Health: Ibuprofen pain pill is said to be higher risk than morphine

Health: Ibuprofen pain pill is said to be higher risk than morphine

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Underestimated pain reliever

Most people assume that painkillers such as ibuprofen or acetaminophen are harmless because they are available for sale. Palliative medicine specialist and pain expert Sven Gottschling emphasized: “Many patients swallow ASA, ibuprofen or diclofenac as carefree as smarties - far too often and far too long. And nobody thinks about long-term damage. There are people who have been taking ibuprofen for chronic joint pain for decades. You risk gastric and intestinal bleeding, kidney damage and are at high risk of a heart attack or stroke, ”the specialist from the Center for Palliative Medicine and Child Pain Therapy at Saarland University Hospital told Focus Online.

In his new book “Becoming Painless: Why So Many People Suffer Unnecessarily and What Really Helps”, the doctor shows why many therapies fail and shows what could be better. Because 4,000 patients die annually from internal bleeding as a result of the use of painkillers. These are more fatalities than from traffic accidents.

Careless handling of drugs is dangerous

An ibuprofen is quickly taken for knee problems, a paracetamol or an aspirin for headaches if it is difficult to get out of bed in the morning. According to estimates, 3.8 million Germans swallow painkillers annually and save themselves many visits to the doctor. But such careless handling of supposedly harmless products can be dangerous. "On the whole, Germans use painkillers responsibly," Prof. Kay Brune of the German Pain Society told the dpa news agency. "Still there is abuse."

Anti-inflammatory with a lot of complications

The over-the-counter medications are taken too often by many and without knowing how the preparations work or when it makes sense to use them. Anti-inflammatory painkillers such as ASS (aspirin), diclofenac and ibuprofen, which can be obtained in any pharmacy without a prescription, are the most common. Common to these remedies is that they prevent the formation of pain messengers, lower fever and counteract inflammation. "Anti-inflammatories are used most often, but they have a lot of complications," says Müller-Schwefe. Depending on the dose, they could increase the risk of a heart attack or bleeding from the stomach. "The fact that they are available for sale does not make them harmless medicines," says the expert.

The risks increase with age

The pharmacologist Brune also sees the dangers: "The anti-inflammatories mentioned suppress the warning symptom of pain and hinder healing." This is done by inhibiting a number of the body's own protective hormones (prostaglandins). Müller-Schwefe explains: "They are there, for example, to protect the gastrointestinal tract, the kidney and the cardiovascular system." He warns: "Such drugs change the body sustainably. You don't have to panic, but these are not lozenges. ”According to Brune, the harmful effects strongly depend on the type of therapy, dosage and age of the patient. Younger people without underlying illnesses shouldn't have to worry if they take a pill every now and then, but with increasing age the risks increase: "Unfortunately, it is the older people who need their daily pain reliever to cope with the daily challenges."

Paracetamol is toxic to the liver

Paracetamol only works in the central nervous system and not like ASA, ibuprofen or diclofenac in the inflammatory areas. The drug has been criticized for a long time. "It has only emerged in recent years that paracetamol, like ibuprofen or diclofenac, hinders the formation of tissue protective substances," said Brune. Paracetamol could therefore have all the problems of the so-called prostaglandin synthesis inhibitors. To make matters worse, the drug has a toxic effect on the liver and must therefore be administered in low doses. It is also dangerous that the active ingredient is contained in numerous combination painkillers and is therefore not easy for either the patient or the doctor to see whether the maximum recommended daily dose has been exceeded. Since overdose can easily occur according to Brune, patients who already have liver damage, are severely underweight or have chronic muscle diseases should not take acetaminophen.

Medicines with morphine on special prescriptions

Other pain relievers, which require a prescription, dock onto the opiate receptors throughout the body - in the nervous system, the periphery, on inflamed tissue, in the spinal cord and in the brain. These drugs are primarily used to combat chronic pain, for example from cancer, after serious accidents or when other forms of therapy do not have sufficient effects in rheumatic conditions, said Brune. The active substances in this group are derived from morphine. “They have their own problems and are rightly only available on prescription, mostly on special recipes. Your addiction potential is great. ”Using the opiates could result in respiratory disorders, nausea and vomiting, weight loss and some other complaints.

Antiepileptics and antidepressants

Antiepileptics are also pain relievers that have a stabilizing effect on the nerve cell membrane. These are used when the pain is not caused by a tissue disorder, but the nerve incorrectly sends pain information without there being any damage. As Müller-Schwefe explained, these agents are used for infections, nerve injuries, but also for metabolic disorders. Also worth mentioning are the so-called coanalgesics that help relieve pain, even though they are not painkillers at all. An example of this are antidepressants. "They act on the sodium ion channels and are able to relax the muscles," said the expert.

Never take pain relievers without medical advice

The most common over-the-counter pain relievers often differ in their various side effects or in whom they are better or less suitable. Some damage the gastrointestinal tract more than others or have different effects on blood clotting. Some drugs are not allowed during pregnancy or under the age of 16, and others should be avoided if you are allergic. Basically, for all over-the-counter pain relievers, Ursula Sellerberg of the Federal Association of German Pharmacist Associations (ABDA) advises not to take them longer than three days in a row and no more than ten times a month. It is important to use such drugs as rarely and as low as possible. And the president of the German Society for Pain Therapy, Gerhard Müller-Schwefe, said: “Even simple painkillers should never be taken without medical advice. It makes a lot more sense to have an exact diagnosis first. ”(Sb, ad)

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Video: Update on Novel Pain-Relief Modalities - Charles Berde, MD PhD - Advances in Pediatric Health Care (August 2022).