Ibuprofen is commonly prescribed for relieving pain, mostly swelling and inflammation. It is also a common and main ingredient of various over the counter (OTC) medications for fever, headache, cold, osteoarthritis, menstrual cramps, arthritis, rheumatoid arthritis and back pain [1,4].
If pain to too strong, and OTC Ibuprofen does aid in pain management, then a higher dosage can be prescribed by a healthcare provider.
Using an Over the Counter Pain Medication
Ibuprofen is a widely prescribed medicine and is available OTC. It is easily available and can be taken by both adults, children, and infants 6 months and older [4]. Ibuprofen is part of the non-steroidal anti-inflammatory (NSAID) group and the recommended dosage limit for Ibuprofen is 3,200mg daily for adults. This equals to about 16 tabs at 200mg per day.
There are significant side effects that can occur at doses lower than the recommended daily limit, which an include stomach ulcers, kidney failure, and increasing symptoms and severity of those with congestive heart failure [1].
The side effects are typically consistent with dosage levels and length of time taking medication. Up to 70% of the Western population in the world uses pain relievers regularly, for headaches and other pains [2] and over the past 15-20 years approximately 187 billion tablets of Ibuprofen have been consumed by 170 million US adults [2].
Excessive Use Of Ibuprofen
The abuse of Ibuprofen can be partly due to the exceeding the specified dosage frequently, or relying on the drug for longer than necessary or prescribed. Many individuals who are looking for a way to manage pain, can easily turn into becoming dependant or developing a tolerance for it.
Many individuals who are dependant or addicted to Ibuprofen may feel it is needed to function or carry out daily tasks and activities [4]. Ibuprofen can have a numbing effect on the body and emotions.
NSAID works by inhibiting cyclooxygenase 1 and 2 (COX 1 and COX 2) enzymes within the body, or pain receptors [2, 6].
These enzymes are part of the synthesis of unstable precursors of prostaglandins [2]. Both COX 1 and 2 are able to reduce inflammation, and antiinflammatory in the body.
These enzymes play a role in everyday physiological processes both in the periphery and central nervous system (CNS). A normal adult dose of Ibuprofen is 4g per day and 50mg per day is sufficient enough to inhibit function [2].
NSAID are typically used for mild to moderate pain and are used for primarily musculoskeletal disorders to include, osteoarthritis, rheumatoid arthritis, and sports related injuries. NSAID are typically well absorbed and highly bound to plasma proteins, and are excreted through either a glomerular filtration or tubular secretion and accumulate at sites of inflammation.
Do I Have An Addiction?
Ibuprofen abuse can often be called an addiction to over the counter (OTC) medication. Addiction can be defined as a craving, uncontrollable, or compulsive use of a drug and use even when causing harm [1, 4]. Addiction is characterized by abnormal or aberrant behaviors over a period of time.
Some signs of an addiction are noticing prescriptions have been lost or stolen of friends/family or the prescriber reports to their healthcare provider or pharmacist that the script has been lost or stolen; the person asks for early refills; taking medication without being told too by healthcare provider; increasing dosage without approval; getting the pain medication from multiple providers; and continuing medication even with adverse side effects [1].
If an individual has been using Ibuprofen above the dosage recommendation and for long periods of time, they may notices symptoms of dependence such as GI ulceration, diarrhea, drowsiness, nausea, swollen face or eyes, ringing in the ears, itching or rashes on the skin, and fatigue or tiredness [4].
Signs and Symptoms
Most OTC drugs are anti-inflammatory, antipyretic, and analgesic and are commonly in the Nonsteroidal Anti-Inflammatory drug Category. The most commonly used OTC medications are Acetaminophen and Ibuprofen and are the top 10 drugs in the United States warning Network Statistics for emergency room contacts resulting from self-administered drugs with evidence of suicidal intent [4].
In a survey of Florida high school students, reported that 17% did not think that acetaminophen could be lethal, and 23% significantly underestimated to the dose that could be lethal. This lead researchers to conclude that many patients admitted for acetaminophen overdose may be making a gesture with a druge they did not perceive to be particularly dangerous [2].
Ibuprofen can lead to dependence due to exceeding the specified dosage or relying on the drug for much longer than the prescribed time period. It can turn from managing mild pain to developing a tolerance and taking increasing amounts to relieve pain.
The individual may not get addicted to the drug, but may feel a need for the drug to carry out everyday activities, or sports. Taking Ibuprofen for a continued length of time it may have a numbing effect on the user, both physical and emotional. It can have psychological effects of numbing emotional pain as well as physical pain [4].
Using Ibuprofen for a long period of time can have effects such as GI ulceration, diarrhea, drowsiness, nausea, swollen face or eyes, ringing in ears, itching or rashes, fatigue or tiredness. If these symptoms appear, stop taking the medication and see a healthcare provider.
In conclusion, most people do not think about the consequences of taking too much ibuprofen over time. It is important to meet with your healthcare provider if you are experiencing pain for a continued amount of time, or increasing doses of OTC medicines to relieve pain.
Community Discussion – Share Your Thoughts Here!
Did you know that OTC medications can be addictive or numbing to the body?
About the Author: Libby Lyons, MSW, LCSW, CEDS, is a Certified Eating Disorder Specialist (CEDS) who works with individuals and families in the area of eating disorders. Mrs. Lyons works in the metropolitan St. Louis area and has been practicing in the field for 11 years. Libby is also trained in Family Based Therapy (FBT) to work with children-young adults to treat eating disorders. Mrs. Lyons has prior experience working with the United States Air Force, Saint Louis University, Operating Officer of a Private Practice, and currently works with both Saint Louis Behavioral Medicine Institute within their Eating Disorders Program and Fontbonne University
References:
[1]: http://eorthopod.com/medication-approach-to-chronic-pain/
[2]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1188892/pdf/jpn00074-0015.pdf
[3]:https://www.researchgate.net/profile/Mike_Miller3/publication/44663637
[4]: https://rehab.international/ibuprofen-detox-abuse-treatment-recovery-withdrawal-symptoms-and-effects
[5]: https://www.elementsbehavioralhealth.com/news-and-research/long-term-use-ibuprofen-bad-for-elderly/
[6]: http://www.webmd.com/drug-medication/otc-pain-relief-10/pain-relievers-nsaids
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.
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Reviewed By: Jacquelyn Ekern, MS, LPC on January 15, 2017.
Published on AddictionHope.com