A 2013 analysis of 7 years of data from the National Ambulatory Care Survey reported that 95% of the almost 7 million patients in the study sample who used at least 1 chronic pain medication, chose over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) as that pain reliever. In other words, household names like Tylenol and Advil. People will take pain medication without consulting a physician because they are sold over the counter, they do not have particularly strong warning labels or education around hazards and patient are very wary of prescription pain medications. Patients are also not familiar with non-medication based methods of pain relief and are much more apt to “take a pill” than to try something that might take longer to work or be perceived as less effective, ie, ice packs, massage, or menthol rubs.
However, there has been a recent push in the medical community to educate people around the hazards of NSAIDs. Just because something is sold OTC, you still need to use caution when using it. You should check with your physician if you are using it for anything more than occasionally pain relief, if you have any other chronic or acute condition that might interfere with it’s metabolism (liver, kidney, diabetes, gastrointestinal illnesses), or if you are are taking any medications that might interact with these OTC medications.
Even more disturbing is the fact that the population with the highest NSAID use are those over age 65 years. The American Geriatrics Society recently updated a list of medications that are potentially inappropriate in elderly patients. NSAIDs are listed to be avoided for chronic use in patients greater than 75 years of age due to GI issues. But chronic use can be difficult to monitor for an over the counter medicine. In addition, a new study has been published in BMJ Open, showing that taking NSAIDs for 2 or more weeks chronically can increase the risk for atrial fibrillation (a heart condition that can form clots and lead to stroke) substantially.
Let’s not leave the risks of NSAIDs unsaid.
http://www.jpain.org/article/S1526-5900(13)00462-8/abstract
http://bmjopen.bmj.com/content/4/4/e004059.full
http://www.medscape.com/viewarticle/762283_1
picture attribution:
By Michelle Tribe from Ottawa, Canada (500) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons