DR. HOOK- Hurtin': Pain meds can harm more than help

Americans probably swallow more NSAIDs (nonsteroidal antiinflammatory drugs) than vegetables. There are over 50 types of NSAIDs out there, including aspirin, ibuprofen, Celebrex, naproxen, and acetominophen. Personally, I love veggies because they're so healthy, fresh, and tasty– and I'm talking about un-fried veggies (I know, not very Southern of me). Fresh vegetables are good for your heart (as is exercise), although taking a daily aspirin seems to be easier for most Americans to reduce the risk of a heart attack.

Over 17 million Americans take NSAIDs everyday for pain or their heart. Look at how many NSAID commercials are vying for your attention (and money). "Headache, backache, heartache? Take our NSAID!" Sure, no one likes to be in pain (well, almost nobody), but as with all good things, there are side effects of NSAIDs. 

"Through the lips and past the gums. Watch out, tummy, here it comes." The most common complaint of NSAID users is "It's tearing up my stomach." Gastric and duodenal ulcers can develop with NSAIDs because these anti-inflammatory medicines inhibit production of prostaglandins– something that protects the stomach lining from acid. 

I know when I take NSAIDs, I feel like a habanero pepper is having a fiesta in my stomach. Ole, ouch! If the ulcer gets too bad, it can bleed, which can be deadly. Five to seven percent of hospital admissions are due to adverse effects of NSAIDs, and GI bleeds are one of the big complaints.

Acetominophen (Tylenol) does not cause ulcers and is different from the other NSAIDs. But it's not an anti-inflammatory like the others. The COX-2 inhibitors like Celebrex and Mobic don't decrease the prostaglandins as much as the other NSAIDs, but still ulcers and gastritis can occur. That's why many NSAIDs users take an antacid like Prilosec to reduce the risk of ulcers. But not everyone with ulcers or even bleeding ulcers has symptoms such as stomach pain or nausea, which presents a problem.

Platelets don't clot up as easily in the presence of NSAIDs, so there's increased risk of bleeding. Petechiae, spot-like bruises, can occur– it looks like a rash. Some NSAID users ask me, "Why do I look like an extra from a Jackie Chan movie?" Some of the NSAIDs can fatally stop the bone marrow from working, so red and white blood cells aren't produced.

Some people are allergic to NSAIDs and can get nose polyps, rashes, or a type of pneumonia. I'm telling you, being allergic to pain medicine is worse than being allergic to Simon Cowell, because you can't sing your pains and inflammation away like on American Idol.

Although aspirin has been shown to reduce heart attacks and the main type of stroke, the other NSAIDs might actually reduce the effectiveness of aspirin. So there's a slightly increased risk of heart attacks for NSAID users who rely on aspirin for their hearts. Also NSAIDs can drive the blood pressure up in hypertensive folks.

Think someone is talking about you? Well, that ringing in your ears (tinnitus) might be from using too many NSAIDs. Worse than tinnitus is having psychosis and cognitive problems from NSAIDs, particularly evident in the elderly. 

So many people abuse over-the-counter NSAIDs, thinking, "More is better." They take NSAIDs like eating M&Ms and end up with liver and/or kidney toxicity. I'm amazed to hear how many NSAIDs pills people use due to misinformation. Talk to your pharmacist or doctor first!

NSAIDs are safe to use, in particular if used correctly. But it isn't as safe as chicken soup, so watch out for those side effects. I think I have NSAID enough.

Dr. Hook cracks a joke or two, but he's a renowned physician with a local practice. Email him with your questions.


1 comment

Dr. Hook,
I liked your article and the style you used to write it.

I have had Reiter's Syndrome since 1972 (when diagnosed) and most likely had it since I was six years old (I remember sore ankles, etc). I've taken many NSAIDs but the worst was Vioxx.

I've also been on MTX. That was harder on my system than all the NSAIDs combined. I did take Carafate (Sucralfate). That helped quiet my stomach within fifteen minutes but I had to take Carafate several times daily.

I must have a cast iron stomach or more because I have so far avoided ulcers. Vioxx gave me GERD for which I take Protonix. I also got TIAs and strokes (for which I take Aggrenox, Verapamil, and Clonazepam).

In a future article you may wish to show how Big Pharma peddles its drugs and their consequences. The consumer and those who pay medical insurance get to pay for these "activities."