug seeking. I know why it is. I know there are addicts and bad docs who have not helped. It’s still a shame. I’ve never had codeine cough syrup. I’ve had plenty of pain meds. I would have the tendency to over use. Especially when I’m not at my best(which ain’t exactly perfect). I always second guess before I take a pain med. I don’t need impairment to cause another problem I do not need. ---
**Author:** ![thorny\_locust](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/thorny_locust/32/431_2.png) [@thorny\_locust](https://boards.straightdope.com/u/thorny_locust)\ **Post date:** [September 22, 2024, 2:10pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/27 "2024-09-22T14:10:28Z")
> [@DrDeth](#): > > 500mg paracetamol aka acetaminophen is a solid proven pain reliever. For some people. Not for others. Does nothing at all for me. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [September 22, 2024, 2:29pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/28 "2024-09-22T14:29:11Z")
> [@Beckdawrek](#): > > It’s also a shame you have to be nervous a doctor thinks you are drug seeking. I’ve mentioned before about being discharged from the hospital after a complicated cholecystectomy (JP drain, a week in hospital). I asked my surgeon about pain control. He suggested Tylenol, which made me laugh, which hurt. He said that opiates were tightly controlled. I told him I knew a corner two blocks from the hospital where I can purchase effective medication, and if the police caught me doing this I’d make sure the newspaper spelled his name correctly. He wrote me a script for way more than I needed/expected. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 22, 2024, 3:31pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/29 "2024-09-22T15:31:12Z")
> [@Jackmannii](#): > > An alternative to strychnine and sniffing glue? Also an alternative to licking toads. I’d love to hear what the fuzztones have to sing about that. ---
**Author:** ![raventhief](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/raventhief/32/4_2.png) [@raventhief](https://boards.straightdope.com/u/raventhief)\ **Post date:** [September 22, 2024, 5:15pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/30 "2024-09-22T17:15:11Z")
> [@puzzlegal](#): > > He gave me a prescription for dextromethorphan, which is the cough suppressant in most of the otc stuff. I’m sure i took an overdose. (i mean, i took the dose he prescribed, but it was an overdose for me.) It was an AWESOME cough suppressant, better than codeine. And i also had disphoria and disassociation, and i couldn’t concentrate enough to work and i was too twitchy to sleep. I have a horrible reaction to dextromethorphan. I call it “concentrated flu.” Body aches, cold sweats, splitting headache, twisting muscular pain, disassociation, too restless to sleep and just general misery. It lasts for, oh, about 4-6 hours. So I don’t take that. ETA - this is at the dosage prescribed, or even less. ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [September 22, 2024, 6:35pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/31 "2024-09-22T18:35:36Z")
I hear you. My Daddy had a bad neck from years in the Military and hard work. He did all the standard X-rays, Mri’s, tried physical therapy. A couple Ortho docs told him live with it. He even went down Woo alley, chiropractors and the hanging upside down thing. He got a doctor who prescribed a mild opiate. Omg. Help, finally! He goes thru the rigamarole about how much to take and not to overuse and how much he was given every month. He said it was so tiring dealing with the noise. He finally told the doc, either prescribe it or not, but shut the noise down or “guess what? You ain’t the only game in town” He got his pills. Some people can be aware enough to use a helpful drug, responsibly. ---
**Author:** ![I\_Love\_Me\_Vol.I](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/i_love_me_vol.i/32/521_2.png) [@I\_Love\_Me\_Vol.I](https://boards.straightdope.com/u/I_Love_Me_Vol.I)\ **Post date:** [September 22, 2024, 9:46pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/32 "2024-09-22T21:46:56Z")
> [@Qadgop\_the\_Mercotan](#): > > **I really don’t know why they insist on combining opioids with acetaminophen**. Arguments that it discourages abuse of such meds because people are afraid of dying from the tylenol in it rarely stopped an opioid addict from taking 40 tabs at once. I’ve seen plenty of them in the ER, in need of acetylcysteine to keep the tylenol from killing them. [Bolding mine] I have asked doctors about the common mix of acetaminophen and opiates. I wondered why they couldn’t give me something safer for my liver like opiate + ibuprofen or opiate + aspirin. I was told that APAP (acetaminophen) and opiates like hydrocodone work together to relieve pain to an extent greater than the component parts. (I couldn’t word this the way I wanted to. I’m sorry it’s a bit confused. Perhaps the word I’m looking for is they’re synergistic or something like that.) In any event, perhaps adding a bit of the opiate to the APAP (like the drug mentioned in the OP) simply makes the APAP more effective than it would otherwise be. ---
