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The Dangers of Overusing Pain Relievers

by Dr. Julian Whitaker

Published 04/30/09

When headaches or back pain hit, most people reach for one of the heavily advertised pain relievers-aspirin, acetaminophen (including Tylenol), or ibuprofen.

Americans spend over $6.6 billion dollars each year on painkillers. Half of this amount goes for prescription medications, but the remainder is for over-the-counter (OTC) analgesics. Acetaminophen leads the pack, followed by nonsteroidal anti-inflammatory drugs (NSAIDs including ibuprofen), aspirin, and anti-migraine preparations. Nearly one in five Americans over age 60 regularly takes medication for chronic pain, according to a survey conducted for the National Council on the Aging. Arthritis pain is the most common complaint, followed by bone and joint pain and low back pain.

We all get the occasional headache, muscle pull, or joint pains. However, if you're taking these pain killers every day, you're at risk of serious injury or even death.

OTC Painkillers Have Serious Side Effects

Folks, we've been blinded by the glut of advertising extolling the benefits and safety of OTC analgesics. They may be effective, but they're certainly not safe.

Over 25 percent of those surveyed in the study mentioned above suffered from side effects caused by their pain medication, and about 10% had been hospitalized as a result. In addition, 58 percent were also taking medication for another medical disorder, putting them at risk for potential adverse drug interactions. In fact, long-term use of NSAIDs results in 20,000 deaths annually.

Aspirin and NSAIDs, which operate on the same principle, inhibit the synthesis of prostaglandins, hormone-like substances that cause pain, inflammation, fever, thickening of the blood, and abnormal blood clots. (This is why taking small doses of aspirin is exceptionally effective in preventing heart attack, and I strongly recommend it to my at-risk patients.) As a result, pain, fever, and inflammation subside. The problem is that in addition to inhibiting these pain-causing prostaglandins, NSAIDs also shut down the production of other beneficial prostaglandins, leading to a number of problems.

NSAIDs Cause GI Bleeding and Cartilage Destruction

Gastrointestinal complications are responsible for most of the hospitalizations and deaths associated with NSAIDs. NSAIDs decrease the production of bicarbonate in the stomach, resulting in excess acidity that causes stomach upset, nausea and vomiting. They also increase the permeability of the gastrointestinal tract's mucous membranes and make them more susceptible to ulceration. And because they decrease blood clotting, serious GI bleeding is common in long-term NSAIDs users.

NSAIDs also contribute to cartilage destruction. They exacerbate the very condition for which they are most often taken-arthritis. In one study, Norwegian physicians examined the X-rays of 294 arthritic hips. They found that the hip joints of patients taking the NSAID Indocin had significantly more damage than those not taking the drug.

NSAIDs have other adverse effects, as well. A study in the New England Journal of Medicine found that NSAIDs were the culprit in 15 percent of all drug-induced cases of kidney failure. Exacerbation of asthma, thinning of the bones, allergic reactions, immune system depression, and prolonged bleeding time are also associated with long-term NSAID use.

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