Are Painkillers Bad for You? – Morning Sign Out at UCI

Written by Sadaf Qadir

Non-steroidal anti-inflammatory drugs, known as NSAIDs, are commonly used worldwide as a form of pain relief medication [1]. Aspirin, ibuprofen (including Advil and Motrin), and naproxen medications all fall under the category of NSAIDs [2]. Available as over-the-counter and prescription drugs, they are used for a wide variety of ailments [1].

NSAIDs can help lower fever, reduce pain, and, most importantly, lower inflammation [2]. One of the reasons NSAIDs are widely prescribed to patients with arthritis and chronic back pain is because of their anti-inflammatory capabilities [1, 3]. Because patients use these medications on a daily basis many people often wonder: What are the long-term effects of taking NSAIDs?

The mechanism of metabolism regarding these drugs is important in discussing their long-term effects. NSAIDs get metabolized quickly by the stomach and are absorbed into the bloodstream [3]. The drug is then available to act throughout the body and works to inhibit prostaglandin production [5]. Prostaglandins cause inflammation, pain, and fever because they induce blood vessel dilation [5].

While NSAIDs have many side effects, one of the most common misconceptions is that NSAIDs cause liver damage. However, since the drug is taken up by the body quickly, minimal amounts of the drug reach the liver – a phenomenon known as the first pass effect [4]. Because of this, liver damage due to NSAIDs is very rare [4].

Even though liver damage is not an issue to regular NSAID users, other potential long-term effects may occur. For instance, prostaglandin inhibition can reduce blood flow to the kidney because blood vessels are not properly dilating [4]. This can lead to kidney ischemia which means dead tissue in the kidneys and ultimately lead to kidney injury [4]. Kidney ischemia can generally be reversed when NSAID usage is stopped [4]. Additionally, there are several gastrointestinal (GI) tract related problems including bleeding, ulcers, and other stomach pain [6]. GI-related problems can often be serious and lead to hospitalization [6]. Several studies have also shown that frequent NSAID usage may result in delayed muscle and ligament regeneration after injury [7].

It is for these reasons that many people are choosing alternatives to NSAIDs. Popular alternatives that have shown similar benefits and relief include fish oil, white willow bark, green tea, and capsaicin, a protein found in chilli pepper [7]. Many of these compounds have been used throughout the world historically; however, scientific studies observing their long-term effects is limited [7]. Consequently, these products are sometimes imported with high levels of impurities or sold under false pretences, making it harder to reap the maximum benefits [7]. For these reasons, alternatives are often perceived as unbeneficial [7].

Without a doubt, NSAIDs have side effects that can become serious with long-term use. It is advised to take caution and check in with a doctor if NSAIDs are used constantly. Alternatives can be explored, but cautiously. However, for those who are looking for quick pain relief for a headache every now and then, it is safe to use NSAIDs [4].

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