NSAID deaths


J.S.Hochman MD
Executive Director
National Foundation for the Treatment of Pain

On February 15th 2003 I reported on the deadly consequences of NSAID toxicity. Recently I was asked to provide a specific citation on my statistics. Here it is.

These numbers document, again, the utter irrationality of drug policy and law in the United States. One would assume that drug laws would be first concerned with reducing harm to the American public. Instead, the priorities are backwards.

For example, OxyContin, now recognized, along with sustained release Morphine sulfate (Kadian and MSContin) as probably among the safest drugs in the pharmacological armamentarium, have been demonized and attacked by government, the press and the Congress. At the same time, the deadliest drugs in America, the NSAIDs, Tylenol (acetamenophen) most of all, have received virtually no attention and can be bought anywhere for a relative pittance. It's as if possession of a b-b gun was made a capital offense while you could purchase a 50 caliber fully automatic weapon at the local hardware store.

We are not dealing, with rationality, science or fact,when it comes to the drug laws. We are dealing with witch hunting, religious fanaticism, vested interests, international conspiracy and 100 Billion dollars in annual illegal profits. I am now of the conclusion that anyone who supports the continuation of the existing drug laws is a traitor to the United States Constitution, an enemy of the American democracy and a supporter of the international drug criminal conspiracy, until proven otherwise. Although they previously might have been able to beg innocence on the basis of ignorance, the information is now so universally available this excuse is no longer viable.

"It has been estimated conservatively that 16,500 NSAID-related deaths occur among patients with rheumatoid arthritis or osteoarthritis every year in the United States. This figure is similar to the number of deaths from the acquired immunodeficiency syndrome and considerably greater than the number of deaths from multiple myeloma, asthma, cervical cancer, or Hodgkin's disease.

If deaths from gastrointestinal toxic effects of NSAIDs were tabulated separately in the National Vital Statistics reports, these effects would constitute the 15th most common cause of death in the United States. Yet these toxic effects remain largely a "silent epidemic," with many physicians and most patients unaware of the magnitude of the problem.12 Furthermore, the mortality statistics do not include deaths ascribed to the use of over-the-counter NSAIDs."

The URL for the full text is below. content.nejm.org/cgi/content/full/340/24/1888 (www is not part of the URL)

I believe content from NEJM is free online 6 months after publication. Free registration is required. See also www.freemedicaljournals.com

According to the Oct. 2002 edition of Anesthesiology News, there is a graph in an article on NSAIDS that shows that deaths in 1997 from NSAIDS were about equal to the deaths from AIDS. And yet no one hears about the NSAID deaths.

Also see: Gastrointestinal toxicity of nonsteroidal anti-inflammatory drugs.

16 Aug 2003
Wilmington Star News (NC) Wire article
Study: Painkillers can increase miscarriage risk

SAN JOSE, CALIF. - Common painkillers like Advil or aspirin can increase the risk of miscarriage in pregnant women by as much as 80 percent, according to a new Kaiser Permanente study published in Friday's British Medical Journal. But some physicians said that startling finding should be viewed with caution.

Researchers obtained a wealth of data on 1,055 newly pregnant women at Kaiser's San Francisco and South San Francisco medical centers, including their use of painkillers and other drugs, previous miscarriages, smoking and drinking habits, general health, age, ethnicity and income - even use of hot tubs.

Women who had taken "nonsteroidal anti-inflammatory drugs" - painkillers like Advil, Motrin and Naprosyn - had an 80 percent higher risk of miscarriage than women who avoided these medications, said Kaiser epidemiologist Dr. De-Kun Li, the study's main author. The risk increased if such painkillers were taken shortly before or after conception, or for longer than one week. The researchers also found a 60 percent higher risk of miscarriage in women who took aspirin, also considered an anti-inflammatory drug, although they cautioned that the small number of women in that category made their data somewhat unreliable. No added risks were seen from Tylenol or similar acetaminophen painkillers.

Obstetricians typically advise women to avoid Advil, aspirin and similar painkillers - as well as most other medications - because of the potential risk of birth defects. Tylenol is usually regarded as safe during pregnancy.

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