The Downside of Pain-Relieving Drugs

Julian Whitaker, MD

Far too often people look to drugs to relieve their arthritis pain. And while these pain-relieving medications may be okay for occasional use, they are riddled with side effects and relying on them on a daily basis isn’t advisable. Here’s why:

NSAIDs

The primary drugs used by conventional doctors to treat arthritis are non-steroidal anti-inflammatory drugs (NSAIDs). These include ibuprofen (Motrin and Advil), indomethacin (Indocin), Sulindac (Clinoril), and naproxen (Naproxyn). Although they provide temporary pain relief, they do nothing to address the underlying causes of arthritis.

NSAIDs curb the production of prostaglandins, powerful chemical messengers that promote inflammation. At the same time, they suppress beneficial prostaglandins as well, leading to inevitable adverse effects. Studies suggest that NSAIDs actuallyaccelerate cartilage breakdown by inhibiting its repair and regeneration.

The most significant side effect of NSAIDs, however, is adverse effects on the gastrointestinal tract. About 25 percent of people who take NSAIDs develop ulceration of the stomach or intestinal tract. FDA statistics show that each year more than 16,000 people die from gastrointestinal complications directly attributed to NSAID use! The primary reason for blood transfusions in hospitals is not accidental injuries or replacing blood lost during surgery but gastrointestinal bleeding caused by NSAIDs.

Acetaminophen

Acetaminophen (Tylenol) has recently surpassed NSAIDs as the pain reliever of choice for arthritis, according to the American College of Rheumatology. It’s as effective in relieving pain as NSAIDs and aspirin, but without the gastrointestinal side effects. However, continual use of acetaminophen presents its own dangers.

When acetaminophen breaks down in the body, about five percent of it is metabolized into a toxin that must be neutralized in the liver. When the dose is too high—or when other toxins are present—normal detoxification lags and liver damage occurs. In fact, acetaminophen overdose is the leading cause of hospitalization for acute liver failure. Its toxicity is dramatically amplified in the presence of alcohol. Take the case of Antonio Benedi. This 37-year-old man had wine with dinner one evening, then took 10 Extra-Strength Tylenol® tablets over the next four days. The result was acute liver failure, which led to a liver transplant.

Acetaminophen is also hard on the kidneys. A study published in the New England Journal of Medicine revealed that when more than one tablet of acetaminophen a day was taken, the risk of kidney disease doubled. In fact, 10 percent of all cases of kidney failure are linked to acetaminophen.

COX-2 Inhibitors

The latest—but definitely not the greatest—entries in the pain relief market are COX-2 inhibitors. Launched in 1999 along with Vioxx (rofecoxib), Celebrex (celecoxib) quickly became the best-selling arthritis drug in the US. These second-generation NSAIDs were touted as being safer and superior to aspirin, ibuprofen, and the like. But it turns out they were anything but.

Vioxx was pulled from the market in late 2004. It is estimated that this drug caused up to 160,000 heart attacks and strokes and 55,000 deaths! A third COX-2 inhibitor, Bextra (valdecoxib) was also taken off the shelves, leaving Celebrex as the sole drug of its class.

Is it safe? Well, it requires the same label warning about sudden bleeding, ulceration, and perforation of the stomach and intestine as conventional NSAIDs. It’s also known to impair kidney and liver function and interact adversely with alcohol—just like conventional NSAIDs. Then there’s the cardiovascular risk. In addition, Celebrex costs up to two bucks per pill, whereas you can get a 100-count bottle of ibuprofen for as little as $4.00. I recommend you stay away from this drug.

References

• Bloom, MS. Direct medical costs of disease and gastrointestinal side effects during treatment for arthritis. Am J Med. 1988;84:23.
• Brink Susan. Outfoxing Pathways of Pain. U.S. Online News,http://www,ysbews,cin.ysbews.ussye.981212/14pain.htm
• DePalma, Angelo. How Super Are the “Super Aspirins”? Not Very. bioresearch online, wysiwyg://186/http:// news.bioreachonline. com/views-and-opinions/19990114-1071.html.
• Langman MJ et al. Adverse upper gastrointestinal effects of rofecoxib compared with NSAIDs. JAMA. 1999 Nov 24;282(20):1929-33.

Modified from Health & Healing with permission from Healthy Directions, LLC. Copyright 2006. Photocopying, reproduction, or quotation strictly prohibited without written permission from the publisher. To subscribe to Health & Healing, click here.