Just because myriad drugs and supplements are sold over the counter does not mean these pills are safe. They can pose serious health risks and cause major damage, a prominent Midwestern congressman has reminded by sharing her own near-disaster with a well-known OTC drug.
Debbie Dingell, a Michigan Democrat, told the Washington Post that she recently awoke with great pain and a feeling of bloating. Her symptoms were so severe and unrelenting that she called her doctor and was rushed into emergency surgery for a perforated ulcer. She was hospitalized for a week to recuperate.
The likely cause for her serious problems, her doctors told her: Her extended taking of high doses of an over-the-counter pain reliever found in many people’s medicine cabinets — Motrin, or ibuprofen. As she told the newspaper, she took it to ease her pain after dental implants and jaw surgery:
“We think if we’re taking over-the-counter medicines and we’re not feeling anything, we’re OK. I didn’t know I had an ulcer. I had no stomach pain before this.”
Dingell said she made a common error, choosing to self-medicate and failing to consult with her doctors about her pain. She said she took high-dose ibuprofen for a long time because she did not want to cause herself nightmares with opioid painkillers — powerful and addictive medications that have killed hundreds of thousands and debilitated millions more.
The Washington Post reported:
“Taking pain relievers such as Advil, Motrin, Aleve or aspirin, also known as nonsteroidal anti-inflammatory drugs (NSAIDs), is one of the most common causes of ulcers, experts say. But ‘there’s a real education gap’ among members of the public about the potentially serious side effects of these medications, said Kyle Staller, director of the Gastrointestinal Motility Laboratory at Massachusetts General Hospital. ‘Just because something’s available over the counter doesn’t mean it’s safe to be used by everyone for any amount of time,’ Staller said. Though NSAIDs are ‘wonderful medications for the relief of pain,’ he said, it’s important to remember how powerful they are.”
Indeed, besides playing a potentially big role in gastric problems, including aggravating, or causing perforations (ulcers), long and heavy use of NSAIDS can damage the liver. Doctors and patients sometimes seek to ease the problems that these OTC drugs can cause by adding in others, notably heartburn and acid-reducing meds — proton pump inhibitors like Prilosec and Nexium. These carry their own safety risks, especially with heavy and prolonged use.
Dingell went public with her problems, she said, to provide a caution to others that OTC drugs are not risk- or harm-free. This is a warning, sadly, that must be given often and repeatedly because ours has become a nation consumed with drugs and supplements.
Other OTC drugs cause problems, too
Older Americans provide a huge chunk of the market for sales of OTC drugs and supplements — which can menace them with not only interactions among themselves but also with prescription medications seniors may be taking. This can contribute to serious problems for the aged, including falls, depression, confusion, hallucinations, and malnutrition.
As a New York Times health columnist reported several years ago:
“Just because a drug is sold over the counter does not mean it’s harmless. Laxatives, for example, are said to be among the most misused over-the-counter remedies, and I don’t mean by people who abuse them in an effort to lose weight. Over-the-counter sleeping pills that contain antihistamines can lose their effectiveness over time, which can result in people taking more than the recommended dose. They should not be used for more than two weeks. Even if taken as directed, they can result in daytime sleepiness, dizziness, and a thickening of bronchial secretions … Although OTC drugs are generally safe when used occasionally and correctly by healthy adults, those with chronic health problems can risk potentially serious adverse reactions. FamilyDoctor.org includes a list of medical conditions that may require extra precautions: asthma; bleeding or clotting disorders; breathing problems; diabetes; enlarged prostate; epilepsy; glaucoma; gout; heart disease; high blood pressure; immune system, kidney or liver problems; Parkinson’s disease; and psychiatric or thyroid problems.”
Authorities have gotten wise to them and cracked down on their sales to avert illicit uses, but problems persist with the abuse of OTC cold and allergy medications and a common laxative, federal officials warn.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by dangerous drugs, notably as part of the persistent and worsening opioid painkiller abuse and drug overdose crisis. This horror, which Dingell was wise to avoid, took time to blow up — abetted by Big Pharma, doctors, nurses, hospitals, insurers, and many others in health care. Drug makers, using false claims and sketchy advertising and marketing, inundated the country with billions of prescription pain-killing pills, taking a terrible toll of addiction, debilitation, and death.
The prescription painkiller crisis
The prescription meds, especially the synthetic varieties like fentanyl that pack an even greater and deadlier wallop, also opened the door to illicit drugs and their fatal abuse. The mess will take a long time and cost a fortune to clean up.
We all can take a step an individual step, though, to deal with this crisis and prevent others like it from occurring by stopping our over reliance and magical belief in pill popping. Supplements are a major expense in this country — and their value is unproven or marginal at best. OTC meds may be stop-gap remedies for minor issues. But they should not be used for more than that, and maybe it is best to mostly skip them. As for prescription medications, many are life changers and life savers. But too many are too costly and have too little effect. We have much work to do to end our obsession with drugs.