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What do you call it when a warning is issued and no one pays attention to it?

This is the case with common pain medications. The FDA has repeatedly issued very strong warnings to advise healthcare professionals and consumers of the potentially deadly risks associated with pain relievers sold across the counter, yet these warnings are often ignored.

Over the counter (OTC) pain pills such as Motrin, Advil, Tylenol and countless other brand names are so commonly available and so inexpensive that many have come to think of these products as completely safe, innocuous, harmless and safe to take every day.

They are not.

As an example, I am treating a patient today that was recently released from the hospital after several days of treatment for a bleeding ulcer. She had been taking over the counter ibuprofen for weeks for back pain. The hospital physicians informed her that her ulcer resulted from her pain meds.

I asked this patient if she knew that the ibuprofen she was taking could be so dangerous. “I do now.” She replied somberly.

If you are in the habit of taking pills such as these daily or even several times a week, it is important that you stop for a moment to consider the following factual information.

The United Stated Federal Food and Drug Administration has repeatedly issued warnings about the potentially dangerous side effects of non-steroidal anti-inflammatory drugs (NSAIDs). Below is a paragraph taken directly from the FDA website concerning these kinds of products (including Advil, Motrin, Ibuprofen, Aleve, Naprosyn and other drugs of the same type):

“The U.S. Food and Drug Administration (FDA) is strengthening an existing label warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) increase the chance of a heart attack or stroke. Based on our comprehensive review of new safety information, we are requiring updates to the drug labels of all prescription NSAIDs. As is the case with current prescription NSAID labels, the Drug Facts labels of over-the-counter (OTC) non-aspirin NSAIDs already contain information on heart attack and stroke risk. We will also request updates to the OTC non-aspirin NSAID Drug Facts labels.

Patients taking NSAIDs should seek medical attention immediately if they experience symptoms such as chest pain, shortness of breath or trouble breathing, weakness in one part or side of their body, or slurred speech.” 

Many readers may be surprised by the strong language and some may even think, “I didn’t know about that, nobody told me.” Yet this message is clearly written on the package.

But most people never read the labels on products such as these and certainly not the very small print.  You should.

Here are some facts as reported in medical journals about NSAIDs (These are drugs such as aspirin, ibuprofen and naproxen –branded as Motrin, Advil, Aleve, Naprosyn and others.)

• NSAIDS account for 30 percent of hospital admissions for adverse drug reactions (ADR) each year

• From the first dose, taking these common drugs increases risk of gastrointestinal bleeding and ulcers

• Even short-term use of drugs such as Motrin and Advil elevates the risk of heart attack and stroke

• These risks increase as the drug is continued and with higher doses

• These risks are higher for older patients

• These drugs can increase blood pressure and fluid retention

• NSAID’s adversely affect kidneys and can cause serious or potentially deadly kidney damage

What about patients that only use the drugs occasionally?  Unfortunately, the FDA reports that they cannot advise that occasional use is free of risk. From the FDA website: “There is no period of use shown to be without risk,” says Judy Racoosin, M.D., M.P.H., deputy director of FDA’s Division of Anesthesia, Analgesia, and Addiction Products.”

This information causes concern for prescribers and patients alike. There is obviously a very serious problem with the use of narcotic pain drugs (opioids) in our country. Steroid drugs and injections have significant risks as well. Patients and prescribers are trying to find safe ways to alleviate chronic pain. If the NSAIDs have such a significant risk of adverse effects, what options are available for the pain?

Your primary care doctor or specialist may be able to make recommendations on how to minimize the risk of adverse effects of your medications. For some patients NSAIDs may still be recommended by their doctor, recognizing and making efforts to minimize the risks.

For many patients a viable solution is to consider drug-free alternatives for chronic pain. Many medical physicians are beginning to change their thinking and are actively seeking drug-free solutions such as acupuncture or chiropractic care. 

In our office we routinely see referrals from area medical physicians for patients experiencing chronic pain. We receive several referrals from local primary care medical physicians and specialists each week.

Although it is a good thing that area physicians are referring patients to our office more routinely, the good news is that no referral is necessary. Anyone can make an appointment for a free consultation without a referral.

To increase your chances of living a better, longer life with less risk of drug side effects it may be time to consider drug-free alternatives

Dr. Mark Kestner is a chiropractor in Murfreesboro. His office is at 1435 NW Broad St. Contact him at mkestner@DrKestner.com.

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