Kids and Pills; Part 1

Before I say anything about kids and pills, I have to preface it by saying that for adults and pills, whatever I say goes double.

But first a few definitions. Ninety-five percent of the pills I prescribe fall into two categories; anti-inflammatories and pain relievers. Anti-inflammatories fall into two categories; steroids and non-steroidal anti-inflammatories (NSAIDs). Pain relievers also fall into two groups; narcotics and non-narcotics.

Steroids are…well…steroids. They’re also commonly known as cortisone, corticosteroid and prednisone. The most common one used by orthopedic surgeons is methylprednisolone, often prescribed in the form of a Medrol Dosepak, which is a tapering dose of the medication. It’s used for a short burst of this strong anti-inflammatory; even for things like bee-stings and poison ivy reactions, as well as bone and joint conditions. They’re the strongest anti-inflammatory available to mankind. And they can also be injected; in a joint for a site specific effect, or in a muscle for a more systemic effect.  We should have a healthy level of fear of this medication, simply because of its potential for side effects when we take it long term. But it has an important place in the treatment of musculoskeletal disorders.

NSAIDS are a specific form of anti-inflammatory which, as the name implies, do not work the same way steroids do and are not related to them. They include over-the-counter NSAIDs like aspirin, Aleve and Advil, as well as prescription NSAIDs such as Celebrex, Mobic and Relafen.

Narcotics are…well…narcotics and many people think that because they’re prescription, they’re not the same as street drugs. But they are. They are derived from opium or its synthetic counterpart. They’re every bit as addictive as street drugs and might be just as dangerous because many people become addicted unintentionally, while trying to recover from some painful injury or disease. They think that because they’re prescribed, they must be okay.

All drugs are toxins in their own way and all drugs are to some extent, necessary in their own way. Since I don’t prescribe many medications which are needed to save lives, then I have the luxury of saying that most of the drugs I prescribe are taken electively. They are not necessary for survival. So then…next time we can have a conversation regarding the need to take these drugs…or not to.

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