I've been lurking on this thread... here's my 2 cents:<br><br>If you need anything more potent than a hefty dose of Ibuprofen, you probably have bigger problems than some pain killer will solve. The impairment that comes with even a small amount of codine (let alone more powerful "narcotics") would in itself be dangerous.<br><br>Adversity and need, to a point, lend a higher pain tolerence. Our bodies are pretty darned good at managing these things if we don't let our minds get too much in the way.<br><br>I've never been seriously injured (pure luck). I once walked through awful terrain for 3 days with a green stick fracture of one leg. It really gave me a blinding flash of pain if I did something "wrong" - I adapted pretty quickly... Another time, much more painful. I wrecked a wrist in a fall, eventually losing a carpal bone. It did not prevent me from completing my trek, but I had to learn how to field-dress and quarter an elk with my left hand on-the-fly and it took me about 4 years to fully compensate and heal. Another time I had to decend the last 4-5 km from an extended pack-in trip on my butt, hands, and knees - my knees were toast and I could not walk down slope on them without falling - bad form in that location (aiiiieeee splat!) And so on - point is, if there is need, one can work with non-life-threatening injuries.<br><br>I do NOT have a high pain threshold - ask my dentist.<br><br>Injuries that have nearly incapacitated me: <br><br>1. High Altitude sickeness (AMS; Acute Mountain Sickness - I am prone to that about 1/2 the time for about 12 hours after a rapid elevation gain unless I take a prophylaxis like DiaMox (sp) ). I have functioned through that, but it is awfully debiliating and best left to run its course if you can or evac lower if you cannot (it varies for folks - I am familiar with my malaise)<br><br>2. Cut eyeball - I could have trekked with that if I had to, but only because nothing and everything hurt like the dickens - ouch! Staying or going effected no change and it was (barely) tolerable. When I got to a doc, the pain medication that worked knocked me for a loop. Pain or disfunctional - those were the choices.<br><br>3. Nothing else comes readily to mind... err, I had some fractured neck vertebra once, but I was functional after I got the copper taste out of my mouth. Neck movement went on auto-pilot - as I said, the body manages itself pretty well.<br><br>As I said, I've never been seriously injured so far. Various GI distresses can lay waste to one ASAP (I agree with the Lomotil, BTW), and of course things like malaria attacks from what I've seen. Severe injuries are just that - severe injuries. Except for CNS injuries, most folks seem to be able to drag themselves away from imminent danger and then they need immediate aid from someone else. I've seen the gamut, but not personally experienced any. Pain meds are not the sole answer to things like that.<br><br>IIRC Trusbix's post correctly, I thought he had a very sensible list of meds. However...<br><br>If we're talking the tiny tobacco-tin/candy tin size "PSK", I don't think there is much room for effective enough pain killers that will not critically impair one. I carry a short dose of a couple of OTC meds and that's it - for me, it will get me over the hump in an AMS attack. My personal first aid kit - above and beyond the PSK - has meds in it. For an extended trip, I carry an extended first aid and medication capability that is a compromise between what I can afford to carry, what the risks are, and my knowledge and abilities. I would never attempt to make that up in a PSK-size kit - it's just not going to yield anything really useful in that volume, IMHO.<br><br>Sooo... perhaps we can turn the conversation to, say, three stages of kit: 0, 1, and 2 - with zero being the PSK, 1 being a personal first aid kit, and 2 being (for lack of a better term) a "group leader kit". (Or for Doug - a small aircraft kit <grin>).<br><br>Like I said, just my 2 cents worth...<br><br>Regards to all,<br><br>Tom