By Aristotle Economou, DC, LAc
Oftentimes, we reach for a go-to over-the-counter (OTC) medication to cure all ailments: from headaches to joint pain to a runny nose. Unfortunately, many people don’t realize that these OTC pills (as well as prescription drugs) provide a lot of medication to the body—often more than the amount actually needed to dull the pain.
This excess medicine must be included, however, because the liver acts as a filter for the body and cancels out about one-third of medicine taken orally. The remaining medicine is then spread throughout the entire body—because your body doesn’t know that you are only trying to treat a sore knee or strained shoulder.
Every day across the country, millions of people use OTC pills to relieve pain without giving this a second thought. For the vast majority, these pills can safely provide pain relief when used as directed. But pain medication can be tricky to manage; there is a range of options and varying doses, which is why the Food and Drug Administration (FDA) is revamping the approval path for OTC drugs. As reported by The Wall Street Journal, “this move will change how tens of thousands of medicines and personal care items reach US store shelves.”
Despite liver toxicity issues concerning doses higher than 325 milligrams, the FDA still allows a 500-milligram OTC acetaminophen to be sold. “It is inexcusably poor judgment on the part of the FDA to have failed to take action concerning this major source of acetaminophen consumption, and, consequently, acetaminophen toxicity,” said Sidney M. Wolfe, MD, founder and senior adviser of Public Citizen Health Research Group in Washington.
Acetaminophen has a narrow therapeutic window—meaning the difference between a safe, effective dose and an overdose—which, in serious cases, can lead to liver toxicity. This difference is a relatively small increment of mere milligrams.
Ibuprofen, naproxen, and aspirin can cause stomach upset and even ulcers, in a worst case, when not administered at the right dosages. Outside the United States, more people use a balance of topical and external medicines. Topical pain relievers such as creams, gels, patches, and sprays work locally and largely reduce (although they do not entirely eliminate) the systemic risk—accidental or otherwise—that OTC pain pills can present.
Many people enjoy a few glasses of wine with dinner or going out for beers after work. However, combining alcohol consumption with virtually all OTC pain relievers delivered in a pill label is against labeled use. According to the National Institutes of Health publication on alcohol and metabolism, liver damage can occur with as few as four to five extra-strength acetaminophen pills consumed with varying amounts of alcohol.
There are a variety of noninvasive techniques, procedures, specific acu-points, and philosophies surrounding pain relief worldwide. With a topical product, you can deliver much less medicine to the body because you’re applying it directly at the site of pain. The Salonpas Pain Relieving Patch and the Salonpas Arthritis Pain Patch are two products I recommend. These are the first topical non-steroidal anti-inflammatories (NSAIDS) approved through the FDA’s rigorous New Drug Application process—the same process used to approve prescription medicines.
I encourage all my patients to use medicine as directed. It is important for pain sufferers to know their options and consider treating mild to moderate pain locally to improve their pain relief outcomes.
Aristotle Economou, DC, LAc, (Az) DiplAc (IAMA), FIAMA, is a member of The Institute for Functional Medicine. He is the author of Change The Way You Heal: 7 Steps to Highly Effective Healing, and has more than 20 years of clinical experience.
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