By Johanna C. Scully

Carina Scott, a junior drama major, saw first-hand the dangers of over-the-counter painkillers (OTCs). As a freshman in high school her sister had a terrible allergic reaction to Motrin. She developed a rash all over her body, was unable to walk and missed days of school. Her parents had given her the Motrin in accordance to the family doctor’s recommendations for specific aches and pains. Scott doesn’t recall her or her family ever talking to their primary care physician about adverse reactions that can occur when taking OTCs, but now they are very cautious when it comes to these easily available drugs.

“I worry about side effects of taking OTCs. I never take them when I am taking prescriptions or when I drink alcohol. And I make sure to read the labels and understand the dosage,” said Scott, who takes Advil or Motrin every once in a while for headaches and muscle aches despite what happened with her sister.

Tasha Fonseca, a sophomore drama and English major, strongly believes that the American society is overmedicated. There are too many OTCs available at the discretion of uneducated or maybe naïve Americans.

“It’s really alarming how overprescribed people are. I think doctors are telling people to take two pills when they would be fine with one,” Fonseca said.

She also added that this college and other college campuses have a big problem with OTC overuse. Some do it to get high while others took OTCs for weeks for an injury and then became dependent. Doctors don’t warn patients enough that it is possible to become addicted to OTCs and when people stop taking them abruptly, severe withdrawal symptoms can occur.

According to the National Consumers League (NCL), over 175 million Americans take OTC medication for pain relief, 44 percent of them exceed the recommended dose and millions ignore critical label information. People so desperately want the pain to go away so they can go on rushing about their daily lives that they take more medicine than they should, and they don’t talk to their doctors about possible risks. Statistics show that 16,500 people die and 103,000 are hospitalized each year from OTC complications. This is a very real problem and one that consumers must be educated on.

OTC painkiller ingredients, such as Ibuprofen and Naproxen, which are contained in products such as Advil, Motrin, Tylenol and Aleve, are called non-steroidal anti-inflammatory drugs (NSAIDs). They bring relief to millions for arthritis, headaches and other common pains, but people make the mistake of believing that just because they are easy to buy and are approved by the FDA, they are completely safe to use.

Maureen B. Houck, director of the University Health and Wellness Center said, “People need to be smart consumers. We need to teach our students to be smart consumers as well. Not only do we need to be wary about OTCs; we need to be cautious with any supplement or herb. People think that just because it says organic or homeopathic it is safe. You can have an adverse reaction to anything.”

Houck, who does take Tylenol or Ibuprofen occasionally and has been in Healthcare for over 30 years, said that there is always a risk for reaction.

“People think that Tylenol is innocuous, but in reality it can have severe side effects,” Houck said.

The Health and Wellness Center does not recommend the same OTC to everyone. Everything is individualized depending on the patient’s underlying conditions, but in flu season, they say Tylenol is the best OTC for aches and fever. Houck and the doctors of the Health and Wellness Center strongly recommend stress reduction techniques such as listening to music, practicing yoga or Tai’chi or anything that works for you. Exercise really is the best medicine because it releases natural painkillers.

Some people have probably heard about the investigations and lawsuits involving Aleve and Motrin. Aleve, manufactured by Bayer Healthcare, is used to reduce pain, inflammation and stiffness caused by many conditions, such as osteoarthritis, rheumatoid arthritis, gout, injury, abdominal cramps associated with menstruation and tendonitis.

On Dec. 20, 2004, the FDA announced that the National Institute of Health was immediately halting a study involving Naproxen, which is the primary ingredient of Aleve. The study was to see if Naproxen could be used to treat Alzheimer’s. Instead researchers found that the participants taking the drug had a 50 percent higher risk of having strokes and heart attacks than the participants taking the placebo had. This discovery came in the wake of Vioxx being taken off the market for the same reasons.

This year, cases of allergic reactions to OTCs have significantly gone up. In Saratoga, California 9-year-old Kaitlyn Langstaff died after taking Children’s Motrin, 7-year-old Sabrina Brierton Johnson of Los Angeles went blind two months after taking the same drug and 3-year-old Heather Rose Kiss of New Jersey died a week after taking a few doses of Children’s Advil. All three had developed a rare and extremely painful disease from the OTCs called Stevens-Johnson Syndrome. But both the FDA and Children’s Advil spokespeople have said that the disease is so rare because only six in 1 million people get it, that it is not necessary to put it on the label.

The Stevens-Johnson Syndrome Foundation has said that they have seen a rise in the disease involving children and Ibuprofen in the past year and that most doctors and parents don’t know about it.

Vee Ounarath, a senior computer science major, discovered he was allergic to Ibuprofen when he took Tylenol to recover from a hangover and broke out in a rash covering his whole body and his face swelled up so bad he couldn’t see.

Dr. John Amdur, a Human Nutrition professor at the University who also has his own Chiropractic business, Amdur Chiropractic, said that not knowing the risks of OTC use is a dangerous problem especially on college campuses where kids self medicate and mix OTCs with alcohol. He said that doctors today recommend OTCs like they are candy, but they can cause stroke, kidney and liver damage and failure and stomach bleeding and ulcers. He always tells his patients not to use OTCs since they just thin the blood and block the pain so they may not know that they are creating holes in their stomachs. What he does tell his patients who are in chronic pain to use is Arnica, a homeopathic remedy that stimulates the release of natural painkillers in the body. Also he can’t stress ice and heat therapy enough.

“I have had plenty of patients who have had reactions to OTCs such as their throat closing, hives and kidney problems. And all of these symptoms occurred per doctor’s advice,” Amdur said. “Years ago we needed a prescription for these medicines, like Advil, that we can buy so easily today. I say it’s not worth the risk, so if you can avoid them, do.”

Mark Williams, a Columbia University graduate and Pharmacist at Eckerd’s Pharmacy in East Meadow, said that all pharmacists are required to discuss with their patients the risks of mixing OTCs with prescriptions, but many do not. Mixing drugs can be a very dangerous thing. For instance a patient could be taking a drug for alcoholism and also be taking an OTC containing alcohol. Some OTCs can negate the effects of prescribed medicines and some can further irritate the condition you are taking the prescription for. For example, a person on high blood pressure medication who takes an over-the-counter decongestant that warns of increasing blood pressure could have a heart attack.

“I think adults are more health conscious today, and especially with the Internet, the information is out there,” Williams said. “But young people haven’t changed – they think they are invincible, and they need to be more educated on this topic.”

Williams, who has been a pharmacist for 29 years, also added that some people could have a piece of chocolate cake or a bite of lobster and have a reaction or die, Motrin or Advil companies can’t be completely at fault. He does think that it is admirable that Tylenol has stepped up to the plate with its new commercials in which the CEO of the Tylenol company states that if consumers are not going to follow the directions on the back of the package, then the company would rather consumers did not buy Tylenol at all.

Taking too many OTCs, which are supposed to relieve pain, can do the reverse in the case of headaches. If you have recurring headaches and have been taking OTCs such as Advil continuously, stop. Try another technique to banish the pain, such as deep breathing, or aromatherapy or listening to calming music. Again, the best pain reliever for headaches, menstrual pain or minor aches and pains is exercise. So the next time you are in pain, instead of popping a pill and risking your health, try taking a walk, make sure you read all labels and talk to your doctor.

Even though over-the-counter medicines are commonly used for self-medication, abusing them can cause life-threatening problems. (Image courtesy www.aloha-earth.com)