What Are the Long-Term Effects of Over-the-Counter Pain Relievers?

Almost everyone has had pain before Not severe pain, not enough to warrant a doctor visit or rush to the emergency room. Just the plain old everyday headaches, cramps, bumps, bruises, and boo-boos that send us reaching for the bottle in the cabinet. Over-the-counter pain relievers have become a part of everyday life, but many people are not aware of the dangers of long-term use of our NSAID friends, which can be severe and life-threatening.

Most over-the-counter pain relievers are NSAIDS, or non-steroidal anti-inflammatory drugs. These include aspirin, ibuprofen, and naproxen. These work by acting as inhibitors on the enzyme cyclooxygenase, which otherwise would produce the molecules that cause pain, swelling, and clotting. They can effectively stop mild to moderate pain, without the possible mental side-effects of narcotic pain killers.

Today, almost every household in America has a bottle of pain relievers, each one equipped with the warning label we have all become accustomed to. Studies on these drugs prove that in most cases, the positive effects outweigh the negative, however, in an unfortunate few, the risks can be far worse than they ever thought.

All NSAIDs have the risk of causing gastrointestinal (GI) problems in people who take them, especially when taken regularly for a long time. The medicines can cause wear and tear on the GI tract, which can lead to stomach pain, ulcers, bleeding, or even death. One study conducted in 2000 by the Department of Clinical Pharmacology at the University of Oxford showed that people who take aspirin long-term show a "significant increase in the incidence of gastrointestinal hemorrhage."

The risks of GI problems go up in people that have a history of GI problems or eat or drink substances that are harmful to the GI tract along with taking a NSAID, such as alcohol. Drug companies have been trying to find ways to make their medicines less harmful to the stomach and intestines, however, the effectiveness of these methods are still not known.

One of the benefits of NSAIDs, especially aspirin, is the blood-thinning effects, which is why it is often recommended to help reduce risk of ischemic stroke or heart attack. Unfortunately, the medicines may also cause bleeding problems.

Bleeding problems that have been attributed to NSAIDs, besides GI bleeding, is high blood pressure and bleeding in the brain. Micro-bleeding in the brain is thought to be linked to taking NSAIDs, which can lead to hemorrhagic strokes, especially in those who are already at risk.

Reye's Syndrome is a deadly disease, the risk of which is thought to be increased by the use of aspirin, especially in children. It primarily affects the liver, causing fat to build up in it, and the brain, causing inflammation. The disease causes a lot of damage to almost every organ in the body, eventually leading to coma, organ failure, or death.

For this reason, the CDC and the FDA have advised that giving aspirin to children ages 18 or under should be done only after consulting with a doctor, especially in cases where fever is present.

Other problems that have been attributed to long-term NSAID use include:

• Photosensitivity (more easily sunburned)
• Fluid retention
• Dizziness
• Drowsiness
• Diarrhea
• Noise sensitivity or increased hearing loss
• Erectile dysfunction
• Kidney problems or kidney failure
  

In order to better understand if you are at higher risk of seeing any ill-effects associated with over-the-counter pain relievers, be sure to talk to your doctor before you start taking them, or if you develop severe symptoms. As with any medicine, carefully monitor your dosage. Remember, just because a drug is "over-the-counter" does not mean there are no risks involved with taking it!