Recreational Tianeptine Has Potential for Abuse

DEAR DR. ROACH: I’ve been hearing about tianeptine being sold at gas stations. Is it really dangerous? -- S.F.

ANSWER: Like so many substances, tianeptine can be a useful drug when prescribed and taken correctly (it’s used in several countries for depression), but it is indeed dangerous when used recreationally. Its use has been banned in several (unfortunately not all) states across the U.S. It is sold (yes, especially at gas stations) as a dietary supplement. Because it acts on the same receptor as morphine, when used at high doses far beyond the medically approved dose, it has potential for abuse and even overdose, with a handful of deaths ascribed to its use.

I recommend in the strongest possible terms against its recreational use and hope it is completely banned soon.

***

DEAR DR. ROACH: I have severe pain in my right shoulder. I have seen two orthopedists and received X-rays, MRI scans and a cortisone injection, which didn’t work. Both surgeons recommended a shoulder replacement. I am taking three adult aspirins each morning (I am allergic to NSAIDs), which makes the pain go away. Is this safe? I am 83 and otherwise healthy. -- J.B.

ANSWER: Aspirin is a type of non-steroidal antiinflammatory drug and has the toxicities common to all the drugs in that group, including an increased risk for bleeding and potential damage to the stomach and kidneys. But it has additional toxicities beyond NSAIDs like ibuprofen, especially at higher levels. I am very cautious about prescribing aspirin and generally prefer other anti-inflammatory medicines. However, people have long taken aspirin -- sometimes at much higher doses -- usually without problems. The fact that you are taking it only once a day reduces the toxicity, but I have to say I am surprised the benefit is lasting all day. The risk of toxicity is higher at older ages. At 83, you are at a significantly higher risk (seven times the risk) than younger people. Most of the data on exactly what your risk is comes from people taking low-dose aspirin (81 mg, not the 975 mg you are taking), so I can’t give you an evidence-based answer. But, for men in their 80s taking low-dose aspirin, about 1.5% will have a serious bleeding event per year. Your risk will be significantly higher due to the much-larger dose you are taking. However, one has to consider both the benefits of the aspirin treatment (the pain being gone is the best possible outcome) and the toxicity of other possible treatments, such as surgery (which is very significant).

There are many classes of NSAIDs, with very different chemical properties, and it is likely there is another type of NSAID you could safely take, with a lower risk than the dose of aspirin you are currently on. On the other hand, you can’t get any better effectiveness, at least in terms of pain, and the absolute risk is still fairly small, so I’m not sure I recommend you change. I am always very cautious about recommending surgery to someone in their 80s when there is an effective medication available to treat the issue.

***

Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

© 2023 North America Synd., Inc. All Rights Reserved

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CPA

Over 55 years of experience

3 Hillside Drive, Batavia, NY 14020 585-343-5431 • Cell 585-738-0962

Fax: 585-343-3420 • fran@cpafran.com

Older TREADMILL, suitable for older adult who just wants to walk: lorali58isdone@gmail.com

Older SLEEP APNEA MACHINE works well. You pick up: lorali58isdone@gmail.com

ENTERTAINMENT CENTER, solid, light oak. Fits 32” TV or could be used for computer monitor. Excellent condition. You pick up: 585-359-1652

WILTON NOVELTY CAKE PAN shaped like running/athletic shoe. Holds one entire cake mix recipe. Four STONEWARE .5L BEER MUGS. Fairport: jvc45@aol.com

SONY CD/DVD PLAYER. Works. Fairport: jvc45@aol.com

Who collects CLOTHING FOR THE NEEDY: motelmaid37@aol.com

NORDIC TRACK EXERCISE MACHINE. Excellent condition. Pick up, Pittsford: 585-385-9938

STAMPED CROSS STITCH KIT, Serenity Prayer 16” x 20”. All floss and more. Pick up, LeRoy. Text or call: 716-352-1248

WOOD DINING ROOM CABINET w/GLASS DOORS. Good condition. You pick up: 585-213-4023

SUBARU VERTICAL SHAFT ENGINE, did run, needs pull start replaced: 585-737-0491

BOXES and PACKING MATERIALS: donna.lievense@gmail.com

WOMEN’S DIAPERS, size large. Still in bags: 585-236-0426

Clean QUEEN SIZE MATTRESS, 2” thick. Perfect for camper: 585-755-1948

FELLED 4-5’ SECTIONS ASH WOOD; take as much as you want. Easy access; wood on edges of lawn: 585-281-1717

CASTRO CONVERTIBLE COUCH and SLIPCOVER - cushions ripped, but mattress perfect: grleah1@juno.com

FIREWOOD. Large cotton wood tree; felled, trunk and large branches broken down. Easy access. You pick up, Ionia: 585-657-4894

AMPCO PLAYER PIANO and a LOWREY CITATION HOME THEATER ORGAN

You move: 585-323-1762 (leave message)

WURLITZER PIANO - great condition; only one sticky key. Located on the second floor. Text: 585-755-9697

YOUNG CHANG PIANO. You pick up, Honeoye Falls: 585-944-5825

RESMED S8 ELITE II CPAP - Case, Heater/Humidifier, 2 Tanks, Cord, Manual, Hose, but CPAP part probably no good. West Henrietta: cmonroj1@rochester.rr.com

