An NSAID is a nonsteroidal anti-inflammatory drug (such as aspirin and ibuprofen). According to Medscape, over 30 billion doses of NSAIDs, including over-the-counter and prescription usage, are consumed in the United States each year. Over 25 billion doses of acetaminophen are sold per year, according to the U.S. National Library of Medicine.
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The Deadly Truth Behind Painkillers
Consumption of NSAIDs and Acetaminophen
The two major categories of pain relievers, or analgesics, are NSAIDs and acetaminophen. They can be available either over the counter or by prescription.
According to the U.S. Food and Drug Administration (FDA), 980 deaths each year are attributed to drugs containing acetaminophen. However, the American Association of Poison Control Centers (AAPCC) attributes 113 annual deaths to overdosing on medications with acetaminophen. These estimates can be highly inaccurate. Studies use mathematical models and assumptions instead of using reported cases, and data sets fail to account for the number of deaths resulting from chronic NSAID usage.
Acetaminophen is not an NSAID. Common brand-name drugs containing acetaminophen include Pain-Eze and Tylenol. It is often used to treat headaches, and over 25 billion doses are sold each year.
Aspirin is one of the most prevalent NSAIDs, with over 100 billion tablets being produced per year. Aspirin is used to prevent stroke and heart attacks, and it is sold under the following brand names: Anacin, Bayer, Bufferin and Excedrin. Ibuprofen is commonly used to treat sore muscles, fevers, hangovers, menstrual cramps and sinusitis. This drug is available under the brand names Advil, Motrin and Nuprin, and over 20 million prescriptions are written for it each year. Naproxen is often used to lessen symptoms of hangovers and arthritis, and it is available under several brand names, including Aleve and Naprosyn. Over 10 million Naproxen prescriptions are filled per year.
The Side Effects and Adverse Events
While uncommon, acetaminophen and NSAIDs are capable of causing unpleasant side effects and adverse events, which may make individuals hesitate before taking a painkiller.
How Painkillers Work
Painkillers interfere with pain messages sent to the brain via nerve endings, which affects the brain, spinal cord or injured area.
NSAIDs work by blocking the creation of prostaglandins by special enzymes Cox-1 and Cox-2. The tissue does not swell, and the pain message coming from the nerves becomes muted without prostaglandins.
Researchers have been debating whether acetaminophen targets serotonin (5HT) neurotransmission within the central nervous system. However, the currently prevailing hypothesis claims that acetaminophen works by inhibiting the COX enzyme, which relieves pain and reduces fever.
How Side Effects Are Caused
NSAIDs can cause high blood pressure and kidney damage by reducing blood flow to kidneys, making them work more slowly. This could lead to a build-up of fluids and high blood pressure.
NSAIDs can also cause gastrointestinal problems by preventing prostaglandins from being created. Prostaglandin helps protect the stomach lining and GI tract. Without a sufficient amount of prostaglandins, the GI tract can become irritated and damaged by gastric acids, leading to gastric bleeds and gastritis.
Painkillers may make people with asthma more susceptible to extreme allergic reactions, but experts are not sure about what causes this problem.
Side Effects of Acetaminophen
Acetaminophen can cause Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Adverse events linked to acetaminophen use include liver damage with the potential to cause liver failure or death within days. Combining acetaminophen and alcohol can also cause kidney damage and increase the risk of kidney disease.
Side Effects of NSAIDs
Aspirin can cause heartburn, nausea, stomach pain and vomiting. Adverse events connected to aspirin use include hives, stomach bleeding and stroke, among others.
Ibuprofen can cause nausea, diarrhea, peripheral edema and more. Some adverse events associated with ibuprofen use include liver injury, liver failure and severe hypersensitivity reactions.
Naproxen can cause an array of side effects, including dizziness, headache, heartburn, dyspepsia and nausea. Adverse events resulting from naproxen use can include acute hepatitis and liver failure.
Healthier and Safer Alternatives
Long before pharmaceutical companies created fast-acting painkillers, humans learned how to utilize a variety of natural remedies to treat ailments like joint pain, headaches or digestive discomfort. Nowadays, individuals are using yoga or mindfulness meditation to manage pain. Natural alternatives for back and joint discomfort include turmeric, capsicum/capsaicin, glucosamine/chondroitin, and herbs such as comfrey and devil’s claw root. Natural alternatives for headaches include caffeine, white willow bark and a type of tree resin known as boswellia.
Other Natural Alternatives
Probiotics can be used to help reduce inflammation and signs of irritable bowel syndrome. Omega-3 fatty acids can be used to help reduce joint and back pain, inflammation and pain resulting from menstrual cramps. Curcumin can be used to help reduce inflammation, treat digestive disorders and promote wound healing.
Yoga and Meditation
Yoga may be able to reduce chronic lower back pain and improve function while lessening symptoms of anxiety and depression.
Meditation “may reduce blood pressure, symptoms of irritable bowel syndrome, anxiety and depression, and insomnia. Ultimately, deciding whether to take a painkiller as the first course of action to relieve pain or discomfort is up to the individual. However, seeking out information explaining the positive and negative aspects of a painkiller is recommended in order to make an informed decision.