Het Pijnstillersparadijs: Europese Zelfbeheersing vs. Amerikaanse Pillenfeest

Europeans be like: "I'm just gonna take a half tablet, don't want to get dependent on this stuff"
Meanwhile, Americans:
- Ngl I ibuprofen does kinda taste good
  
  Don't be fooled, they put a sugar coating around the OTC stuff. Instant release Adderall on the other hand... that shit tastes pretty good
  
  The coating on advil is sweetened. The actual medicine tastes horrible.
  
  Tastes like old rubber band to me
  
  I dunno. When i take the pill ibruprofen its the most sour thing ever. You can literally see the face muscles of someone taking it contracting.
  
  I wonder if this is also one of those genetic things like cilantro, because ibuprofen tastes nasty as fuck to me. Like "bitter and my tongue wants to cut itself off to stop the taste even after a drink" nasty.

Europeans: I'm taking a pill, if it keeps hurting I'm going to the doctor.
Americans: I'm keeping taking this until I pay the house. It is still hurting, I can refinance the house to see a doctor.
- Really not much exaggeration here
  
  Exaggerated, sure. The point still stands. Unfortunately.
- Also at least in my country I can call in sick if I have a headache, will be paid for the day and there is no number of paid-time-off-days, which will be subtracted by one when I do so. The employer continues to pay up to 6 weeks of salary if you need to stay at home due to sickness, and for a period longer than 3 days you need a dr to confirm you're sick. The number of sick days per year depend on you actually being sick - I was baffled when I learned this is a fixed number in the US (at least for some) . I guess the motivation to work sick when you have a limited number of paid sick days also contributes to the usage of pain killers.

"Lol Americans are so funny, they can't go to a doctor without going homeless, look at these coping mechanisms they use, hilarious"
- Yeah, it's pretty funny considering how absurd it is.
- It is funny since they keep voting in ways that make their healthcare worse instead of better so why should we feel pity?
  
  It's not all of us ☹️
- Still better off than the people in the countries you coup to install dictators.
  
  I coup?
- Calm down liberals its something called "dork humor" 😎

Americans just tell you it's a slight headache. In reality their back is so screwed up it's going to require surgery but they can't afford that and complaining about actual pain is strictly forbidden in American men.
So we take ~~200~~ ~~400~~ ~~800~~ 1600 Motrin, with some bourbon, and ignore it as best as we can.
- That's really sad.
  
  Yup, I know.
- This is my mother for the last year or so because of rotoscoliosis, a bulging disc, and arthritis in her shoulders.
  She can't really get any form of treatment because the only insurance she can afford is a high-deductable plan, which means she would have to pretty much pay for the entire treatment out of pocket.
  
  I'm so sorry. We really need universal healthcare.
  
  The good thing about the HDHPs is the availability to have an HSA.
  HSA money is collected pre-tax. Balances over a certain amount can be invested. But the good thing about it is that it's yours to keep. Not like an FSA that disappears at the end of a year.
  So she could save up for the deductible for her surgery for her debilitating chronic pain over the course of several years. After she pays thousands in premiums and her employer pays thousands more. Like a good American.
  
  Would flying to Europe and getting healthcare there be cheaper? Look into it.
- But they'll only recommend the surgery after trying muscle relaxers ten times over the course of a year.

Is this a serious thing? It seems so normal here in the states.
- Yes, it's a thing. The idea behind it is that you don't want to become dependent on the pills to the point that they have less effect or that you feel worse without them. Sincerely, a Dutch non-techno non-DJ.
  
  Also it can cause or amplify a lot of stomach issues
  
  Also often the pain is telling you that something is wrong - you wouldn't treat a broken ankle with strong painkillers and continue walking as if nothing was wrong just because it doesn't hurt anymore - would you?
  Painkillers should make the pain bearable so you can still listen to your body and not take away the pain completely
  
  I have never heard of this in the context of ibuprofen. I know it’s bad on the stomach which means you shouldn’t take it for long periods of time (unless prescribed by a doctor). However, when the source of the pain disappears it’s pretty easy to kick the habit. Very different from opioids that are addictive beyond their painkilling ability.
  Also between European countries the price of otc painkillers differs tremendously, and my impression is that European pharmacies generally only sell small packages in an effort to maximise profits.
  
