Say no to drugs, even the legal variety

Hypochondriacs now have a real reason to lose sleep. Popping pills to treat illnesses can cause diseases more deadly than the ones they set out to cure, reported three big international studies this week.

Hypochondriacs now have a real reason to lose sleep. Popping pills to treat illnesses can cause diseases more deadly than the ones they set out to cure, reported three big international studies this week.

The most terrifying was the one linking paracetamol — better known as Crocin in India — to asthma in children. It found that adolescents who took it even once a month were twice as likely to have asthma than those who never took.

Taking over-the-counter pain and fever drug also increased the chance of skin allergies (eczema) and allergic nasal congestion (rhino-conjunctivitis).

The report, in the International Study of Asthma and Allergies in Childhood, used data from more than 3 lakh children, aged 13-14 years from 50 countries. The study did not prove that paracetamol directly caused asthma, but said it prompted the body to produce a greater immune response to the triggers. However, it stressed that paracetamol should be taken for pain and fever in kids, (aspirin and ibuprofen can trigger asthma attacks), albeit cautiously.

Following the threat of an increased risk of heart attacks, two Cox-2 inhibitors (rofecoxib and valdecoxib) were pulled from the market in 2004 and 2005, respectively. But a third type called celecoxib is still in the market. Subsequent studies have also raised concerns about the possible heart risks of over-the-counter NSAIDs, including ibuprofen and diclofenac.

But since the findings do not prove that the drugs caused the stroke, the study emphasises the need to use NSAIDS at the lowest dose and for the shortest time necessary to relieve pain.

NSAIDS other than aspirin increase the risk of heart attacks and stroke by increasing blood-clot formation or creating spikes in blood pressure.

International guidelines on pain relief recommend people to first use paracetamols, which are not NSAIDs, or aspirin, which is a blood thinner that protects against heart attacks.

The third study, the controversial one in The Lancet Infectious Diseases last week, did a bad job of highlighting the issue of antibiotic misuse that created superbugs that cause heart infections, meningitis, sepsis, kidney abscesses and infections, and our very own New Delhi metallo-beta-lactamase (NDM-1).

Most fevers, runny nose and chest congestion are caused by viruses, against which antibiotics are useless. Less than 10 per cent bronchitis cases need to be treated using antibiotics, while the percentage needing treatment is at a slightly higher 10 to 15 per cent for cases of sore throats.

Overuse and misuse of antibiotics leads to the spread of drug-resistant bacteria. The history of antibiotic use shows that within two years of a new drug being introduced, bacteria develop resistance to it, forcing doctors to go for stronger medicines or use a cocktail of drugs for treatment.

If overuse of medicines — over-the-counter painkillers and prescription antibiotics alike — is not discouraged, common infections such as meningitis and pneumonia may become too expensive or even impossible to treat over the next two decades. Sometimes, you have to say no to drugs even if they're the right kind.