Health pain pill ibuprofen is said to be higher risk than morphine

Underestimated pain medication

Most people assume that analgesics such as ibuprofen or paracetamol are safe because they are over the counter. The palliative physician 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 the long-term damage. There are people who take Ibuprofen for decades against chronic joint pain. You risk gastric and intestinal bleeding, kidney damage and are at high risk for a heart attack or stroke, "said the specialist from the Center for Palliative Medicine and Child Pain Therapy at the Saarland University Hospital opposite" Focus Online ".

In his new book, "Getting painless: why so many people suffer needlessly and what really helps", the physician shows why many therapies go nowhere and shows what could go better. For only 4,000 patients die annually from internal bleeding as a result of painkiller use. That's more fatalities than traffic accidents.

Careless handling of drugs dangerous

If you have a knee problem, take ibuprofen quickly; if you have a headache, take a paracetamol or an aspirin if you are sick and tired of getting out of bed in the morning. According to estimates, 3.8 million Germans swallow analgesics every year and thus save themselves many a trip to the doctor. But such a careless handling of supposedly harmless means can be dangerous. "By and large, the Germans deal responsibly with painkillers," said Prof. Kay Brune of the German Pain Society to the news agency dpa. "Nevertheless, there is abuse."

Anti-inflammatories with a lot of complications

The over-the-counter medicines are taken by many too often and without the knowledge of how the preparations work or when their use makes sense. Anti-inflammatory analgesics such as the drugs aspirin, diclofenac and ibuprofen, which are available in every pharmacy without a prescription, are the most common. Common to these remedies is that they prevent the formation of painkillers, reduce fever, and counteract inflammation. "Anti-inflammatories are the most commonly used, but have a lot of complications," says Müller-Schwefel. Depending on the dose, they could increase the risk of a heart attack or stomach bleeding. "The fact that they are freely available does not make them harmless medications," says the expert.

With increasing age, the risks increase

Also, the pharmacologist Brune sees the dangers: "The anti-inflammatory drugs mentioned suppress the warning symptom pain and hinder the healing." This is done by inhibiting a number of endogenous protective hormones (prostaglandins). Müller-Schwefel explains: "They are there to protect, for example, the gastrointestinal tract, the kidney and the cardiovascular system." He warns: "Such drugs change the body sustainably. You do not have to panic, but these are not lollipops. "According to Brune, the harmful effects depend heavily on the type of therapy, dosage and age of the patient. Younger people without underlying illnesses would not have to worry about taking a tablet from time to time, but as they get older, the risks increase: "Unfortunately, it's the elderly who need their daily painkillers to cope with the daily challenges."

Paracetamol is toxic to the liver

Paracetamol acts only in the central nervous system and does not act like ASA, ibuprofen or diclofenac in the inflammatory areas. The drug has been in the criticism for some time. "Only in recent years has it been shown that paracetamol, like ibuprofen or diclofenac, hampers the formation of tissue protectants," says Brune. Therefore, acetaminophen can have all the problems of so-called prostaglandin synthesis inhibitors. To make matters worse, the drug has a toxic effect on the liver and should therefore be dosed low. It is also dangerous that the active substance is contained in numerous combination painkillers and therefore it is neither easy for the patient nor for the doctor to recognize whether the recommended daily maximum dose has been exceeded. As Brune believes it can easily lead to overdose, patients who already have liver damage, are severely underweight or have chronic muscle disorders should not take acetaminophen.

Medications with morphine on special recipes

Other painkillers, but prescriptive, dock on the opiate receptors throughout the body - in the nervous system, the periphery, inflamed tissues, spinal cord, and brain. These drugs are primarily used to combat chronic pain, such as cancer, after serious accidents or when in rheumatic diseases other forms of therapy do not bring sufficient effect, said Brune. The active ingredients of this group are derived from morphine. "They have their own problems and are rightly only on prescription, mostly on special recipes to obtain. Your addictive potential is high. "The use of the opiates could cause respiratory disorders, nausea and vomiting, weight loss and some more discomfort.

Antiepileptics and antidepressants

Antiepileptics are also painkillers which stabilize the nerve cell membrane. These are used when the pain is not caused by a tissue disorder, but the nerve falsely sends pain information without any damage. As Müller-Sulfur explained, these agents are used in infections, nerve injuries, but also in metabolic disorders. Also worthy of mention are the so-called Koanalgetika, which help against pain, although they are not painkillers. An example of this are antidepressants. "They act on the sodium ion channels and are able to relax the muscles," says the expert.

Never take pain medications without medical advice

The most common over-the-counter painkillers often differ in their different side effects or in who they are better or worse suited for. Some of these damage the gastrointestinal tract more than others or have different effects on blood clotting. Some remedies are not allowed when pregnant or under 16 years old and others should be kept away from allergic predisposition. Basically applies to all over-the-counter painkillers, they do not take more than three days in a row and not more than ten times a month, advises Ursula Sellerberg of the Federal Association of German pharmacists associations (ABDA). 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 Mueller-sulfur, said: "Even simple painkillers should never be taken without medical advice. It makes far better sense to first have an exact diagnosis. "(Sb, ad)