  You can’t become dependent on ibuprofen, it’s not addictive. You shouldn’t be popping it like candy, but taking it when you are in pain is perfectly fine.
  
  https://en.wikipedia.org/wiki/Medication_overuse_headache?wprov=sfla1
  You can absolutely become addicted to all kinds of painkillers. Thats part of the reason why i write down every dose of painkillers i take. Not just the triptanes for my migraine.
  
  I don't think that actually happens.
  
  Do people develop a dependency on ibuprofen? I didn't know that was possible.
  Then again, I don't see why it wouldn't be.
- To be fair we also have it much easier with our healthcare that doesn't know the concept of sick-days. When you're sick you just don't go to work and your healthcare pays half your salary while your employer continues paying the other half.
  So we can actually afford to stay home in bed and let our bodies do the work while we rest.
  
  Screw your sick days! I'm gonna work myself into oblivion to be able to buy my big-ass coal-roller truck on credit and fill up my garage to the brim with crap that I'll let someone else move when I die from a cheese and Ibuprofen overdose. 'Murica!!!!!
- I'm Dutch and I only take paracetamol when I cannot sleep or function due to pain/illness. I've never taken something stronger like Ibuprofen in my life. When I'm ill I usually just lie in bed and wait for it to blow over
  
  Is acetaminophen really considered to be less strong than ibuprofen? I’d always considered them to be equal with ibuprofen being safer.
  
  You're the second person I've seen saying that ibuprofen is stronger than paracetamol. Where does that come from?
  It is slightly stronger, but the dose is smaller. A single dose of router either is roughy the same pain reduction, and similar damage for exceeding their recommended usage
- Yeah, in the UK they reduced the amount you can buy at once too, so drugs like paracetamol and ibuprofen only come in 16 tablet packs and you can only buy 2 packs at a shop., It's helped lower suicides quite well.
  People here have a real aversion to taking tablets a lot of the time. I have to convince people to take regular paracetamol (which is non addictive and doesn't have side effects so long as you don't take more than the recommended amount) after they have had surgery semi-regularly.
  
  Suicide by by paracetamol is such a fucking horrible way to go, mostly since it doesn't kill you, it just completely destroys your liver.
  Just enough time to regret it, before you die slowly and in great pain
  
  That's... Ugh. That's the worst way to go. You have an entire week of pain to regret your decision while doctors can do nothing to help you.
- Ibuprofen is pretty fucking strong. I stick with CBD and paracetamol and I’m bedridden with a painful disease.
  
  Yeah I just stick to hot railing fentanyl if I have a headache or something. Much less addictive.
  
  Ibuprofen and paracetamol are roughly the same in theme of pain relief and harm in long-term use.
- yes. Pain killers (if you take way too many) can be incredibly bad for your liver, and (while almost impossible with paracetamol and ibuprofen) you can become 'immune' to them, making them work less/not at all.
- Yes, it's real. Just another case of "the European mind cannot comprehend".
- In the UK you're limited to 32 pills of paracetamol(acetaminophen in NA) per purchase. Less if they're high dose.
  
  Yeah I got sick of buying the little packets and just ended up buying a bottle of 500 from the US. Pain in the fucking ass
- I just don't think it's a good idea to take pills without asking a doctor, I'm not a medical professional
- Ibuprofen is famous for making men less fertil and it can cause sterility to the unborn baby when took by pregnant women. Paracetamol on the other hand is very bad for the liver. Better took these two very carefully.

My girlfriend always makes fun that in Germany chamomile tea is the go to painkiller and only if that doesn't help the pills come out. It was one of her strongest culture-shocks she didn't anticipate before coming to Europe
- The pain of drinking chamomile tea does have a masking effect.
- They'll only have the "medicinal" tea if even more Lüften didn't do the trick
- Germans are weird like that
  The rest of us are normal and will take a painkiller
  
  French here and I'm team Germany on that one. The right herbal tea will ease most of the pain. Camomille is perfect for inflammation, verbena for digestation and so one.
- I don't know what's Europe anymore.. Isn't germany in it?