**Author:** ![DavidNRockies](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/davidnrockies/32/6279_2.png) [@DavidNRockies](https://boards.straightdope.com/u/DavidNRockies)\ **Post date:** [September 22, 2024, 10:04pm UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/33 "2024-09-22T22:04:55Z")
There can be a lot of individual variability in how each person process (among other things) medications. **[Codeine metabolizes to morphine via the Cytochrome P450 2D6 enzyme](https://www.medsafe.govt.nz/profs/PUArticles/June2018/SpotlightOnCodeine.htm)**. [**Also see…**](https://en.wikipedia.org/wiki/CYP2D6) ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 23, 2024, 12:44am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/34 "2024-09-23T00:44:21Z")
> [@I\_Love\_Me\_Vol.I](#): > > I have asked doctors about the common mix of acetaminophen and opiates. I wondered why they couldn’t give me something safer for my liver like opiate + ibuprofen or opiate + aspirin. You do get synergy from opioids and acetaminophen together (you nailed the term!), but NOT with opioids and NSAIDs like ibu or aspirin and the rest, hence the pairing. BUT one can also just take a 325 or 500 mg acetaminophen tab with one’s opioid tab, rather than having them in a combination product that’s so likely to be abused. ---
**Author:** ![I\_Love\_Me\_Vol.I](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/i_love_me_vol.i/32/521_2.png) [@I\_Love\_Me\_Vol.I](https://boards.straightdope.com/u/I_Love_Me_Vol.I)\ **Post date:** [September 23, 2024, 12:51am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/35 "2024-09-23T00:51:02Z")
> [@Qadgop\_the\_Mercotan](#): > > You do get synergy from opioids and acetaminophen together (you nailed the term!) Perhaps, but I did _not_ nail the term “opioid” which I should have used instead of “opiate”. 🙃 ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 23, 2024, 12:58am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/36 "2024-09-23T00:58:25Z")
> [@I\_Love\_Me\_Vol.I](#): > > I did _not_ nail the term “opioid” which I should have used instead of “opiate”. “Opiate” means derived from opium, and can be interpreted either as 1) limited to the active drugs in opium (morphine, codeine, thebaine) or can be interpreted as 2) any drug that is synthesized out of the ingredients in opium (and thus includes heroin, hydrocodone, oxycodone and others). “Opioid” means a molecule that’s active at the opioid receptors in the human body, including the ones which are completely synthetic and hence not made from opium. This includes stuff like methadone, fentanyl, sufentanyl, carfentanyl, and a host of others. But those are pretty much academic distinctions and I don’t think it makes much difference whether one says ‘opiate’ or ‘opioid’ unless they’re getting deep into the weeds about details. ---
**Author:** ![Beckdawrek](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/beckdawrek/32/3647_2.png) [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)\ **Post date:** [September 23, 2024, 1:14am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/37 "2024-09-23T01:14:12Z")
Don’t wanna hijack. But please explain Tramadol. It is absolutely useless. ---
**Author:** ![abcdefghij](https://avatars.discourse-cdn.com/v4/letter/a/43a26b/32.png) [@abcdefghij](https://boards.straightdope.com/u/abcdefghij)\ **Post date:** [September 23, 2024, 3:03am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/38 "2024-09-23T03:03:33Z")
> [@Qadgop\_the\_Mercotan](#): > > “Opiate” means derived from opium […] > “Opioid” means a molecule that’s active at the opioid receptors in the human body I thought it was an opioid before it entered the atmosphere and an opiate after it hit the ground. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [September 23, 2024, 3:13am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/39 "2024-09-23T03:13:05Z")
> [@Beckdawrek](#): > > Don’t wanna hijack. But please explain Tramadol. > > It is absolutely useless. My mom had pain from a broken hip. They gave her morphine, which totally knocked her out, she was completely non-functional. For various reasons, it wasn’t safe for her to take nsaids. Tramadol was a lifesaver, as it blunted her pain and left her functional. ---
**Author:** ![crowmanyclouds](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/crowmanyclouds/32/19884_2.png) [@crowmanyclouds](https://boards.straightdope.com/u/crowmanyclouds)\ **Post date:** [September 23, 2024, 3:14am UTC](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318/40 "2024-09-23T03:14:58Z")
One way to remember is that opiate has a “t” in it, as in “top” and opium has a “m” in it, as in “mountain” in case you’re ever stuck in a cave and have a lot of pain. [Previous page](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318.md?page=1) [Next page](https://boards.straightdope.com/t/are-these-painkillers-i-bought-a-placebo/1007318.md?page=3)