The dormant killer

THESE DAYS people pop pills at the slightest feeling of pain to get on with their hectic schedules without giving a thought to the after effects. The indiscriminate use of painkillers, without adhering to the recommended usage, can be termed as "painkiller abuse." The availability of painkillers over the counter is what makes them a deadly killer.

A painkiller is any medication that relieves pain. In medical terminology, it is referred to as an "analgesic." Analgesics trigger the release of natural body substances called prostaglandin, which play many roles in the blood circulation in the kidneys.

Dr. K.S. Nayak, senior consultant (Nephrology), Global Hospital says, "the most harmful effect of the painkillers is on the kidneys and next on the gastrointestinal system. There are two types of painkillers - the narcotic kind which includes morphine, pethidine and extropropoxyphene (commonly knows as proxyvon) and the non-narcotic kind which includes the `NSAIDS' or Non Steroidal Anti Inflammatory Drugs like aspirin, phenacetin, ibuprofen, naproxene and the newer ones like the Cox II inhibitors."

While the narcotic painkillers are addictive, the non-narcotic variety is equally dangerous, as they tend to become addictive over a period of time. When consumed over a period of six years for example, they could add up to almost 2 kgs of drugs.

More important is the fact that, the newer painkillers though safer than the older variety are far from being completely safe. NSAIDS when taken over a long period of time could cause kidney, liver and gastrointestinal damage, hypertension, and asthmatic attacks.

Nayak says, "it is usual for a doctor to prescribe an APC (aspirin, phenacetin and codeine) for a patient complaining of pain of any kind. Painkillers taken individually do not cause as much harm as they do when they are taken in combination. The aspirin and phenacetin combination is known to be the most lethal combination, which when consumed over a period of time is said to cause the worst of diseases."

In medical terms, overuse of analgesics is called "analgesic abuse," and results in serious damage to the kidneys calling for dialysis and even a kidney transplant. The effect of overuse of painkillers on the gastric system is as bad with patients developing black, tarry stools and chronic anaemia.

Dr. Anil Kumar Cherukuri, Senior Consultant,Gastroenterology says, "pain could be due to inflammation or compression. Dentists, orthopaedics and general physicians prescribe painkillers often. These prescribed painkillers could be either anti-inflammatory or sedatory, wherein through inducing sleep, the pain is reduced."

Both the doctors are of the opinion that, women in their 30s are more susceptible to analgesic abuse, as they are more prone to migraine and middle age backache. Whereas, men tend to use painkillers at a later stage in life when they develop joint pains.

Dr.Cherukuri says, in case of occasional ache and pains, painkillers could relieve the patient completely, but in most chronic cases like arthritis or pancreatitis though painkillers are meant to reduce pain completely, they do so only for a little while, after which the pain does come back.

The only solution in such cases is to increase the dosage of painkillers at shorter intervals. Many of the patients who come to him with ulcers or bleeding are those who have been consuming painkillers indiscriminately for a long time. The solution is not to tell them to stop taking painkillers, but to relieve the patient of the pain, which will automatically stop him from consuming them.

Painkillers are not all bad for as Dr.Nayak says, "a controlled use of aspirin could prove to be a wonder drug for heart patients. The only point to remember is that, such drugs are most often misused." The answer to this addiction lies in "thinking twice" before you pop a pill.


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