Most of us have experienced taking a pill to relieve a headache or find temporary relief after a procedure or dental work. But sometimes painkillers become part of our daily routine, either to treat a severe illness or chronic pain condition. Painkillers are an easy and convenient way to relieve often persistent discomfort, but they may be masking a serious impact our health.
This article goes behind the headlines to investigate what chronic use of painkillers, from over-the-counter anti-inflammatories such as ibuprofen and acetaminophen, to prescription opioids, does to your body in the long term. If you ever wondered what the risks of relying on painkillers for too long are, this is your guide to the dangers and potential outcomes, as well as safer alternatives.
Why This Is a Must-Read
Most articles on this topic are skin-deep, skimming the surface of painkillers’ short-term side effects or simply warning about them over the course of a few paragraphs. Our cover story goes much further, detailing how different forms of painkillers you are more likely to rely on can affect your body over time, from liver damage to rising addiction concerns and what you can do to stay safe while still managing your pain.
Painkillers: A Quick Overview
Analgesics are used to relieve pain. They are referred to as painkillers. We will be focusing on two categories of these drugs:
- Over-the-counter (OTC) painkillers: This category includes acetaminophen (Tylenol) as well as nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and aspirin.
- Prescription painkillers: This group, which includes narcotic drugs such as oxycodone, hydrocodone and morphine, can be more potent than over-the-counter drugs, and are thus used for more serious pain.
These drugs work in a different way, but given enough time and mis-use, they can also take a toll on your body.
The Hidden Dangers of Long-Term OTC Painkiller Use
We tend to see over-the-counter painkillers as fairly innocuous. If you can pick them from a shelf in your local pharmacy, they must not be too bad for you, surely? Wrong.
Although they’re considered safe for short-term use, chronic use and overuse of such medications can have adverse health effects, even at recommended doses.
1. Liver Damage from Acetaminophen (Tylenol)
Acetaminophen is the world’s most widely used painkiller and among the most effective. Except when it’s not. Then it can cause severe liver damage if used regularly, especially in high doses.
Your liver filters everything you ingest, including your drugs, and, if it is forced to break down too much acetaminophen, toxic molecules pile up and overwhelm the liver’s ability to heal itself. The result can be liver failure – a fatal condition.
Who’s at Risk?
- Those who frequently use acetaminophen for chronic conditions such as headaches or arthritis.
- Individuals taking acetaminophen with alcohol (even socially) are at increased risk for liver damage.
2. Kidney and Gastrointestinal Issues from NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin are wonder drugs for inflammation and pain, but they come with considerable risk if used long-term. They can damage your kidneys and digestive system by diminishing production of prostaglandins, chemicals that help protect your stomach from acid. When prostaglandins fall, your risk for ulcers and gastrointestinal bleeding can soar. NSAIDs also reduce blood to the kidneys, potentially causing long haul.
Who’s at Risk?
- Individuals who take NSAIDs daily. For example, people with arthritis or back pain.
- Anyone who uses NSAIDs higher than the recommended dosage.
3. Cardiovascular Risks
Research shows that long-term use of NSAIDs increases the risk of heart attacks and strokes, particularly in those who already suffer from cardiovascular diseases. The risk is not an immediate one, but it builds up over time, so for chronic users it is very significant.
Prescription Painkillers: The Long-Term Risks of Opioids
First up: prescription painkillers. Opioids, as this class of drugs is called, are amazing medicines when used to control severe pain, but with that benefit comes the long-term risk, and it is not trivial.
1. Addiction and Dependency
The greatest long-term threat of opioids was addiction; opioids tap into the body’s reward system and, as well as relieving pain, make a person feel ‘high’. In time, the body becomes accustomed to the drug and requires ever-greater doses to achieve pain relief.
It can be a way to manage post-operative pain or a chronic condition, but end up as physical dependence or a full-blown narcotic addiction.
