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Pain Relievers Pose Predicament

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There is bad news for people in pain. Those who have had a heart attack raise their risk of another if they take popular pain relievers such as celecoxib (Celebrex), diclofenac (Cataflam, Voltaren), ibuprofen (Advil, Motrin, etc) or naproxen (Aleve). That's what Danish researchers concluded after studying medical records for roughly 84,000 patients (Circulation, May 24, 2011).

It's not just people with heart disease who may be at risk. In 2004 the popular prescription pain reliever Vioxx was pulled off the market because it was linked to an increased risk of heart attacks and strokes in seemingly healthy people.

Vioxx raised a warning flag. Then researchers found that other nonsteroidal anti-inflammatory drugs (NSAIDs) might be hazardous to the heart. Not only do such drugs raise blood pressure, they also damage the lining of the stomach. For some, that can lead to bleeding ulcers.

Many people switch to acetaminophen (APAP, Tylenol) if they need pain relief without digestive distress. This ingredient is also found in many prescription narcotics, such as hydrocodone with APAP (Lorcet, Lortab, Vicodin) or oxycodone with APAP (Percocet, Tylox).

Now, even acetaminophen is under fire. High doses can be toxic to the liver. Because many consumers are unaware of the ingredients in products such as cold remedies, allergy pills, cough medicine and nighttime pain relievers, some people can end up with an unintentional overdose of acetaminophen.

Long-term use of acetaminophen has just been linked with certain blood cancers. People who took acetaminophen-containing products at least four days a week for four years or more had nearly double the risk of being diagnosed with leukemia or lymphoma (Journal of Clinical Oncology, online May 9, 2011).

Because blood cancers are rare, the impact of acetaminophen was quite small overall. Nevertheless, there is growing recognition that a medication perceived to be one of the safest drugs in the pharmacy may have some unexpected risks.

Another potential complication associated with acetaminophen is asthma. Several studies have suggested that regular use might be linked to an increased risk of wheezing or asthma (Chest, Nov. 2009; American Journal of Respiratory and Critical Care Medicine, Jan. 15, 2011).

Hearing loss is an additional risk that may arise from regular use of over-the-counter pain relievers. It has long been known that aspirin or NSAIDs can cause tinnitus (ringing in the ears). A study in the American Journal of Medicine (March 2010) found that even acetaminophen use may boost the risk of hearing loss. The youngest men in the study, those between 45 and 50, almost doubled their likelihood of hearing problems if they took acetaminophen frequently.

It's tragic that people in pain don't have safer, more effective options. All of the commonly used pain relievers have downsides.

It's hardly any wonder that people are seeking more natural approaches, especially for chronic inflammatory conditions. Our Guide to Alternatives for Arthritis offers a number of these, from herbs such as boswellia and turmeric to foods like cherries and pineapple.

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6 Comments

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I don't take Rx pain meds, but I do take extra strength Excedrin (generic) because it helps, with the combination of aspirin, acetaminophen and caffeine. I also have to take an aspirin a day for my blood. (yes the doc knows I take the Excedrin). I thought I was doing so good to stay away from the Rx pain meds but now I'm wondering if there's anything I can take to help with my chronic pain.

If not for the nabumatone, I wouldn't be functioning. It's an anti inflammatory I take 2X a day (Rx) When I don't take that, I can't function. Is there anything out there that's safe anymore??? If anyone has any suggestions, please let me know.....

Pain medications have little effect on my body. Yes, even the morphine and Oxycodone given while under cancer treatment did practically nothing. For severe enduring pain I have found that meditation (TM) helps to get through it as well as using magnets. No, it doesn't take the pain away but makes it more livable.

There are millions of people living with pain that could be helped with these two remedies. It is not easy learning TM but it is well worth it.

Debi, I've lived with chronic pain off and on since a bad fall in '88, Pain meds don't work on me-no, not even the heavy duty stuff. Dr. Donsbach offers a remedy made with curcurmin called RE-LEV-IT that does work. I always take it with a digestive enzyme. If I don't it doesn't always work. His site is letstalkhealth.com.

Thank you for this article. My mother had tinnitus for 30 years before she died in April. No doctor could ever help her suffering with the constant ringing in her ears. No one could ever give her a reason for her having the problem, either. She told me that I'd probably, eventually, have it, too. (A doctor told her that it was genetic) This article gives me answers that would make sense in answering my mom's question of "why".

She took an over abundance of pain meds throughout her life thinking there would be no side effects. I don't live with pain but I do have pretty bad allergies. I take a Zertec daily. Am I doing damage to my liver? Taking it daily helps me not to have any symptoms but maybe I should wait for symptoms before I take anything. Please advise. Thank you. Frances in California

My Dr recently changed my pain med from motrin to diclofenac, I have been having chest pains and was concerned- reading your column I believe has saved my life. Thank YOU! I have chronic pain from a knee replacement- this is the 1st time I've read your column- I don't normally buy the Sunday paper.

Did you neglect to mention the common NSAID, aspirin, on purpose? So many of us take a daily aspirin tablet (either 81 or 325 mg.). Of course your Dr. should help you decide which, if any aspirin tablets you should take because it can be really hard on some people's stomach lining.

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