He Said, She Said, NSAID

I ran across an interesting study the other day on pain in America that was reported by Rheumatology Network. While there is some very interesting data about pain in the US, a major focus of this discussion was Non-Steroidal Anti-Inflammatory Drugs, better known as NSAIDs.

NSAIDs are a major weapon in the battle against pain as they not only help relieve pain, they also relieve inflammation. As you can imagine, a lot of people with arthritis (of all kinds) take NSAIDs. They’re available as a prescription but there are also many forms available over-the-counter (OTC) including such brand names as Advil®, Aleve®, and Motrin®¹. The most commonly available NSAID is aspirin. NSAIDs are in such widespread use that in 2014, 123 million prescriptions were filled for them in the United States, according to an audit from IMS Health and one-third of the general population have used over-the-counter NSAIDs.

Even at the lower-dose OTC levels, these are powerful drugs and, as such, can have powerful side effects. While the most common are associated with stomach issues, NSAIDs also carry warnings for more serious complications including heart and kidney problems.

I found a couple of very interesting things about this study:

• Nearly half of the more than 1,000 adults surveyed didn’t know what an NSAID is, and
• Of those who indicated they knew about NSAIDs, nearly half didn’t identify common brands as NSAIDs, including medication they were currently taking or had taken in the past.

This is concerning on a number of levels. The first and foremost is that if you don’t understand what medication you’re taking, you also don’t understand the potential risks and side effects.

Figuring out why there is such a knowledge gap, especially for such a common class of drugs, is more complicated.

I think part of it is that many times people don’t understand the terms their doctors use. When our cardiologist warned my husband against taking NSAIDs, my husband promptly piped up and asked him what an NSAID was. The doctor was used to using the term, but my husband wasn’t familiar with it and therefore didn’t connect it to the pills in our medicine cabinet. While doctors have a responsibility to provide us with information, we patients have a responsibility to let them know when we don’t understand what they’re telling us.

Another part of the knowledge gap is that I believe that many people dismiss OTC medications as being inconsequential – that it only counts as “medicine” if you have a prescription for it. This attitude seems to cover not only medications but vitamins and other supplements, all of which can have a powerful effect on a person. What many people don’t understand is that at one time, the dosage levels of many medications now available for purchase at your local big box store used to be available only through prescription. Everything you take is important in understanding your overall care and risk factors.

So a major take-away for me from the study is communication with your doctor. It’s a two-way street. If you don’t understand what the doctor is telling you – speak up. And be sure and tell your doctors about ALL the medications and supplements that you take. It could be lifesaving.