Surprising Dark Side of OTC Pain Relievers

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Aches and pains are sometimes more than just an inconvenience. Sometimes they can prevent us from doing the things we need or want to do in life. So for millions of men in the U.S. over the counter drugs are the way to find relief. Unfortunately, although most of the drugs are safe when used infrequently and cautiously, they also carry some serious dangers. Because these common drugs are available without a prescription - even in convenience and grocery stores - many men mistakenly think they are harmless. However, these drugs lead to hundreds of thousands of emergency room visits and thousands of deaths every single year in the United States. Learning how to stay safe and what to do in case of an accidental overdose can save your life. Read on and learn.

Tylenol: The Danger Lurking In Your Cabinet

Tylenol is the popular brand name for a drug called acetaminophen, which is also sold under other names in the United States and elsewhere. And it is included in 600 different over the counter drugs. Unlike many other pain relieving drugs, Tylenol is not an anti-inflammatory drug. It does reduce fever and relieve pain, but differently than drugs such as aspirin or ibuprofen.

Because acetaminophen works differently than other popular pain relieving drugs, it doesn’t have some of the same side effects. In particular, it is not irritating to the stomach and it doesn’t cause problems for those with salicylate allergies. These facts make it safer than some other drugs in some situations. For example, acetaminophen is safer than aspirin for someone with a severe salicylate allergy or a stomach bleeding problem. However, in all other ways, acetaminophen is the most dangerous of the bunch.

According to the U.S. federal Consumer Products Safety Commission's (CPSC), nearly 80,000 people land in the emergency room for acetaminophen-related injuries each year in the U.S.. Of those, nearly 500 die.

What makes those numbers even more startling is the fact that according to the CPSC, only 30 percent are injured from overdoses (almost all of which are accidental). That means that 56,000 people every year land in the hospital for acetaminophen harm despite taking less than the recommended amount.

The main harm caused by acetaminophen is liver damage. The 500 people who die each year die due to liver failure. And many more people don’t die, but end up with long-lasting liver injury or have to have a liver transplant.

So long as you take no more acetaminophen than your liver can handle, you will be safe. Your liver is able to process many toxins without permanent harm. However, if you accidentally take more than your liver can handle at that time, the toxins will harm the liver instead.

What should you do? If you choose to take acetaminophen, be aware of the risks. Most people who take the drug do not end up in the hospital, but enough do that it is important to know that is a possibility. Be conservative with your use of the drug. Use the minimum amount needed to offer satisfactory pain relief. Use the drug no more often than recommended. And never use more than is recommended. Also, never drink alcohol with acetaminophen or within a day of using the drug. Alcohol makes acetaminophen even more toxic to the liver.

Additionally, read labels of all drugs carefully. Since 600 different drugs contain acetaminophen, you should be sure that you aren’t accidentally combining several of them and going over the maximum dose. In the U.S. acetaminophen will be spelled out as such or it will be abbreviated APAP. Products from other countries may use the name paracetamol instead.

If you accidentally take too much, don’t panic. It is a serious matter, but it doesn’t need to be fatal. Experts say that those suffering from too much acetaminophen will not be able to overlook the symptoms, which typically include nausea, vomiting, sweating, and pain, especially in the area of the liver (on the right side at the base of the ribcage). These symptoms typically start several hours after ingestion. Death does not occur typically for approximately 5 days. However, the sooner action is taken, the better.

What action should you take? Going to the hospital may be the best course of action. In the hospital the standard treatment for acetaminophen overdose is to administer the N-acetyl cysteine to prevent further liver damage. N-acetyl cysteine is available as a nutritional supplement. While taking N-acetyl cysteine on your own may not serve as an adequate substitute for an emergency room visit (in other words, seeking out qualified medical help for such a medical emergency is a smart thing to do), having some on hand might not be a bad idea. The sooner it is taken the better. Most experts agree that it works best if taken within 8 hours of ingesting the drug.

Non-Steroidal Anti-Inflammatory Drugs Also Unsafe

A class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs) includes drugs such as ibuprofen and aspirin. NSAIDs combined cause 16,500 deaths per year in the United States.

NSAIDs are generally not as as acutely dangerous as acetaminophen. Although they can produce serious adverse reactions after just one use, those effects are less common. More common are adverse effects resulting from chronic use.

Whether resulting from acute or chronic use of NSAIDs, some adverse symptoms include stomach bleeding, strokes caused by bleeding in the brain, high blood pressure, and kidney damage.

Reaching for a NSAID for occasional use is likely safe for most men. However, if you have pre-existing kidney disease you should be cautious. Those with salicylate allergies should avoid aspirin. And for all but aspirin, pre-existing heart disease or high blood pressure may be a reason to think twice before using NSAIDs. And no matter what, stay safe by using no more than is needed to offer adequate pain relief. Avoid chronic use of any NSAID unless you are confident that you are educated about the risks.

What To Do?

For many men it is safe to use over the counter pain relieving drugs infrequently and using no more than recommended. But they are not without serious risks. Therefore, it is advisable to fall back on those drugs only when necessary.

If you are in the habit of reaching for over the counter pain relieving drugs often, consider safer alternatives first. Not only are some alternatives safer, some may offer long term relief rather than a temporary fix.

Depending on the condition for which you are seeking pain relief, the alternatives will vary. We’ll explore many of these topics in other articles in more depth. But here are some examples. For recurrent migraines studies show that the herb feverfew may be more effective than drugs. For joint or muscle pain due to inflammation, natural anti-inflammatory extracts such as curcumin or boswellin are clinically proven to offer safe, side-effect free relief to many. For neuralgia temporary relief can be found with topical application of capsaicin creams. And for many types of chronic pain diet and lifestyle changes can offer long term relief. For example, studies show that walking just 6000 steps per day can reverse knee arthritis pain for many people and removing sulfites from the diet can relieve migraines for those who are allergic to sulfites.

Over the counter pain relief drugs can offer much needed relief to many and improve their quality of life when used sparingly and correctly. But stay safe by knowing the dangers, taking precautions, and seeking out safer alternatives first. Do these things, and you can enjoy a fuller, freer life.

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