“It relieves pain five times faster than normal drugs”. This is the slogan used to advertise a painkiller on one of the local radio stations. With such catchy adverts, many people are lured into buying these drugs with the hope that it will relieve them of pain soon after swallowing.
While it is possible to experience short-term relief, doctors warn of the dangers of over relying on painkillers to manage pain. According to health experts, over or misuse of painkillers can damage the liver, kidney and affect hearing, especially among women.
A Harvard University study published in the American Journal of Epidemiology suggests that women who frequently use painkillers such as ibuprofen or acetaminophen (tylenol) have an increased risk of developing hearing complications. “Women who took these pain relievers at least twice a week were more likely to experience hearing loss, and more frequent usage increased the risk by up to 24 per cent,” the study reveals.
“Ibuprofen can reduce blood flow to the cochlea (the snail-shaped hearing mechanism in the inner ear), which could result in cellular damage and cell death. Acetaminophen may deplete the antioxidant glutathione, which protects the cochlea from damage,” says study author, Dr Sharon Curhan, from the Harvard Medical School.
She says such medicines provide good pain relief for many people, but when used over long periods of time, they are likely to cause other costly adverse health effects. “Therefore, it is important to take these medications mindfully and limit their use as much as possible,” says Dr Curhan.
Common painkillers such as ibuprofen, diclofenac, indocin, aspirin and piroxicam are classified as non-steroidal inflammatory drugs. Doctors say the biggest misuse of painkillers happens because of self-prescription, with people sometimes buying drugs to treat what they think is a mild headache, yet it could potentially be a life-threatening health condition. The public is therefore advised to take medication after a prescription.
Painkillers: What you should know
Painkillers are medicines that are used to treat pain. There are several painkillers available on the market that come in various brand names. They can be taken by mouth as liquids, tablets, or capsules or though an injection.
Some painkillers are also available as creams or ointments.
There are three main types of painkillers. Non-steroidal anti-inflammatory drugs, paracetamol and opioids. Each works in a different way. Most people only need to take painkillers for a few days or weeks at most, but some people need to take them for a longer time. You can buy painkillers from pharmacies and drug shops around town.
Non-steroidal anti-inflammatory drugs include ibuprofen, diclofenac, and celecoxib. Aspirin is also a non-steroidal anti-inflammatory drug, although these days it is mainly used in low doses to help keep blood from clotting. Paracetamol is normally prescribed if your pain is not too serious and you do not have inflammation.
Non-steroidal anti-inflammatory drugs are generally prescribed for people who have pain and inflammation. For example, if you have pain in your joints (arthritis) or muscles (back pain). This is because people with such conditions are likely to experience inflammation, and these drugs work to treat the pain and the inflammation.
Effect on the body
Dr Vincent Karuhanga, a general practitioner, at Friends Poly Clinic says ordinary painkillers such as paracetamol are safe if taken in the right amount and for the right purpose. He says a person can only develop negative effects if they take such medicines in excess amounts.
For instance, he says an expectant mother, especially one who is expecting a baby boy is advised against using paracetamol in large quantities. “Overuse of paracetamol affects the development of the testis, and the child in the womb may end up developing with one testis,” he says.
Besides affecting the development of body organs, Dr Karuhanga says excess use of painkillers is likely to cause symptoms such as vomiting, constipation and allergies. This is particularly common for people who use drugs such morphine, pethidine and tramadol.
Dr John Ayebare, a general practitioner at Care Clinic and Nursing Home, on Bombo Road, says medicines such as ibuprofen, aspirin and piroxicam are likely to aggravate symptoms of ulcers in people who already have the condition. “In such cases, the ulcers can become severe and lead to bleeding. This can subsequently damage other internal body organs such as the pancreas, kidney and liver,” says Dr Ayebare.
This is common when the drug is taken on an empty stomach, or when a person is dehydrated. “We have an enzyme in the stomach known as cox, which works with the mucosal lining to protect the stomach. However, overuse of painkillers, on an empty stomach limits the production of cox, thereby eroding the mucus lining and causing ulcers,” explains Dr Ayebare.
Painkillers have additives that limit any side effects to an individual, unless one is allergic to ingredients such as starch. According to Peterson Mugabe, a pharmacist at Mulago National Referral Hospital , medicines such as paracetamol are only harmful when taken in large quantities. He says once paracetamol affects the liver, the effects are irreversible. “The high concentration of this toxin in the body can affect the liver cells and cause damage to the liver,” he says. Painkillers can also have an effect on the kidney, although this depends on the type of drug that a person is taking.
Dr Denis Muyaka, a general practitioner at AAR health services, at Acacia Avenue, says narcotic pain killers such as pethidine, morphine, codine and tramadol are commonly used by women who have undergone surgery after birth. He notes that in some instances, mothers may be given diclofenac after birth, especially if they are bleeding.
Dr Ayebare says narcotic pain killers are also known as drugs of addiction. “Narcotic painkillers make people who take them feel good about themselves. The effect of such painkillers is that the people taking them become addictive, and this may affect them over a long time,” says Dr Ayebare. Narcotic painkillers are addictive and it is advisable that they be administered only for people suffering from terminal illnesses such as cancers.
People’s attitude towards painkillers
“ I usually buy painkillers from a drug shop without prescription from a doctor but I have never developed any side effects,”
Maureen Kangume, Student
“I have a medical insurance. I usually suffer from painful joints and so I receive my medication from a clinic in Bugolobi. I do not know the name of the medicine they always give me,”
Joseph Ebunyu, security guard
“When I develop any kind of pain, I visit a local clinic and when it worsens, I go to the hospital. I mostly use paracetamol which is prescribed by a nurse and I have not developed any side effects yet,”
Irene Maneya, Security Guard
“I usually buy paracetamol and use painkillers without prescription from a health worker, but I ensure to drink a lot of water and juice when I take such medications,”
Andrew Wataka, Businessman
“Paracetamol is the most common painkiller that I use, which I buy from pharmacies around my neighbourhood. I usually self-prescribe,”
Magdalene Asayo, teacher Mukono District
“I mostly suffer from joint pain. So when I go the pharmacy, I describe the pain I have and the pharmacist gives me an ointment which I apply. But when I apply too much of the ointment, I feel a lot of heat,”
Patrick Kagoro, boda boda cyclist