Not Just Opioids: NSAID, Ibuprofen Abuse Common, Many Unaware Of Risks Of OTC Pain Relievers
We’ve all heard about the tragedies of the opioid epidemic – but underlying opioid abuse is another widespread crisis, of sorts – chronic pain. According to the National Center for Health Statistics (2006), more than 76 million, or one-quarter of all Americans, have experienced pain that lasts longer than 24 hours. Indeed, chronic pain is the most common cause of long-term disability.
Therefore, we should not be surprised that opioids aren’t the only pain-relieving drugs being overused. New research has found that a substantial number of Americans are taking too many over-the-counter pain remedies, as well.
According to the study, for example, among those surveyed who use ibuprofen (i.e. Advil) or other nonsteroidal anti-inflammatory drugs (NSAIDS), 15% reported exceeding the maximum daily dosage.
NSAIDs are a class of medication that includes aspirin, Advil, Motrin, naproxen sodium, and the prescription pain reliever Celebrex.
For the study, researchers monitored the weekly intake of NSAIDs of 1,300 adults from 2015-2016. All subjects had used an ibuprofen medication at some time during the month before completing their reports.
Many subjects stated they’d taken more than the maximum daily limit of a single NSAID, had used two different NSAIDs in combination, or had taken a second dose earlier than recommended.
David Kaufman, study author and director of Boston University’s Slone Epidemiology Center, per HealthDay News:
“…most NSAID use is over-the-counter with users deciding what to take without involvement by health care providers.”
Kaufman contends that NSAID abuse may cause serious side effects, which may include gastrointestinal bleeding and an increased risk of cardiac arrest. He believes his team’s findings “can help guide programs that will lead to safer NSAID use.”
About the Study
The study participants had an average age of 45, 75% were Caucasian, and around 60% were women.
About 85% stated they had taken over-the-counter ibuprofen during the seven days they recorded their use. About 37%, however, also took other NSAIDs. Aspirin was the most common, followed by naproxen sodium.
Oddly, less than 40% actually knew that the medications there were using were, indeed, NSAIDs. Also, 11% of ibuprofen users and 23% of naproxen users recorded taking more than the recommended daily dosage at least one time during the week.
In total, about 15% of study participants had exceeded the dosing indications for at least one NSAID on at least one day during the week.
Researchers also found that the risk for excessive NSAID use was higher among those who were in poor physical condition and also battled chronic pain. Participants who had a relatively poor knowledge about appropriate dosing also had a higher risk.
Kaufman somewhat negated the idea that participants were using excessive amounts of NSAIDs to avoid opioid painkillers:
“My guess is that while avoidance of opioids may influence prescribing decisions by doctors, it may not affect consumer behavior very much.”
Rather, Kaufman posits that some consumers may simply opt to use an excessive amount of medication, but also that such behavior could be mitigated with improved education.
Side Effects Of NSAIDS
The side effects of NSAIDs are similar across the different types (aspirin, ibuprofen, and naproxen sodium) and may include:
- upset stomach, heartburn, indigestion, nausea, and vomiting
- gastritis, gastrointestinal ulcerations, and abdominal pain
- bloating, gas, diarrhea, and constipation
- dizziness, headache, and nervousness
- mild itching, rash, or tinnitus (ear ringing)
- dizziness and drowsiness
- increased bruising and bleeding
Many Do Not Know The Risks Of Acetaminophen (Tylenol)
While there do not appear to be any recent studies on the use or overuse of acetaminophen (Tylenol), there was a survey in 2013 that revealed many Americans have a lack of understanding of the potential risks of using this medication.
Moreover, around half stated that they were unaware of any safety warnings associated with using acetaminophen. Still, 4 out of 5 did say that overdosing on the medication could result in serious side effects.
Over one-third of those surveyed believed it was safe to combine Tylenol specifically with another medication that contains acetaminophen. This action, however, could result in an accidental overdose.
The findings suggest only modest success for both the required labeling on packages of Tylenol that intend to warn consumers about the dangers of the medication.
Since 2009, the FDA has required that OTC acetaminophen have a warning label that the medication can cause severe liver damage. It also required that prescription drugs that contain acetaminophen warn that an overdose can be fatal. This warning is not required for OTC acetaminophen, however, and in reality, about 60% of the medication is sold without a prescription.
When used as indicated, acetaminophen is most often safe, with very few side effects. But in excessive doses, it can damage the liver with painful and deadly consequences.
According to the Centers for Disease Control and Prevention, about 150 people die from accidental acetaminophen overdoses every year. Thousands more are admitted to emergency departments and hospitals due to acetaminophen poisoning.
The FDA refers to acetaminophen toxicity a “persistent, important public health problem.”
~ G. Nathalee Serrels, M.A., Psychology