It's always amusing how you can read Dutch with some difficulty by combining German and English.
- You can read German with little difficulty by combining actual English with phonetic English.
  
  You can read Bayerish by combining German with a pitcher of lager.

Don't know about Ibuprofen, but Paracetamol overdose is horrible, agonizing death.
- Overdosing on Ibuprofen is harder and less deadly iirc but it can really mess up your stomach and/or damage your kidneys.
  
  ODing on ibuprofen is terrifying

I had a tooth surgically removed a few years back, took 90 min, and I got strong paracetamol and even a small pack of morphine.
I never used the morphine, I keep it sealed at home if I need it.
- It's probably expired.
  
  Oh absolutely, that doesn't mean it won't work though, probably less effective though...

Fun fact for Europeans: we call paracetamol acetaminophen
- ...but it is amid, not amin, no? Why do americans call it acetaminophen instead of acetamidophen?
  
  Nope it's amin according to Google.
  I actually thought I spelled it wrong at first. Weird.

Americans be like
- The pills will ease the Payne.

If those bottles are sold as a pair and each has 500 pills, 1000 pills is more than a hospital grade package in my country.

I'm kinda in this meme. I went through one of those big bottles roughly every 1-2 months for 20 years. Sometimes 12 pills in one day, with 4-8 acetaminophen on top (they do giant double packs of those too). Chronic migraines, but every doctor I asked for help just told me to lose weight so it went untreated and got worse and worse. Our health care suuuucks.
I did lose the weight. It didn't magically fix my migraines, or affect them at all. Insurance dicked me around for another year and a half while my neurologist tried to help every way she could, but we finally got it down to only one migraine a week. I'm truly glad for that, but I still think about the years of unnecessary suffering, and how much better it might be now if I'd been treated sooner.
- You know what sucks as well? Taking too many painkillers against headaches actually causes headaches. Horrible ones at that. Glad to read that you're feeling better, but that's a real trap many people out there are stuck in.
  
  Yup, it was the first thing we checked when I actually got treatment. I'm sure that didn't help, but compared to the pain of the migraines it was negligible. Having to refrain from pain meds for a while to make sure was a hell of a ride though. I lasted about three months. The doctor was satisfied with 1-2 but I wanted to be damn sure.
  I give people the same warning nowadays. Don't take that stuff more than once a week.
- Holy shit, how did you not die from stomach ulcers?
  
  Prilosec presumably

I guess I'm Americaning wrong. As far as painkillers go, 've only taken one ibuprofen in the last year. I even had a severe gut pain event where they prescribed me some oxy but I never took anything.
- I think a lot of Americans are wary of Oxy now. I was in a car crash and the first thing I told the paramedics was, "no narcotics". I deal with enough in my life, I did not need a drug dependency too.
- If you're in severe pain oxy doesn't really get you high. At least not more than adrenaline. Just kills the pain and otherwise makes you feel fine.
  IV dilaudid was the good stuff. I'm glad it was only during my hospital stay though. They sent me home with tons of oxy. Took it as prescribed a couple weeks before deciding I'd rather be able to have a beer and a functional colon.
  I do get why people get addicted to the stuff though. Kills emotional pain right along with the physical.

Is it common for ibuprofen to not really help? With physical pain it does nothing for me. It kind of helps with head aches sometimes. I use it maybe a couple times a year, so it's not tolerance.
- Ibuprofen is a non-steroidal anti-inflammatory (NSAID). It will reduce inflammation and the associated pain. If your pain is not caused by inflammation then you should talk to a pharmacist about what the best analgesic is for you.
- There are several families of painmeds some more harmless than others. Anecdotally I know people that only seem to get relief from ibuprofen, and others that swear only paracetamol (Tylenol) helps, while again others sweat to asperin. Like the other person said.. talk to a pharmacist about options, and see if others work for you.
  Some like paracetamol can me taken over the course of a day for multiple days for example post operation.. and they build a level that causes them to work even stronger. But paracetamol can cause lover damage if taken too much.
  Like with all drugs, read the darn pamphlet. Opiates are not your friend and should only be taken very sparingly under proper supervision, if at all.. sure they dull pain but are highly addictive.
  Source, not a medical professional, so take what I wrote with a grain of salt and consult a professional.
  
