Four out of five U.S. adults often take OTC meds for such complaints, as well as problems like skin disorders and digestive trouble. There are more than 300,000 OTC drugs on the market in the U.S. alone, and in 2014, Americans spent $44 billion buying them.
It's important to realize that just because you don't need a prescription doesn't mean that a drug is harmless. This is particularly important to remember if you're using OTC drugs for your children. As senior author of the featured study, Dr. Bruno H. Stricker, told the New York Times:8"I would really strongly advise that older people be very careful with using these drugs. They don't do anything except relieve pain. Pain is a nuisance, but dying is a nuisance, too."
4% of the world's population use 80% of the pain killing drugs.
Non-steroidal anti-inflammatory drugs or NSAIDs are among the most widely used pain killers in the world. In the United States, more than 70 million prescriptions for NSAIDs are written each year.
If you include over-the-counter (OTC) NSAIDs such as ibuprofen and aspirin, more than 30 billion doses of NSAIDs are used annually1 to relieve pain associated with everything from backaches and headaches to menstrual and rheumatoid arthritis pain.
NSAIDs work primarily by inhibiting your body's ability to synthesize prostaglandins, which are hormone-like chemicals made in response to cell injury. Unfortunately, many are completely unaware that these medications can actually cause very serious harm.
Stomach upset, nausea, and vomiting are among the most common side effects, but numerous studies have linked NSAIDs to far more adverse effects, including death.2 According to a 1998 study published in the American Journal of Medicine:3
"Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone. The figures of all NSAID users would be overwhelming, yet the scope of this problem is generally under-appreciated."
NSAIDs Carry Potentially Serious Health Risks
The poster child of deadly NSAIDs is Vioxx, which was released in 2000. A year before Vioxx was approved, I warned my readers about the cardiovascular risks associated with the drug. It took four years and 60,000 deaths (due to heart-related side effects) before warnings were heeded and Vioxx was removed from the market.
In 2004, the US Food and Drug Administration (FDA) also cautioned that NSAIDs, including COX-2 inhibitors like Bextra (which was removed from the market in 2005) and Celebrex, along with other over-the-counter varieties like Aleve, ibuprofen, and aspirin, are all associated with potentially serious side effects, including:
- Cardiovascular problems
- GI bleeding4
- Kidney problems
- Increased blood pressure
In February this year, the FDA took another look at the heart risks associated with various NSAIDs. Some research had indicated that naproxen might be less risky than other NSAIDs, but the panel ultimately voted 16-9 against changing the warning label on naproxen to suggest it's safer for your heart other drugs in this class.5
Avoid NSAIDs During Pregnancy, and When You Have a Cold
Pregnant women were especially warned against using NSAIDs. One study reported that prescription and OTC non-aspirin NSAIDs, such as diclofenac (Voltaren), naproxen (Aleve), celecoxib (Celebrex), and ibuprofen (Advil), increased their risk of miscarriage.
As mentioned earlier, these drugs suppress the production of prostaglandins, which are needed for successful implantation of the embryo in the womb. Other pregnancy-related side effects linked to NSAIDs include heart problems in the offspring, low amniotic fluid, and prolonged labor.
If you're in the habit of taking aspirin or acetaminophen when you have a cold, beware that previous research has also found that these drugs suppress production of antibodies and increase cold symptoms, with a trend toward longer infectiousness.
In test-tube studies, therapeutic levels of aspirin were found to suppress the ability of human white blood cells to destroy bacteria. Another study found that a host of pain relievers, including aspirin and ibuprofen, inhibited white-cell production of antibodies by as much as 50 percent.
NSAIDs Again Linked to Increased Heart Risks
Most recently, a Dutch study published in BMJ Open6 found that use of NSAIDs may increase your risk for atrial fibrillation, a heart condition characterized by a rapid and irregular heartbeat. This condition in turn increases your risk of heart failure and stroke. As reported by Counsel & Heal:7
"[T]he researchers... analyzed a wide variety of NSAIDs, such as aspirin, ibuprofen, naproxen, Toradol, Aleve and Celebrex. The team studied 8,423 participants who had an average age of 68 at the beginning of the study and did not have atrial fibrillation. The participants were monitored over an average of 13 years...
The researchers found that participants who used NSAIDs were 1.8 times more likely to be diagnosed with atrial fibrillation in comparison to people who did not take the pain relievers. People who were chronic and current users had a 76 percent increased risk of atrial fibrillation."
Previous research has shown that rofecoxib (Vioxx) and lumiracoxib (Prexige) (both withdrawn from the market) were associated with twice the risk of heart attack, while ibuprofen was associated with more than three times the risk of stroke. Etoricoxib (Arcoxia) and diclofenac were associated with the highest risk of cardiovascular death.
Truth be told, it's very difficult to find a drug-based method of pain relief that is not saddled with severe side effects. (The FDA also recently limited the amount of acetaminophen allowed in prescription products and added a boxed warning due to liver toxicity concerns.)
As a general rule, I advise you to avoid ALL medications, including OTC drugs, to the greatest extent that you possibly can. It's important to realize that just because you don't need a prescription doesn't mean that a drug is harmless. This is particularly important to remember if you're using OTC drugs for your children. As senior author of the featured study, Dr. Bruno H. Stricker, told the New York Times:8 "I would really strongly advise that older people be very careful with using these drugs. They don't do anything except relieve pain. Pain is a nuisance, but dying is a nuisance, too."
There Are Many Ways to Address Pain Without Drugs
In related news, PreventDisease.com 9 recently ran an article covering nine different pain killers alternatives to NSAIDs. Their list includes the following. For the rest, please see the original article:
• Boswellia: Also known as boswellin or "Indian frankincense," this herb contains specific active anti-inflammatory ingredients. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
• Curcumin: In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility. A past study also found that a turmeric extract composed of curcuminoids blocked inflammatory pathways, effectively preventing the overproduction of a protein that triggers swelling and pain.10
• Medical cannabis has a long history as a natural analgesic.11 At present, 20 US states have legalized cannabis for medical purposes. Its medicinal qualities are due to high amounts (about 10-20 percent) of cannabidiol (CBD), medicinal terpenes, and flavonoids. As discussed in this previous post, varieties of cannabis exist that are very low in tetrahydrocannabinol (THC)—the psychoactive component of marijuana that makes you feel "stoned"—and high in medicinal CBD. The Journal of Pain,12 a publication by the American Pain Society, has a long list of studies on the pain-relieving effects of cannabis.
• Capsaicin or cayenne cream. Capsaicin, the active ingredient in hot chili peppers, helps alleviate pain by depleting your body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
• Devil's Claw. A South African herb found to be particularly effective against pain caused by inflammation, including arthritis and muscle pain. According to Prevent Disease: