Risks of Pill-Popping: Side Effects in the News

By Cathie Dunal, MD, MPH:  A few months ago we were astonished to learn that common medications—sleep meds like Sonata and Ambien, anxiety meds like Xanax and Valium, and over-the-counter allergy meds like Benadryl and Chlor-Trimeton—are all associated with increased risk of Alzheimer’s disease.  A five percent increased risk with as little as ninety days of use in your lifetime! Yikes!

The latest medicine surprise is NSAIDS, or non-steroidal anti-inflammatories. They bring a ten to fifty percent increased risk of “cardiovascular thrombotic events”—heart attacks and strokes.  We pop these pills like candy—the most common are Motrin/ibuprofen, Aleve/naproxen, and prescription anti-inflammatories.  The new advisory from the FDA is to take as little as possible for as short a time as possible.

My take is that we ought to wake up to the possibility that popping a pill isn’t the optimal first step to treating medical conditions.  (Note that I’m not talking about serious infections, endocrine conditions, etc.)  The first step should be prevention via lifestyle.  The next first step, assuming a problem is already raising its ugly head, is lifestyle treatment.  Then—but only after addressing immediate and preventive lifestyle interventions—we should delve into non-pharmacological interventions–and prescriptions.

Let’s take aches and pains as an example.  Self-care options include ice, exercise, and the all-important stop-whatever-you’re-doing–that’s-triggering–the-problem-for-a-while strategy. Walk or swim. Get enough sleep.  (And do you have a good mattress and pillow?)  Try Tai Chi.  You might see an athletic trainer, massage therapist, physical therapist or acupuncturist.  Strategies as simple as drinking more water and stopping smoking can significantly improve back pain.  Look at your posture.  Lose some weight.  See your doctor, orthopedist, or chiropractor for help.  Food-based alternatives to NSAIDS are curcumin and ginger, and these also come in pills that are easy to take like the drugstore ones—with less risk of stomach upset.

Please know that “tincture of time” heals many musculoskeletal problems, and the default in the medical community is to do a little something to take the edge off so you can wait to see if it gets better on its own.  The” little something” has often been an NSAID.  But now we know better!

However, the larger issue isn’t any particular medication or over-the-counter drug, or any particular condition.  The take-home from this latest “yikes” warning is that we need to look at our lifestyle to prevent and treat “medical” conditions.  Not pop a pill.  We need to take an active approach to our health, not a passive one.  And yes, it’s work.  It’s harder and less convenient.  But it’s safest.  And it’s also a great way for us each to do our part to rein in our galloping healthcare costs.

For more information, see: FDA website www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAltersforHumanMedicalProducts/ucm454141.htm, American Academy of Family Practice News http://www.aafp.org/news/health-of-the-public/201507nsaidrisk.html, BMJ 2014;349:g5205 (British Medical Journal), JAMA Intern Med. 2015 Mar;175(3):401-7.