In an earlier Insights, I discussed the dangers of opioid drugs and the epidemic of opioid abuse. At the time, some in the local media dismissed my concerns. Since then, sadly, the truth of my commentary has been made abundantly evident. The most obvious example occurred on April 21 with the death of popular musician Prince at the age of 57. Prince’s death was reportedly related to long-term use of prescription opioid drugs to treat hip pain and back pain associated with years of performing in high heels. Also, Wilmington has now been identified as the city with the highest rate of opioid abuse in the United States. Yes, that is Wilmington, North Carolina. Subsequently, the news has been awash with reports on the dangers of opioid drugs. The public has been warned to use safer drugs. My purpose this month is to alert you that “safer” drugs can also be dangerous. 
 
Case in point is acetaminophen, the main ingredient in Tylenol and several other drugs. Acetaminophen is commonly recommended for the treatment of spinal pain, arthritis pain and other aches and pains. In fact, acetaminophen is the most widely used “pain reliever” in the United States. Alarmingly, due to its pervasive use and the false belief that it is harmless, acetaminophen is responsible for 50 percent of all acute liver failure in the United States. Also, acetaminophen consumption causes 56,000 liver-related emergency room visits, 26,000 in-patient hospitalizations, and more than 450 deaths a year in the United States alone. 
 
Adding insult to injury, research shows that acetaminophen fails to relieve back pain or arthritis pain. Research published in March 2015 by the British Medical Journal concluded that acetaminophen is “ineffective in the treatment of low back pain” and provides only “minimal short term benefit with osteoarthritis.” The researchers caution doctors to reconsider recommendations to use acetaminophen for patients with low back pain and osteoarthritis.
 
The following circumstances create an exceptionally heightened risk of injury or death from acetaminophen use: fasting (as commonly is the case when patients are ill or in extreme pain); dieting; alcohol consumption; mixing medications; liver disease; malnutrition; anorexia; AIDS; and kidney disease. However, it is important to note that even “routine use” and chronic consumption of acetaminophen can cause liver toxicity. Initial signs and symptoms of acetaminophen toxicity are nausea and vomiting. Liver damage in response to acetaminophen consumption may also develop without immediate or obvious symptoms.
 
You cannot depend on acetaminophen to relieve your pain, but you can be pretty well assured that it will damage your liver. Oh, and it might kill you. Over-the-counter (OTC) medications which contain acetaminophen include Tylenol, Children’s Tylenol, Tylenol PM, Excedrin, Excedrin PM and  Alka-Seltzer Plus Cold & Flu. Common prescription drugs which contain acetaminophen include Vicodin, Darvocet, Percocet, Endocet, Roxicet, Ultracet and Midrin. Warnings about acetaminophen consumption generally appear on acetaminophen-containing product labels in print with a font size that can be read by any owner of a giant magnifying glass or microscope.

So acetaminophen is ineffective and potentially dangerous. What to do then? Well, NSAIDs (non-steroidal anti-inflammatory drugs) are a bad alternative as NSAIDs also cause significant health problems, resulting in more than 100,000 hospitalizations and 16,500 deaths each year in the United States. NSAIDs are key ingredients in common OTC drugs including Advil, Motrin, Aleve, Orudis, many cold and flu medications and prescription drugs including Mobic, Celebrex, Bextra and Vioxx.
 
There is good news. Safe and natural solutions for pain do exist. The American Chiropractic Association provides the following options to consider:

1. Chiropractic structural care can replace acetaminophen or NSAIDs as a means of relieving pain and reducing inflammation in many cases. Chiropractic physicians are trained to relieve pain and improve joint function through natural therapies such as chiropractic adjustment and manipulation, trigger point therapy, individualized exercise programs, and various physical therapy modalities including the use of therapeutic lasers. There is strong evidence for the effectiveness of these interventions in the treatment of back, neck and joint pain.
    
2. A healthy diet is critical to reducing and preventing inflammation. Some foods and food combinations actually promote inflammation while other foods are anti-inflammatory. Reduce inflammatory components of your diet by increasing consumption of nutrient-dense foods such as lean skinless meat, fish, vegetables, fruit and nuts. Consult your chiropractic physician or other health care provider for individualized dietary recommendations.
    
3. Natural anti-inflammatory agents and supplements also can be of great benefit. For instance, research indicates that two grams of omega-3 fatty acids daily reduced joint pain and the need for NSAIDs in 59 percent of patients with neck or back pain. Many other vitamins, minerals and herbs also offer great benefit for the reduction of pain and inflammation. However, as with any health care intervention, your regimen of herbs and supplements should be individualized to meet your specific needs. In our office, we develop individualized recommendations based on patient history and physical examination, as well as thorough blood analysis and other laboratory evaluation.

We do have a problem with opioid drugs … but more drugs may not be the best solution to a drug problem. As the most widely used pain-reliever, acetaminophen might be said to be the “emperor” of the pain-relief drug category. The March 2015 British Medical Journal article has now revealed that “the emperor has no clothes,” Acetaminophen is not helpful in reducing back pain or arthritic pain. Consult your chiropractic physician for safer and more natural ways to reduce and prevent pain.
 
Dr. R. Todd Shaver is a chiropractic physician at Shaver Chiropractic & Natural Medicine. As a distinguished fellow of chiropractic biophysics, Dr. Shaver utilizes spinal adjustment and other chiropractic physical medicine procedures to address injury and pain and to promote wellness. He is Wilmington’s only chiropractic physician to have achieved specialty status (D.I.C.C.P.) in chiropractic pediatrics and prenatal care. To learn more, go to www.shavernaturalmedicine.com, call (910) 452-5555, or contact his office at [email protected].