WELLNESS--An over the counter painkiller is often classified as Non Steroidal Anti-Inflammatory Drug (NSAID). These include but are not limited to aspirin, Advil, Aleve, Motrin, Celebrex, and Feldene. More than 30 million people use NSAIDs every day and they account for 60% of the over the counter analgesic drugs sold. Like most drugs, there can be side effects including cardiovascular events, blood pressure increases, congestive heart failure and gastro-intestinal issues.
According to a study put out by the national institute of health, specific gastro-intestinal issues include ulcer, perforation and bleeding. About 2% of NSAID users equaling roughly 600,000 people experience these serious complications during use, and according to the study risk of ulcer increases up to five-fold for NSAID users compared to non-users.
With this ulcer risk comes the risk of bleeding, and in some cases perforation and even death. The FDA puts the number of annual deaths by NSAIDs at 4,626 while other estimates put it closer to 16,500. Regardless of the correct number, too many people are unaware of the dangers of these seemingly harmless drugs. The pathomechanism for the damage caused consists of the drug being absorbed across the gastric mucosa and get trapped in those cells. The gastric ulcers follow and over time perforation, bleeding and death can occur.
Keep in mind that this is usually with chronic ongoing use of NSAIDs and does not usually occur with the infrequent user. Because these drugs are sold over the counter and taken so liberally, most people are not aware of they can be dangerous and even fatal.
When it comes to NSAIDs, if one feels they need to take them I tell my patients to try to take them early on for an injury or sprain along with lots of ice on the injury. If one can get the inflammation down within the first few days of injury, one will be less likely to have to deal with chronic pain and therefore chronic use of NSAID’s. These over the counter medications, like so many others are not meant for long term use but rather short periods of time to get over the initial pain and inflammation of a new injury or short illness like aches and pains.
For longer-term relief from chronic pain there are diets that can be incorporated and other less damaging supplements and even drugs. People with chronic inflammation for example have many other options besides NSAIDs for relief and will be well served to learn about anti-inflammatory diets and drugs like CBD and THC to help with pain and inflammation over the longer term.