How Safe Are Your Pain Medications?

15 April 2015
15 April 2015, Comments: Comments Off on How Safe Are Your Pain Medications?

As the “baby boomer” generation enter its Medicare years the prevalence of arthritis and musculoskeletal pain is increasing at an accelerating pace. Some call this epidemic of chronic pain America’s biggest health problem. According to a 2011 report by the Institute of Medicine (part of the National Academy of Sciences) chronic pain will affect at some point 100 million Americans (40% of the adult population). Chronic pain is the number one reason Americans go to doctors.

Probably the most common treatment for chronic pain is the use of medications, either prescribed or over the counter. A particular kind of prescription pain medication, opioids, have been making news in the past few years due to the sharp increase in both the amount prescribed, and the number of people overdosing, and sometimes dying, with these medications. The number of prescriptions for opioid medications increased ten-fold from 1999 to 2010. Over the same period of time, and according to data provided by the Centers for Disease Control (CDC), the annual number of deaths attributed to opioid overdose increased from about 4,000 to more than 16,500.

Because of the media attention and the responses from government agencies, most Americans are aware of the potential serious side effects and complications that arise from the use of opioid pain killers. However, most Americans tend to underestimate or ignore the risks, sometimes serious, of other kinds of medications used to treat pain. Many of these medications are now sold without prescription, so, many patients assume that they are completely safe.

One type of non-narcotic pain medication that is frequently used to treat pain is non-steroidal anti inflammatory (NSAID’s). Examples of NSAID’s include Celebrex, Naprosyn, Motrin, and over the counter Aleve, Advil, etc. It is estimated that every year there are more than 70 million prescriptions written for NSAID’S and more than 30 billion pills/tablets are sold over the counter. These medications are considered by many Americans to be completely safe, and certainly much safer than opioids. However, the reality is that these medications are responsible for a large number of hospitalizations, and the deaths of several thousands of Americans every year, mostly due to gastrointestinal bleeding. As a matter of fact, before the recent sharp increase in the number of deaths attributed to opioids, NSAID’s were by far the number one reason for drug associated deaths in the USA.  The number of hospitalizations due to use of NSAID’s is over 105,000 per year. A 1999 paper published in the New England Journal of Medicine estimated the number of deaths associated with NSAID’s to be around 16,500 per year (about the same as the number of deaths caused by opioid overdose in 2010). That estimate has been challenged as being too high, and in 2010 a paper by Dr. Daniel Solomon in the Archives of Internal Medicine calculated the hazard ratio, and the mortality risk for each type of pain medication and found opioids to have a higher relative risk as compared to NSAID’s.

So, the use of opioids appear to involve more risks than the use of NSAID’s, but NSAID’s still carry a significant risk; a risk that is often not recognized by patients. Even acetaminophen (Tylenol) can be risky. Approximately 1,000 Americans die every year due to complications produced by medications containing acetaminophen. That number is very small compared to the number of deaths associated to the use of opioids or NSAID’s, but, a fact to remember is that intoxication with acetaminophen is the number one reason for calls to Poison Control Centers, resulting in some 100,000 calls per year.

It is important to realize that, not only opioids, but all and any medication used to treat pain can potentially produce serious side effects and even death. Therefore, reducing and minimizing the use of medications should be part of the goal of treatment for arthritis and chronic musculoskeletal pain. A good diet, nutritional supplements, a regular exercise program, and avoiding a metabolic syndromes may help protect against the development of osteoarthritis and chronic musculoskeletal pain. But, if arthritis or chronic musculoskeletal pain occur, then regenerative medicine therapies offer a safe, effective, non-surgical alternative for treatment.

To learn more about non-surgical alternatives to joint surgeries go to: .