Real-World Example: A person who has gone through knee surgery has been prescribed painkillers but finds, after a few days, that he needs a larger dose than before to get the same effect. Before long, he sees himself starting the day with a pill, then another one at lunch, and a third in the evening. Eventually, he finds it nearly impossible to function without them, even though the original pain has faded away.
.2. Respiratory Issues
Opioids depress the respiratory system, which means that they slow your breathing. This is why opioid overdoses can be so dangerous because people’s breathing can slow so much that they stop breathing. Even without an overdose, chronic use of opioids can make your body work harder to breathe normally, especially when you are asleep.
3. Hormonal Imbalances
Long-term opiate use can wreak havoc on your hormonal homeostasis, resulting in hypogonadism, in which the body produces less than normal levels of sex hormones (testosterone in men and estrogen in women), which can result in fatigue, depression, a reduced sex drive, and infertility.
Psychological and Emotional Effects of Long-Term Painkiller Use
It’s not just your body that’s at risk, either. Chronic use of painkillers can take a significant toll on your mental health:
1. Cognitive Decline
It’s also important to note that, in the long term, some research has indicated that memory, attention, and other cognitive functions can be affected by opioid use. It might be harder to concentrate or you might feel more confused. If this goes on for a while, it can become a chronic problem at both work and at home, impacting the quality of your life, your relationships and everything else.
2. Mood Swings and Depression
Certain painkillers, especially opioids, can induce euphoria, relax or calm you, or otherwise alter your mood. But prolonged use, especially dependency, can bring with it mood swings, irritability, and depression. The highs and lows can take on characteristics of mental health disorders.
Safer Alternatives to Long-Term Painkiller Use
So what can you do if you have chronic pain but don’t want to risk the side-effects of a lifetime of painkillers? Here are some ideas.
1. Physical Therapy and Exercise
In many cases, chronic pain is a result of an underlying physical issue such as problems with a joint or muscle. In these cases, physical therapy can be used to treat the underlying cause of pain, helping to increase strength, flexibility and mobility, gradually over time.
In addition, regular exercise can be used to decrease pain levels, even without the use of medication. Exercise, particularly low-impact exercise such as swimming or yoga, can be a good substitute for pain-killers over the long term.
2. Alternative Treatments
There are also non-addictive remedies for chronic pain, such as acupuncture, chiropractic and massage. While these treatments might not help every pain patient, many individuals find that integrating them with other therapies can reduce their need for painkillers.
3. Mind-Body Techniques
Mindful attention, meditation and cognitive-behavioral therapy (CBT) can all help people to cope with pain. Learning to take control of your body’s reaction to the pain signals extends the time it takes you to respond so that you have the option to choose how you respond and what you feel. This ought, in theory, to halve or even a third your demand for medication.
4. Non-Opioid Medications
If you do indeed need something to treat chronic pain, ask your doctor about a non-opioid alternative. There are other medications that help regulate pain, including antidepressants or anti-seizure drugs – medications that can help alleviate pain, particularly nerve pain, without the risk of opioids.
Protecting Your Health for the Long Term
Painkillers, whether over-the-counter medications such as paracetamol or ibuprofen, or stronger prescription opioids such as codeine, oxycodone or morphine, can be life-saving when they help us manage pain while recovering from trauma or surgery, or when the pain is chronic, and persists for longer than a few months. But if taken long-term, they can take their toll – not but also on your mind.
The point is this: there are other options out there, and safer ones at that. Managing pain is fine. Managing pain wisely is better. Tell your doctor that you’d like to consider your other options. And, if you are currently taking a painkiller, always keep an eye on how much you are taking and how often.
Where to buy painkillers
Here are the most reliable and trusted sites where you can purchase painkillers:
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Do you have a long-term experience with painkillers and can describe the consequences for you? Write below about your experience (for instance, how you managed to quit it, what you use instead, or how you cope with the pain without too much medication) and share your experience with other people. You might help someone in a similar situation.
