Pain pills revealed as major killer

Every year, people consume 26 billion over-the-counter (OTC) aspirin and non-aspirin pain relievers, and doctors write more than 100 million prescriptions for these drugs. Although they are touted as being "safe and effective," these pills are responsible for almost as many deaths as AIDS.

In a report published in the New England Journal of Medicine, researchers at Boston University School of Medicine (BUSM) discussed significant and potentially fatal side-effects of nonsteroidal anti-inflammatory drug (NSAID) use. NSAIDs include medications such as aspirin, ibuprofen (Advil, Motrin), naproxen sodium (Aleve, Naprosyn, Naprox), diclofenac (Voltaren), indomethacin (Indocin), and many others.

M. Michael Wolfe, M.D., professor of medicine at BUSM and chief of the section of gastroenterology in the department of medicine at Boston Medical Center led the study.

"This is, in many ways, a silent epidemic because gastrointestinal complications are not preceded by any warning signs in a majority of individuals," said Wolfe. Many primary care physicians and consumers may not necessarily be aware of the potential for NSAIDs to cause serious and sometimes fatal side-effects.

"Only a minority of patients who have serious gastric complications reported any kind of discomfort or dyspepsia. We've got to increase the awareness level of what is a very serious problem," he added.

Wolfe and his colleagues reviewed mortality reports from a number of sources, including data related to arthritis sufferers on long-term NSAID therapy. They concluded that in a substantial number of people, serious adverse gastrointestinal complications do occur.

"In many cases, potentially fatal events occur as a direct result of gastrointestinal damage due to NSAID use," Wolfe stated. "Even someone who may take aspirin for something as simple as muscle pain is at high risk for gastric damage...we estimate that approximately 16,500 deaths occur annually in the U.S. from ulcer-related complications associated with their use."

With 26 billion OTC aspirin and non-aspirin pain remedies consumed and 100 million NSAID prescriptions written annually, Wolfe added that there is a significant portion of the population at high risk for gastrointestinal bleeding and other complications.

SOURCES: "Pain relievers may be more of a concern than previously suspected," media advisory, Boston University, June 16, 1999.