Paracetamol- a secret killer?

Do we take too many painkillers? Foto: Diana Madej

You wake up in the morning and go to the bathroom. On your way you realize that you got a mild pain in your head. You stop for a second and feel that the pain is getting stronger and is coming from behind your eyes. You reach the bathroom, open a cupboard and take out the strongest painkiller you got. And that solves the problem. Or at least you would think so.

Most of us do this same ritual far more often than we care to admit. But can an excessive use of painkillers become an addiction? Recent surveys shows that while trying to treat a headache we can actually cause it by overdosing analgesics.

According to Nuffield Health a third of UK pain sufferers are worried about being dependant on analgesics. 37% of respondents also admitted they use them only to be able to stay at work.

There are a variety of painkillers available on the market with different names. They can also be taken in different ways. The most common ones are tablets or capsules.

Analgesics can be divided into three categories:

• NSAIDs (Non-steroidal anti-inflammatory drug) are considered the least harmful painkillers which are used for many reasons such as to relieve pain, reduce inflammation, and to bring down a fever. Short term use of NSAIDs usually doesn't cause any side effects.  The most known examples are ibuprofen and aspirin.
• Second group are opiates such as codeine, Tramadol, Vicodin and morphine.  These are considered narcotic drugs so have tendency to be addictive. They work by binding to certain receptors in the brain, or other parts of the body. More than third of those who use painkillers are taking Codeine and Tramadol, according to the survey by Nuffield Health.
• paracetamol (acetaminophen)

Paracetamol has its own category because it is not supposed to treat inflammation. Also, the exact mechanism how this drug works is still unknown. It is thought that it might be blocking certain enzyme in the brain.->

Is paracetamol addictive?

Paracetamol is considered to be safer than opiates and therefore to be a non-narcotic drug. However over a prolonged period of time it might cause damage to the liver and potentially death.-> This threat multiplies if you drink alcohol.
Even though paracetamol is used to treat high fever or to reduce pain, it can ironically also cause headaches.
Up to one in 10 people who have frequent headaches do so because they take painkillers too often, says Dr Fayyaz Ahmed, consultant neurologist at Hull Royal Infirmary.->
We call them rebound headaches because they come back when the body needs more paracetamol. This occurs to people who do not take the recommended dosage. The drug should not be taken more than twice a week for longer than 3 months. Once paracetamol wears off from the body, it will simply “ask” for more by causing you another headache. That urges us to take another pill and then we are stuck in a loop.

However, it is easier to quit paracetamol than other drugs. According to Dr Ahmed if you won't take paracetamol for more than ten days, you can get rid of the rebound headaches. After that you are safe to take the painkiller again, but of course this time only the recommended amount. This is never wise doing with narcotic drugs.

There are also different opinions on paracetamol addiction as it causes other withdrawal effects including irritability, anxiety and already mentioned headaches:
“Any drug that has both toxicity and a “reward” effect, such as providing pain relief, has a capacity to become addictive.”->

The pharmaceutical companies claim that the physical addiction to paracetamol is minimal. It seems there is more of a psychological addiction, or so called placebo affect, to paracetamol.

Do we take too many painkillers?

In the United States the use of Vicodin has increased enormously over the last few years. The UK is not doing any better.
The report by Nuffield Health found that “one in seven of those questioned admitted to exceeding the recommended daily dosage of drugs in order to combat pain and its effects.”
Moreover, young people are severely misusing painkillers. One third of British young adults admitted to take analgesics on a daily basis, according to the survey by Tiger Balm. ->

Another survey shows more than 10 million people in the UK experience regular or frequent headaches. NICE further states that this makes them one of the most common health complaints. Headaches could be caused by many factors such as stress, lack of sleep, illness. However if we treat every mild pain with a painkiller, it will mostly likely have the reverse effect.

Bibliography upon request