Use pain medicines safely

According to recent studies and news reports, Americans consume 80 percent of the world’s prescription pain medicines (opioids). In fact, opioid addiction in America has been declared an epidemic by the U.S. Centers for Disease Control and Prevention (CDC). Roughly 40 people per day, or 14,000 per year, die from opioid overdoses.

While prescription opioids are among the most commonly prescribed medicines in America, over-the-counter (OTC) pain relievers (aspirin, acetaminophen, ibuprofen and naproxen) are also in almost every home across the country, used for everything from headache to back pain to toothache and more. In fact, the pain relief medicine acetaminophen is found in more than 600 different medicines—both prescription and OTC pain relievers, fever reducers, and sleep aids as well as in OTC cough, cold, and allergy medicines. In fact, the pain reliever acetaminophen is the most common “drug ingredient” in America. Yet, taking multiple medicines with the same pain relief ingredient like acetaminophen can be dangerous. Knowing more about pain medications—and how to take them safely and prevent misuse—is key.

Just as there are many different types of pain, there are many different types of pain killers (also known as “analgesics”). This chart describes common types of pain relief medicines, general safety concerns, and tips for taking them safely.

Pain Relief Medicines Commonly Used to… Potential Safety Concerns and Side Effects Play it Safe

Acetaminophen available in prescription form and as an OTC medicine; this common pain relief medicine is an ingredient in more than 600 medicines, including cough suppressants, cold and allergy medicines, and some sleep aids.

Relieve headache, muscle ache, and pain from sinus pressure; reduce fever.

Serious liver damage if taken in larger amounts than directed; Risk for liver damage may be increased in people who drink three or more alcoholic beverages a day while using medicines with acetaminophen.

  • Taking a higher dose than recommended will not provide more relief and can be dangerous.
  • Do not combine multiple acetaminophen-containing medicines.
  • Ask a healthcare professional if you are unsure about whether you are taking too much.

Non-steroidal anti-inflammatory drugs (NSAIDs) include ibuprofen, aspirin and naproxen; available in prescription form and as an OTC medicine.

Reduce swelling by inhibiting certain chemicals from forming in your body that can make pain symptoms worse.

Potential for gastrointestinal bleeding. The risk is low for people who use NSAIDs intermittently but goes up for people who take them regularly, especially for people who are older than 65, people with a history of stomach ulcers, or  who take blood thinners or corticosteroids (prednisone).

Using NSAIDs (except for aspirin) increases the risk of heart attack or stroke.  Use of NSAIDs can also cause reversible kidney damage.

 

  • People who have cardiovascular disease—particularly those who recently had a heart attack, cardiac bypass surgery or stroke—are at the highest risk for adverse events related to NSAID use. 
  • If you take an OTC NSAID for longer than 10 days to manage pain, you should see your doctor.
  • Whatever NSAID medicine you may take to manage pain, always aim to use the lowest effective dosage strength for the shortest time.

Opioid medications (morphine; oxycodone; and codeine); available by prescription only.

Treat moderate-to-severe pain that may not respond well to other medicines.

Opioids carry serious risks, including risk of misuse and abuse, addiction, overdose, and death.

Common side effects include drowsiness, dizziness, nausea, vomiting, constipation, and slowed or difficult breathing. Can interact with antidepressants and migraine medicines.

Risks increase if taking opioids along with benzodiazepines (medicines for anxiety, insomnia and seizers) or other central nervous system depressant medicines, including alcohol.

May cause respiratory depression that in some cases can lead to death.

  • Regular (i.e., several times a day, over several weeks or more) or longer-term use of opioids can lead to physical dependence and, in some cases, addiction. For this reason, these medicines have a high “street value” and are commonly taken from medicines cabinets. Store these securely.
  • Opioid should be taken for the shortest amount of time possible and used under the supervision of your prescribing physician.
  • Never take opioid medicines together with alcohol. 
  • Dosages vary widely. What is safe for one person may be high enough to cause a dangerous overdose in someone else.

Remember: all medicines (OTC and prescription medicines) can cause side effects and all medicines should be taken as directed. Understand the benefits and the potential risks of pain relief medicines and how to use them correctly.