Ann Robinson 

Are painkillers such a bitter pill to swallow?

According to new research, painkillers can increase your risk of a heart attack by 50%. But what does that actually mean?
  
  

What are the risks of relief?
What are the risks of relief? Photograph: Peter Dazeley/Getty Images

Painkillers are turning out to be a real pain: according to a new study in the BMJ, taking them for just a week can increase your risk of a heart attack by 50%. The research suggested that the risk associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) was greatest with higher doses and during the first month of use, with a potential increase in risk of 75% for ibuprofen and naproxen, and more than 100% for rofecoxib.

It all sounds bad but, if your risk is very low – say, one in a million – a 100% increase means you still only have a two in a million chance. Of course, all painkilling medication that works can have side-effects – nothing is guaranteed to be safe and effective. Paracetamol has very few (unless taken in excess, in which case it can cause fatal liver damage), but it isn’t very effective.

NSAIDs in small doses for short periods of time can be effective and safe as long as your heart, kidneys and gut are in good nick. Opiates, including codeine and morphine, are strong painkillers but potentially addictive and often cause constipation and drowsiness. But don’t despair; your GP can offer guidance and refer you to a pain clinic. And for ongoing pain, Tens machines and other ways of distracting the brain, such as mindfulness and exercise, may be the best option.

Scientists at Harvard have recently done a (quite horrible) study on mice; they subjected them to extremes of hot and cold, applied pressure to their rear legs and injected the irritant capsaicin (from chilli peppers) into their feet, before timing how long it took them to respond to the pain. Sleep deprivation increased their discomfort, while stimulants such as caffeine and modafinil made them less responsive to pain. This has been widely reported as showing that a good night’s sleep and cup of coffee in the morning may help pain – but don’t chuck out the pills quite yet.

 

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