World’s Most Dangerous Drug?

I was reading this week about a woman in New Hampshire suing a major pharmaceutical company for $24 million in damages. We’ve become an overly lawsuit happy society, but as I read the details of this one I couldn’t help but think this lady has a serious case.

Wide availability of drugs does not mean they’re safe

Karen Bartlett, who was an otherwise healthy 45-year old woman, started taking the prescription drug Clinirol (Sulindac) for shoulder pain. Two weeks later she was admitted to a local hospital with a growing rash and complaining of a feeling of “pebbles” under her eyelids and in her throat.

Five hospitals and nearly four months later, 65% of Karen’s skin had been burned off her body. Her throat, stomach and lungs were painfully seared. And also as a result of the Stevens-Johnson Syndrome / Toxic Epidermal Necrolysis (SJS/TEN) the drug apparently induced, she is now permanently disfigured and legally blind.

All in the pursuit of pain relief. Clearly this poor woman got much more than she bargained for. Unfortunately, while Sulindac has more reports of SJS/TEN than any other non-steroidal anti-inflammatory drug (NSAID), every single NSAID carries a tremendously high risk.

Most Prescribed Dangerous Drug

In the world of medical drugs, nonsteroidal anti-inflammatory drugs are more frequently prescribed than any other class of drugs. And that doesn’t even count over-the-counter purchases of NSAIDs like ibuprofen and naproxen.

Funny thing is, regardless of whether prescribed or not, or how much you pay for it, there’s very little difference between one NSAID and another in effectiveness at treating pain. More on that in a minute. What you might not know is just how dangerous this common medicine is.

While cases of SJS/TEN are rare, the death rate for NSAID gastrointestinal complications alone remains astronomical. It dwarfs overall population death rates for cervical cancer, asthma, and malignant melanoma. It even comes close to the U.S. death rate for leukemia.

You can buy NSAIDs everywhere from the pharmacy to the grocery store to your local dollar store. So can they really be that bad? Absolutely. An evaluation by the medical journal Pain found death rates after just 2 months of use average 1 in every 1,200 users from GI complications.

And as you age, the risk from NSAID use is magnified. After age 45, your risk of dying from NSAID-related GI bleeding more than triples. Continue using NSAIDs after age 75 and your risk of death skyrockets to 19 times younger adults face.

While GI bleeding is the most talked about harmful side effect, it’s hardly alone. Besides SJS/TEN, NSAIDs have been associated with an increased risk of heart attacks, strokes and other blood clots. They’re toxic to your liver, cause damage to your kidneys and intestines, and cause a host of other “minor” side effects like headaches and abdominal cramping.

Effectiveness of NSAIDs

A few years ago Consumer Reports published a buyer’s guide for NSAIDs. In it they looked at well over a dozen different NSAIDs, both prescription and over the counter and in various dosages.

In their review, they found NSAIDs typically reduce pain by about half and increase mobility for about 60% of osteoarthritis sufferers. They also found that after hundreds of studies, not one NSAID was proven to reduce pain more than any other. That means your cheap bottle of generic ibuprofen is roughly as effective at reducing pain as that $200+ per month prescription of Celebrex.

But why settle for less than a 2/3rds chance of increased mobility or only a 50% reduction in pain when much safer and potentially more effective remedies are readily available?

How about a topical pain cream that helped 100% of arthritis patients — that’s every single one — get pain relief and move better? Oh, and how about with zero side effects.

Or, if you want to fight inflammation naturally, simply supplement with the proteolytic systemic enzymes your body used to make more of. By reducing inflammation, you not only get pain relief, you also reduce the risk of heart attacks and stroke rather than increasing it like with NSAIDs.

My bottom line is, as always, you should exhaust natural means of treatment whenever possible before going down the pharmaceutical drug and surgical methods of treating pain.

Quoting the defense in Karn Bartlett’s lawsuit, “A reality in society, and in the medical society, is there are risks associated with drugs. There are a lot of drugs on the market, and a lot of drugs have side effects.”

I don’t know if that comment helped or hurt Mutual Pharmaceutical Co’s case, but I’d say it just made mine.

References

Tuohy, L. NH jury deliberates federal drug liability case. Bloomberg Businessweek. 2010 Sep 3.

Saag KG, Cowdery JS. Nonsteroidal anti-inflammatory drugs. Spine. 1994 Jul; 19:1530-1534. Tramèr MR, et al. Quantitative estimation of rare adverse events which follow a biological progression: a new model applied to chronic NSAID use. Pain. 2000 Mar;85(1-2):169-82.

Consumer Reports. Treating Osteoarthritis and Pain: The Non-Steroidal Anti-Inflammatory Drugs. Comparing Effectiveness, Safety, and Price. 2005 Jun.