Ibuprofen, sold as Motrin and Advil, and other anti-inflammatory drugs are in the news again, and not for a good reason. The U.S. Food and Drug Administration is ramping up its warnings about the risks of these drugs for their role in causing heart attacks and strokes. Some of the other drugs include Celebrex, Aleve, Naprosyn and Toradol. (Aspirin was not included in this recent warning.)
It has been known for some time that these drugs — called nonsteroidal anti-inflammatory drugs, or NSAIDs — have serious side effects and are a major cause of drug-induced injury. They are estimated to cause at least 16,000 deaths per year and send 100,000 people to the emergency room in the U.S. The most common problems they cause are digestive ulcers and associated bleeding. In fact, some doctors give a drug to reduce stomach acid to minimize the stomach-damaging effects of NSAIDs. (Of course, that drug is not without side effects of its own.)
Studies also have shown increased risk of other conditions, including atrial fibrillation, where the heartbeat becomes rapid and weak; kidney damage; and delayed or blocked healing, both of fractures and soft tissue injuries.
The FDA just reversed itself on using “baby aspirin” to prevent heart attacks and strokes, finding that it really doesn’t reduce deaths, but does expose the patient to significant risks.
When using NSAIDs, we are warned not to exceed the dosage, not to take them for too long, or to avoid taking more than one of these drugs at a time. But there is newer evidence, which led to these stronger warnings, showing that even short courses of these drugs at recommended doses can have serious side effects.
Dr. Judy Racoosin, deputy director of the FDA’s Division of Anesthesia, Analgesia, and Addiction Products, said of NSAIDs in the new warning, “There is no period of use shown to be without risk.” She also addressed the fact that while people who already have heart disease may be at more risk, even those without any history of this problem may develop it from taking these drugs.
I have a better idea. Rather than using a drug with the potential for serious side effects, why not use natural treatments? While NSAIDs are used for a lot of conditions, the majority of them are taken for chronic joint and muscle pain. But these problems respond very well to many treatments, including manipulation, massage and acupuncture. For some patients, a simple lifestyle change such as eliminating wheat or soda from the diet makes a big difference. We also use whole food-based supplements and anti-inflammatory herbs with good success.
Many of our patients with chronic pain are able to give up their NSAIDs for one or several of these natural, safe alternative treatments, or at least limit their drug use to an occasional dose if they overdo it, or during rainy weather. (Yes, that does affect pain levels.)
This includes patients who have taken these drugs for decades. It is not uncommon for a patient to be prescribed these drugs by a doctor, and the prescription is never reviewed again, even after many years of taking it. Later, the patient is given another drug to counter the side effects of the anti-inflammatory drug, or undergoes a series of tests to determine why they are developing these new health problems that may all be caused by the NSAIDs. Using natural health care in the first place helps patients avoid this “prescribing cascade” where one drug leads to more and more medical care and declining health.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at email@example.com.