USE AND ABUSE OF OVER-THE-COUNTER ANALGESIC AGENTS

Pain and discomfort in everyday life are often treated with over-the-c ounter (OTC) analgesic medications. These drugs are remarkably safe, b ut serious side effects can occur. Up to 70% of the population in West ern countries uses analgesics regularly, primarily for headaches, othe r specific pains and febrile illness. It is not known whether the patt erns of use are consistent with good pain management practices. OTC an algesics are also widely used to treat dysphoric mood states and sleep disturbances, and high levels of OTC analgesic medication use are ass ociated with psychiatric illness, particularly depressive symptoms, an d the use of alcohol, nicotine and caffeine. More than 4 g per day of acetylsalicylic acid (ASA) or acetaminophen over long periods is consi dered abuse. People using excessive amounts of OTC analgesics may need more effective treatments for chronic pain, depression or dysthymia. The possibility that these drugs have subtle reinforcing properties ne eds to be investigated. Certainly phenacetin, which was taken off the market in the 1970s, had intoxicating effects. A better understanding of patterns of use is needed to determine the extent of problem use of OTC analgesics, and whether health could be improved by educating peo ple about the appropriate use of these drugs.