AVANA COMFORT MATTRESS ELEVATOR (king size). Pick up, Webster: 585-872-6756

PATTERNS for an 18” doll: 585-624-5144

DELL 3.06 GHz UBUNTU LINUX, 500Gb HDD, DVD, 4Mb RAM, Ethernet 100, onboard graphics. NO monitor. NO KB: m0kpc6s3g@mozmail.com

20 HP MERCURY OUTBOARD MOTOR for parts. Will pick up. Text: 585-230-9380

SLEEPER SOFA, any size. Please, not if it smells like smoke or cat urine. Will pick up! Thanks! 585-443-9338

VINTAGE FOOTBALL, BASKETBALL or BASEBALL CARDS. Also, VINTAGE ADVERTISING CARDS. Thankful & Grateful! 585-729-1259

VINTAGE ELECTRONICS - Tubes, tube testers, vintage stereo equipment, radios, microphones, motors, speakers, meters, turntables, communication gear, Advertising, Ham, Test Equipment: 585-538-9341

ROSARIES (old and new) to add to my 300+ collection: 585-293-2199

COMICS AND SPORTS/COLLECTIBLE CARDS, any condition, will pick up. I enjoy everything. Thank You! God Bless. Text: 585-260-0437

KEYBOARD in working condition for a 90s Dell computer for a disabled person to work with: 585-346-7022

CLEAN STORAGE BOXES, like copier paper boxes, with lids for moving. Stored indoors. Will pick up: 585-497-2327

HP PRINTER INK CARTRIDGES #60 and #61, new or expired okay. Thank you: 585-519-3325

CRAFT SUPPLIES, YARN, PAINTS, CLAY, FABRICS: Jeank71112@gmail.com

OLD ELECTRONICS, will refurbish and pass on to others in need, or recyclecomputers, stereos, printers, etc.: terrybeckley1@gmail.com

Senior Navy Veteran needs any running VEHICLE that has passed inspection for himself and animal rescue: 585-531-4004

Rock music - 8 TRACK TAPES, CASSETTE TAPES, and VINYL RECORDS for my own personal collection. Thanks in advance: gzintel@yahoo.com

BOX TRAILER: 585-323-1762 (leave message)

COOPERSTOWN DREAMS PARK TRADING PINS and carrying case for granddaughter who will be in this summer’s tournament: 585-334-6134

AIR COMPRESSOR - 10+ gallons: mhoskins@pvac.org

INVERSION TABLE, for senior with bad back: stujaxon@yahoo.com

TRAILER WHEEL & TIRE, ST175-80D13 13” wheel, 5 lugs: 585-993-1917

BUILT/UNBUILT MODELS OR KITS. Parts and pieces ok. Longtime collector seeks projects/restorations/customs. Auto, Truck, Plane, Military, etc. Call 585-314-6989, thanks

DIRT BIKES, ATVs, GO-KARTS wanted that are running or not running for father-son project. Thank you in advance! 315-576-1278

Looking for a WEBER GRILL you are no longer using. Thank you and feel free to call or text me: 315-576-1278

Looking for GARAGE SIGNS, OIL CANS, or other decorative automotive memorabilia from the 1970s and earlier. Thank you! 315-576-1278

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Milton CAT is in search of New York State certified MBE/MWBE and SDVOB subcontractor enterprises that can provide selected goods and/or services to us. Subcontractors must be able to meet insurance, financial and bonding requirements as contained and specified in general contract documents and other New York State entity requirements.

If interested, please contact us at goodfaitheffort@ miltoncat.com to begin the screening process.

DID YOU KNOW? Thyroid cancer is the most common cancer to affect the endocrine system. While many cancers have decreased in prevalence, ThyCa: Thyroid Cancer Survivors’ Association, Inc. indicates incidence rates for thyroid cancer have increased in recent years. The American Cancer Society expects thyroid cancer deaths to increase to 2,200 in 2021 out of an estimated 44,280 people affected by thyroid cancer. Unlike most other adult cancers, thyroid cancer is commonly diagnosed at a younger age. Women are three times more likely to develop thyroid cancer than men. Thyroid cancer is largely treatable, most notably with the removal of a portion of the gland or the entire thyroid gland depending on cancer stage. People who have had their thyroids removed (thyroidectomy) will need to take daily thyroid hormone pills.

All cra supplies, needlework, Xstitch, plastic canvas, painting & knit/crochet instruction books, ribbon, silk owers, gi s and greeting cards.

ALL 50% OFF!

*sale does not include jewelry, fabric, vintage items, paperback & hardcover books - Additional 10% discount on instruction books -

• Sports Injuries

• Shoulder/Mid Back Pain

Dr. Nick Ryan, Palmer Graduate with 10 yrs. of practice. Offering Spinal Decompression and Laser Therapy. Accepting New Patients! Most insurances accepted, workers comp/auto accidents

Fish Fries During Lent –Every Wednesday, Thursday & Friday

Corned B f and Ca age

Served Wed., March 15th to Sun., March 19th (or sold out)

$13.99

March 17th Breakfast Specials:

Green Eggs & Ham Omelette

Fresh Corned Beef Hash Scramble

Broccoli Cheddar Quiche

Open

Step back in time at Jen’s Joint!

Wed.-Fri. 6AM-8PM

Sat.-Sun. 6AM-2PM

4974 Ellicott Street Road Batavia • (585) 219-4064