Sorry to ask so much but we’re learning lots here.

Ketamine is a new one for me in terms of chronic pain. You remain conscious, like it’s a low dose?

I’ve never done intravenous acetaminophen plus an NSAID so I could see that being much better than oral potentially.

How often can you do nerve blocks and what’s the longest they last like half a day?

You’re good I was just looping it back into the conversation which is opioid replacements. And yes I only emphasize side effects because the drastic severities for example dementia later in life versus some tiny weight loss or gain.

Good list but yeah very situational. Also I do not know if I am an outlier but unless I have swelling I do not take NSAIDs and acetaminophen has never done much in my experience. Maybe it helped with one headache in my life haha. Tylenol liver issues and NSAID issues but they make special formulas for longer term use now (coated to not harm GI).

Gabapentinoids maybe but it has its own side effects - might not be great for neurology long term like most things though I guess but might be more pronounced in a drug like pregabalin (neuroplasticity).

Clonodine and fluoxetine don’t seem very light either not to bash them if they work great for someone and they do not mind side effects.

Local anesthesia seems to have some serious draw backs from my quick read and makes sense why I haven’t heard of it more.

I’ve known someone who had back pain from like a pinched nerve in a herniated disk get a steroid shot that lasts a long time but I don’t know how many situations that can be applied to and what steroid side effects are like.

Alcohol seems a bit meh to suggest as chronic pain reliever and magnesium seems like a long shot but if it works I’m glad for those people. I do not use pain medicine or have had issues with chronic pain so I do not mean to bash the list but yeah we are in desperate need for drugs that produce analgesia or block pain like opioids do.

Oxycodone and Purdue is a problem that definitely should be talked about but if we hyper-focus on it too much we are missing about a hundred chapters of the rest of the story. Or twenty chapters, I don’t have an exact number but you know what I’m saying.

https://www.painnewsnetwork.org/stories/2018/3/8/the-myth-that-americans-consume-80-of-the-worlds-opioids

I thought that sounded like that number made about zero sense, and I found that the “80%” figure you mentioned has been repeated all over the place and it’s incredibly false. At one point in time, at one point, the United States had 80% of world’s sales for oxycodone. 99% for hydrocodone (every other country uses different stuff like classic morphine). Careful with statistic facts and numbers out there, I tend to remind myself constantly.

Can you list them please