Think Twice About Pain Killers

coverI’ve used my unfair share of painkillers over the years, being a chronic migraine and body pain sufferer.  I’ve always considered them to be mostly harmless, moderately effective but too easy to pop.  About 3 years ago I discovered that the pain meds I had been prescribed for my migraines for the last 30 years had been clearly shown to actually increase recurrent migraines and since then I’ve gradually reduced my use. I thought that my bad experience was fairly unique and restricted to pain killers containing codeine and the triptans, but it seems that the bad news keeps on coming.

This weeks New Scientist points out that in the US there were 16,500 NSAID related deaths for Arthritis patients alone, even more worrying is data about the ‘mostly harmless’ paracetamol that we pop so frequently in the UK.  Recent research suggests that long term paracetamol use may result in as much internal bleeding as NSAIDS, a full unit of blood over a period of three months and two units when combined with ibuprofen.  In addition paracetamol accounts for 800,000 emergency room visits arising from overdoses in the US (most of them accidental). 

If it was effective maybe these risks would be acceptable, but out of seven studies that compared paracetamol to placebo two found it provided no benefit at all and the rest showed it’s effectiveness to be marginal.  In fact for paracetamol and aspirin (the two over the counter meds studied) for every 4 people who took them, only one person experienced a 50% reduction in pain, so I assume the other three experienced no benefit better than placebo.

So if they are risky and not very effective why do we take them so often well I think it comes down to three factors:

  1. they are too easy to get and very cheap
  2. the placebo effect means they feel more effective than they really are
  3. if you use them regularly the body develops a dependence on them and when you stop taking them you get a rebound headache, so you pop some more. 

As the NHS web site explains:

What happens is that your body gets used to the painkillers.  A rebound headache develops if you don’t take a painkiller within a day or so of the last dose. You assume it’s just another tension headache or migraine and take a further dose of painkiller.  When the effect of the painkiller wears off, another rebound headache develops and the cycle continues.

After reading the New Scientist article I did a bit of research into how frequently you can use painkillers before they would be considered a problem, the NHS web site provides this advice:

“If you take painkillers for your headaches more than twice a week for more than three months you’ll be at very high risk of getting rebound headaches,” says Dr Ahmed.

Twice a week is very worrying, exploring further the Migraine Trust is a little more relaxed:

The extent to which frequent usage of analgesics or triptans causes problems seems to vary from one drug to another, and in all likelihood varies considerably from one patient to another. Our experience is that over-usage of ergotamine, triptans and opiate based medications (from codeine-based products up to morphine) tend to cause problems most frequently, with paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen less likely to do so. The International Headache Society criteria for medication overuse reflect this, with opiate or triptan over-usage defined as ten days or more per month, whereas over-usage of paracetamol or NSAID is deemed to be present when these drugs are used 15 or more days per month.

Personally I try to keep my usage below 10 days a month and as an alternative I use 4Head, read the articles at source and make up your own mind. 

If you are anything like me though you will find that the less you use them, the less you will need them.  It’s also worth bearing in mind that headaches are often a signal that something is out of balance in your life, maybe you need to eat better, relax more, take more exercise, take a read through my simple guide to health for tips.

The photo today is of the cover of the New Scientist magazine, in case you didn’t guess!  Back to relaxing beach scenes tomorrow!

Steve Richards

I'm retired from work as a business and IT strategist. now I'm travelling, hiking, cycling, swimming, reading, gardening, learning, writing this blog and generally enjoying good times with friends and family

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