  Main benefit for acetaminophen(the American name for paracetamol) is that you can use it on top of an NSAID. That's something you can't do with aspirin. It's good to stagger the dosage for something like a toothache or take both at once for a headache (this is what most OTC migraine medications are, an NSAID[usually aspirin], acetaminophen, and caffeine in one pill).
  
  Noones talking about opiates though?
  Can you post a source about acetaminophen building up over time the way you describe? It seems unlikely with such a short half life but I could be wrong.
- Tbh I usually take 600 mg instead of the 400mg. That usually gets it going for me
- Try taking it with a dose of acetaminophen. Those two have a synergistic effect that is better than either alone and is often used post surgery for that reason.
- It helps marginally better than placebo for me. Hence why Americans use it for fairly trivial aches and pains.
  I can't imagine it would do anything for pain I'd consider 'serious'.
- Depends, I guess. It does nothing for period pains with me, but when I burst my ear drum last month, it took the pain from excruciating to manageable.

I honestly don't understand the Dutch techno reference.
- It's about the perceived drug use (namely ecstasy) within the electronic music scene. Amsterdam, because of its ports and proximity to western Europe, became a hub for typically higher quality drugs.
  
  Their substance laws are also way more lax than the rest of Europe.
  
  Oh, that. I was wondering why would djs pop ibuprofen lol.

Also Australians (where the most economical package of paracetamol/acetaminophen is 200 pills for A$4).

Two 500mg tablets of acetaminophen please, thank you
-A Certified American

Honestly I think the Americans have it right, here.
You end up taking fewer painkillers of you start taking them early and get ahead of the pain. If you wait until the pain is already severe, you end up taking more.
Idk why this happens, it's info I got from a nurse, and intuitively it feels right.
- But also, we have small bottles, too. Kirkland is the Costco brand, the place where you buy shit in bulk.
  It's like showing some natural peanut butter from the grocery store vs. a tub of jif from Sam's club.
  
  Yeah, the double pack of Kirkland ibuprofen will typically last an entire family a year or more
  
  I think you replied to the wrong comment
  
  That's true, but you can also get these big bottles pretty much anywhere.

Hi. American here with atypical trigeminal neuralgia.
I don't even bother with analgesics for anything at this point. You hit 10 on the pain scale enough times and anything below 6 you mostly shrug off.
Unless I stub my toe. That shit hurts like a motherfucker.

200 mg? I know people over here that will pop a pair of 800 mg tablets.
- Isn't 800mg Rx-only? If they're doing it under their doctor's supervision, then that's their business.
  
  Or... And doctors hate this one trick...
  8 200mg pills
  
  Technically it's prescription only. In reality if you ask a random group of men there's always someone with a bottle. Around military bases it's even worse because the military just throws the 800mg pills at everything.
  
  Here 600 is under prescription for sure, I think 400 too.

2 for 1

Ibuprofen is for my migraines only. Nothing else touches those damn things.
- What about paracetomol ?
  
  Wont even touch my migraines. Ibuprofen is the only thing Ive found that works. Ive had them since childhood.
- Ibuprofen doesn't help at all with my migraine. Triptanes are the way to go.

- I've got a bum leg. Costco Advil is my friend.
- Right? I buy my ibuprofen at the Dollar Tree and it still tends to expire before I use it all.

This is so so so so true. Americans especially ww take more ibuprofen and excedrin in a month than surely you should in a lifetime.

In the UK you can't even buy that many at once 😆 without a prescription at least - paracetamol and ibuprofen are usually 16 per pack and they don't let you buy more than one of each

People actually do that? I only take a few painkillers when I'm on my period.
- If I'm sore I probably take 3 ibuprofen every 4 hours.

I agree with the sentiment but are 200mg common where you live? Here in Germany I always get 400mg packs.

i had to take 3.2g of ibuprofen for years before i got my gout under control. then like magic, naproxen actually starting working for me. now its just 600mg of that for the same effect
- Allopurinol for a change?