June 2008
Beware of overusing over-the-counter pain relievers
Non-prescription pain relievers are so ubiquitous you might think they're harmless. But all of them—including acetaminophen
(Panadol, Tylenol), aspirin (Bayer, Bufferin), ibuprofen (Advil, Motrin IB, and Nuprin), and naproxen (Aleve)—pose some risks,
especially if not taken as directed.
To gauge how people are using over-the-counter pain relievers, the Consumer Reports National Research Center conducted an online survey of 47,283 subscribers in 2007. Only 69 percent said they always or nearly always carefully follow instructions on the label. We also found the following:
Overuse might be even more prevalent nationally than among our readers, according to pain experts and published research.
Of the 36 million Americans using OTC pain drugs daily, 25 percent exceed the recommended dose, researchers reported in the
Journal of Rheumatology in 2005. Half were unconcerned about or unaware of potential toxicity.
WHY THEY'RE OVERUSED
Readers who routinely overused nonprescription pain relievers usually offered three explanations: The pain was severe, they felt no side effects, or their weight or height was above average. "They may have believed those were valid reasons, but they are rationalizations," says Penney Cowan, founder and executive director of the nonprofit American Chronic Pain Association, in Rocklin, Calif.
Other readers don't think of OTC products as being in the same league as prescription medicine. Debra Latimore, 52, of Whiting, Ind., told us she's been taking Advil for osteoarthritis pain daily since 2006 without telling her internist. "I forget to list it on doctor forms because it's over-the-counter," she says. "It's not something I think of as a drug."
One percent of surveyed readers suffering side effects from the use of OTC drugs visited a doctor or hospital in the past year for treatment. Nationwide, nonprescription analgesics were implicated in 1 to 3 percent of adverse events treated in emergency departments, researchers reported in the Journal of the American Medical Association in 2006. Overdoses of acetaminophen were the leading cause of acute liver failure in the U.S., according to a 2005 issue of Hepatology.
WHAT YOU CAN DO
Ask for advice. Your pharmacist or doctor can help in choosing an OTC pain reliever. Input is especially important if you're 60 or older, have underlying health conditions, or take other medications or supplements. If OTC pain relievers don't help, prescription drugs might. Ask about any confusing label instructions.
Investigate nondrug treatments. Research suggests that therapies such as acupuncture, counseling, biofeedback, and relaxation techniques might help.
Resources. For more on drug treatments, go to www.ConsumerReports.org/health for free CR Best Buy Drugs reports, updates, and safety alerts. For support, education, and pain specialists, go to the Web sites of these nonprofit groups: American Chronic Pain Association (www.theacpa.org), American Pain Foundation (www.painfoundation.org), and the National Pain Foundation (www.nationalpainfoundation.org).
To gauge how people are using over-the-counter pain relievers, the Consumer Reports National Research Center conducted an online survey of 47,283 subscribers in 2007. Only 69 percent said they always or nearly always carefully follow instructions on the label. We also found the following:
- 5 percent used OTC pain relievers daily for two weeks or more without a health expert's approval, ignoring label directions.
- 4 percent routinely took excessive doses without consulting a health professional.
- 4 percent experienced serious side effects, including ulcers and kidney, liver, and heart problems, that a health professional
said could be traced to use of OTC drugs.
WHY THEY'RE OVERUSED
Readers who routinely overused nonprescription pain relievers usually offered three explanations: The pain was severe, they felt no side effects, or their weight or height was above average. "They may have believed those were valid reasons, but they are rationalizations," says Penney Cowan, founder and executive director of the nonprofit American Chronic Pain Association, in Rocklin, Calif.
Other readers don't think of OTC products as being in the same league as prescription medicine. Debra Latimore, 52, of Whiting, Ind., told us she's been taking Advil for osteoarthritis pain daily since 2006 without telling her internist. "I forget to list it on doctor forms because it's over-the-counter," she says. "It's not something I think of as a drug."
One percent of surveyed readers suffering side effects from the use of OTC drugs visited a doctor or hospital in the past year for treatment. Nationwide, nonprescription analgesics were implicated in 1 to 3 percent of adverse events treated in emergency departments, researchers reported in the Journal of the American Medical Association in 2006. Overdoses of acetaminophen were the leading cause of acute liver failure in the U.S., according to a 2005 issue of Hepatology.
WHAT YOU CAN DO
Ask for advice. Your pharmacist or doctor can help in choosing an OTC pain reliever. Input is especially important if you're 60 or older, have underlying health conditions, or take other medications or supplements. If OTC pain relievers don't help, prescription drugs might. Ask about any confusing label instructions.
Investigate nondrug treatments. Research suggests that therapies such as acupuncture, counseling, biofeedback, and relaxation techniques might help.
Resources. For more on drug treatments, go to www.ConsumerReports.org/health for free CR Best Buy Drugs reports, updates, and safety alerts. For support, education, and pain specialists, go to the Web sites of these nonprofit groups: American Chronic Pain Association (www.theacpa.org), American Pain Foundation (www.painfoundation.org), and the National Pain Foundation (www.nationalpainfoundation.org).
