Over the Counter Pain Killer

Dear Actuaries,

Do you take Advil, aspirin, Tylenol, Allieve and other drugs like this? I have a deep concern a good friend of mine has a drug addiction problem with this stuff but I don't know if i'm overreacting or if he's endangering his life.

He will take huge quantities of this stuff for his headaches I believe. I was with him for a 2 day period and in that time, he had 30 Advils which is way above the dosage maximum. He doesn't respect doctors and think they don't know more than him so he hasn't told his doctor about his ingestion. He was always take Benadrill to go to sleep at night and Tylenol Sinus PM also. He says he needs to take these pills in dosages of 6 sometimes for them to have a noticable effect.

Do you all think I should have a sit down with him and other friends? Is this a serious problem? I don't ever take these drugs so I don't know how dangerous they are but it seems like he's over using them and it could have bad effects. Please advise if you have knowledge of these matters. Thank you.

[The Drunken Actuary]

I don't know if it's a problem. Ask a doctor, pharmacists, or call the drug manufacturer. My guess is that they will all say your friend takes too much and is damaging something.

[Maine-iac]

Not sure about Aleve, but IIRC, excess aspirin can damage your stomach, excess Advil can damage your liver, and excess Tylenol can damage your kidneys.

But excessive ANYTHING is bad for you, and your friend sounds like he has a real problem. It also sounds like you can't do much about it. You could easily find articles documenting the dangers of excessive OTC drugs, but if he doesn't believe doctors, and package inserts, why would he believe articles?

FWIW, I once had a doctor suggest Advil/Motrin to me for an occasional pain problem. He said he used to prescribe Motrin for the problem, before ibuprofen was available OTC, and that the prescription dose was equivalent of 4 of the OTC pills. He said one would probably be too weak to do anything, but not to take more than four, and take the lowest number in between that would work. I never needed more than 2 or 3.

[L. Mo]

At first glance, he sounds like he's dependent on the OTC pain meds. And, Maine-iac has a good point about how overdosing them can create liver-kidney-etc. problems.

I'm guessing his headaches are severe migraines. First thought, his doctor is unaware of their severity, so is ill-equipped to treat them. There are prescription meds now that are much better than in the past. Maybe he needs to see a specialist.

But, of course, I'm not a doctor.

[Loner]

At a minimum, his doctor needs to know in case he takes any OTHER medications.

I take a fair amount of Advil for flareups of chronic back pain and did show slightly elevated liver enzymes, but that may have been due to a chronic genetic condition I have. When it's going poorly I will take 4(800 mg) every 6 hours. If it's still hurting badly then I talk to the doc about the narcotics(which I only take so I can get some decent sleep).

Advil and Aspirin and Aleve can all cause stomach bleeding with excessive use(not to mention hemorrhagic stroke - he might be setting himself up for a whole nother level of headache.)

Tylenol messes up your liver, especially if you drink.
the other thing he needs to know is that a noticeable effect in a lot of drugs depedns on building up a level in the blood - it's stupid to jump start that by taking 6.

Bottom line - there's lousy doctors out there - if he doesn't like his, he needs to find another, not simply self-medicate. Doctors do have an annoying tendency to pooh-pooh symptoms of those who are "too young." I can't tell you how many doctors shrugged off my serious back pain when I was in HS and college. When I finally got a diganosis in my early 30s one guy wanted to operate right away, the other said "wait as long as you possibly can, but oh yeah, you will definitely need surgery."

If he just does what you saw like one weekend a month, he's probably ok, but if he takes that much day in and day out, then yes I'd say he may well have a problem - or he will.

[Loner]

Another thing - this guy's headaches could be a sign of something like an aneurysm, in which case the **** he's taking is absolutely the wrong thing to take.
Try to talk him into seeing a neurologist.

[tommie frazier]

when I need em, I often take advil 4 at a time. but only short term. liver and stomach issues can happen. I don know a guy who took an NSAID until he had a bleeding ulcer. in that case, more <> better.

if he still "needs" more, either he has something they won;t address (loner's example) or has an issue with them.

[The Waiting Hurts]

Originally Posted by tommie frazier

when I need em, I often take advil 4 at a time.

Same here except in my case advil = motrin.

Too much of any OTC pain killer is going to be damaging to one of your major organs (depending on the drug).

A pharma and a drug manufacturer will refer you to the adverse effects section of the patient leaflet. A doctor may prescribe a script for a heavier med so that your friend takes less.

Maybe you should alert your friend of the potential side effects of taking too much of this drug. I'm sure you can find pictures on the net that show what a persons liver, kidneys, etc. look like after "abusing" OTCs - since pictures sometimes do tend to speak louder than words.

[Loner]

BTW - I really think you don't get "addicted" to the OTC stuff like the narcotics(man, just a couple of days of Vicodin and I could see how people develop problems - the world definitely seems a whole lot less miserable on that stuff).

Obviously you can overuse them, but it's not like they cause withdrawal. Your concern shoudl be less an intervention type thing than a "That stuff has side effects that you are not seeing coming" thing. I do know someone who was hospitalized for Advil-induced ulcers and I don't think he was an especially heavy user.

[Miss Fitz]

I think he definitely has a problem. My guess would be that he's addicted. Of course, I get paranoid about over the counter drugs because I'm a complete lightweight and even tiny doses (half, quarter, sometimes less) can really do a number on me. I get totally high, can't hold a conversation, get super paranoid, lose all sense of direction (I've gotten lost inside a building I was familiar with), and I've found them to be physically (but not psychologically) addictive. There must be something wrong with the receptors in my brain or something, since that clearly isn't normal, but I just wanted to establish that it is possible to get addicted to non-prescription medications. Even if he's not addicted, though, his behavior isn't normal and there are other serious health risks as stated by maine-iac and others.