A panel from the US Food and Drug Administration met this week to discuss pain medications, particularly those containing acetaminophen. The dangers of taking too much acetaminophen have been in the news lately, as the medication can be lethal if the recommended daily dose is exceeded. Because many of these medications are available over-the-counter, many unsuspecting people looking for pain relief may get much more than they bargained for: severe, potentially deadly liver damage.

The panel recommended the maximum dose of over-the-counter acetaminophen be restricted to 650 mg, even though products with nearly double that amount are currently available for purchase in any drug store. They hope this might reduce some of the yearly acetaminophen-associated deaths.

Many people who suffer from chronic pain rely on over-the-counter painkillers such as NSAIDs and acetaminophen to manage their pain, or to control breakthrough pain. Though the dangers of overdosing on acetaminophen are clear, making the strongest version available by prescription could make the drug harder for some to access, and possibly more expensive. There is a big difference between walking into a convenience store and having to pay a copay at the doctor to get a prescription.

How many of you take acetaminophen regularly for your chronic pain? If the FDA panel's recommendations go into effect, how will it impact your pain control?

When you think of a drug overdose, you may think of a rock star strung out on heroin or a celebrity found unresponsive amidst multiple prescription bottles. However, recently the FDA has begun to consider drug overdoses that come from a more unlikely source: over-the-counter pain relief.

A recent Time Magazine article detailed the FDA's scrutiny of over-the-counter medication labels of drugs such as acetaminophen, commonly used both for fever reduction and pain relief. One of the potential risks of chronic acetaminophen use is liver damage, however there may be a risk with occasional use as well. Acetaminophen is sometimes taken with other over-the-counter or prescription drugs that contain more acetaminophen, boosting the daily intake over four grams, the maximum amount considered to be safe per day. Any more than that, the FDA points out, can lead to potentially fatal liver damage.

Many other over-the-counter pain relievers have also been under scrutiny lately, particularly NSAIDs, for their potentially serious gastrointestinal effects. Acetaminophen and NSAIDs are some of the most commonly used medications for pain control, including both acute pain and chronic pain.

By bringing these issues to the public's attention, I hope the FDA succeeds in preventing some potentially deadly over-the-counter drug interactions. We are so used to just taking a pill when we get a headache or a backache, that we often don't stop to consider the consequences of long-term use. Or, we don't think about the potential interaction with other medications we take regularly. Based on these recent findings, it's time we pay closer attention!

Everywhere you turn, there is another theory about the pop icon Michael Jackson's death. One of the most recent, and most chilling to me, is that he suffered a fatal Demerol overdose. While it is purely speculation at this point, it does touch a nerve with me as the Guide to chronic pain.

Demerol is a narcotic pain reliever, available only by doctor's prescription. It is classified as an opioid analgesic, and is similar in strength and effect to morphine. Like other opioids, it has potentially deadly side effects if used inappropriately. For people with certain conditions, such as sickle cell anemia and respiratory problems, Demerol use can have serious complications. It can also cause respiratory distress or even death when combined with alcohol or other sedatives.

There is no doubt that Demerol is serious stuff. But why does it bother me so much that Demerol complications might have potentially led to the death of such a prominent celebrity? Well, it seems that every time I turn around, another celebrity is in the news talking about their addiction to painkillers. In the past few years, we have lost both Anna Nicole Smith and Heath Ledger to prescription medication overdoses. Each was reportedly taking multiple medications with potentially deadly effects when mixed together. It just makes me wonder, why were their physicians prescribing such potentially lethal combinations? It also makes me wonder how many ordinary people out there die of accidental overdoses and receive no press at all.

It seems to me that the greatest risk for deadly prescription combinations happens when you see multiple specialty doctors. You may assume that each doctor knows what the other is prescribing, but having worked in the health industry for over fifteen years I can assure you that this is not always the case. To protect yourself, you must keep good records of your medications. If you keep a pain journal, you can detail your daily doses there. Bring your journal to every doctor's appointment to ensure each has your current medication list, both prescription and over-the-counter. It might even be wise to carry a list of your prescriptions with you at all times, in case of emergency.

If you take Demerol for chronic pain, don't panic. But please, do go over your medications with your doctor and discuss any concerns you may have. It could very well save your life.

Are you considering using an alternative treatment for chronic pain? With many choices available these days to treat our pain, we no longer have to rely solely on medication for relief. However, there are a few things you should consider before you take the plunge.

First, what kind of relief are you looking for? Do you want something you can do in addition to your usual medication? Or, are you looking for something to replace your medication completely? Complimentary medicine is non-medical treament that is used in addition to your normal treatment regime. Alternative medicine, on the other hand, replaces your former medical pain control methods. If you are on the fence, you should talk to your doctor. Read this article for more information about making the decision to switch to alternative medicine.

Next, what do you want to try? There are plenty of options available, from yoga to acupuncture to herbal remedies. Figuring out where to start can be overwheming. Ask your friends, read chronic pain forums and do a little research online. Be sure to ask questions about safety and success rates of the treatments you are considering.

Finally, ask yourself what you will do if the treatment does not work. Are you willing to try something different? Would you just go back to your old regime? Having a loose plan in place can help you take the next step without getting as frustrated. Keep in mind that, much like pain medication, it may take time and a little experimentation to find a complimentary or alternative treatment that works for you.