Title: Aspirin: Upside, Downside
Author: Jennifer James
Publisher: Do It Now Foundation
Publication Date: October 2002
Catalog Number: 138

..‘Four Out of Five Doctors Recommend…’

If you’ve watched the evening
news on TV more than three times in your life, you might think
you know all there is to know about aspirin.

Because in that short time, you
would have seen aspirin buffered and time-released, extra-strengthed
and effervesced, in a dozen different forms in a dozen different

You’d have seen it rush to where
it hurts five times faster while it was twice as gentle to your
stomach, unclanging bell-ringer headaches as it neutralized neuritis,
neuralgia, and a long list of muscular aches and pains.

You’d have seen migraines pampered
and vanquished, and arthritis pain formulized out of existence.
And, increasingly, you would have heard it extolled as a way
of preventing heart attacks.

But what would you really know
about the most widely-used pain reliever of all time?
Not much, probably. Because in spite of the enormity of aspirin
use, most of us know less about it than any other drug.

Oh, we know it works — usually,
when taken as directed — but that’s about it. And there’s a
lot more to it than that.

Because aspirin is a drug. And
although it’s safe and cheap and effective, it can be dangerous
— even deadly — when used incorrectly or in larger-than-recommended
That’s why we’ve put this pamphlet together.

We think it’s your right — your
obligation, even — to know about this popular and potent drug.
And knowing more about aspirin could save you, or someone you
care about, a headache or two — or even a doctor or hospital
bill someday.

Want to know more? Then read

..Aspirin, the Drug

Since its commercial introduction
in 1899 by the Bayer Company, worldwide popularity of acetylsalicylic
acid — better known as aspirin — has grown steadily. And so
has the variety of aspirin available.

Today the drug is sold in everything
from tablets and capsules to chewing gum and elixirs. It’s combined
with caffeine and countless other drugs, both prescription and
It’s swallowed to prevent heart attacks and taken to relieve
headaches, fever, rheumatism, arthritis, inflammation, hangovers,
and other disorders, real and imagined.

It’s available wherever you might
happen to be: grocery and drug stores, gas stations, airports,
restaurants, glove compartments, purses, and desk drawers.

But no matter what form you buy
or where you find it, all aspirin works in the same way: by blocking
production of hormone-like chemicals (called prostaglandins)
involved in everything from blood circulation and clotting to
body temperature, digestion, and breathing.

At high levels, prostaglandins
cause pain — and aspirin just eats up pain.

..Uses, Abuses

When used correctly, aspirin
is a wonder drug. Its ability to relieve pain is unequaled even
by many highly-touted prescription drugs.

But for best results, it’s important
to use aspirin only as directed. Other points to keep in mind:
Don’t take aspirin on an empty stomach, and be sure to wash it
down with a glass of water. Relief begins within minutes; peak
effect is reached in about two hours.

Some experts say a good way to
take aspirin is to crush it and mix it with orange juice or honey
and lemon to reduce stomach irritation and permit faster absorption.

There are also a number of possible
side effects and other problems you should be aware of if you
take aspirin. Just consider these, for starters:

For some users, aspirin can cause
ringing in the ears, dizziness, vomiting, and hearing loss. Such
symptoms usually disappear when aspirin use stops.

The most common effect of overuse
is stomach upset — from pain and nausea to bleeding ulcers and
chronic indigestion.

Regular aspirin use also damages
the kidneys and can trigger sudden renal failure.

..Overuse, Overdose

Still, the greatest danger of
overuse is overdose. As little as 10 grams — about 30 regular-strength
tablets — can be fatal in adults. In 1996, aspirin ranked eighth
among all drugs as a cause of overdose and poisoning.

A reason aspirin ranks so high
is simple availability.

A bottle is always around somewhere,
waiting to be downed by a curious child (aspirin is still a leading
cause of poisoning in kids) or by adults who think that if a
little aspirin makes them feel better, a lot will make them feel

These are the people statistics
are made of.

That’s why aspirin overdoses
should always be regarded as life-threatening emergencies requiring
fast medical attention.

As with any other drug, users
should also be careful about interactions with other drugs. Aspirin
interferes with many types of medication, including drugs taken
for gout, diabetes, and kidney disease.

Its effects are also altered
by vitamin C, which slows elimination of the drug from the body,
and by alcohol. And despite its use as a hangover cure, aspirin
is even more irritating to the stomach when used with alcohol.

..Other Problems

Even when taken as directed,
aspirin still stirs up problems for some people.

Those with conditions such as
hemophilia, asthma, or allergies should consult their doctors
before using any amount of the drug.

Because aspirin can disrupt normal
blood clotting and cause bleeding, it should be avoided at least
one week prior to surgery and during pregnancy.

In fact, evidence of the drug’s
dangers in pregnancy — including prolonged labor, heavier bleeding,
and abnormal clotting in mother and child — has prompted federal
officials to recommend warning labels for all aspirin products.

Children and teenagers are also
better off with substitutes. Aspirin can trigger a serious, often
fatal sickness called Reye’s syndrome in young people recovering
from chicken pox or the flu.

The syndrome can cause brain
damage and death. Because of the risks, aspirin makers are required
by law to add warning labels about Reye’s syndrome to product

..Aspirin Alternatives

If you’re one of the people who
can’t take aspirin, there are alternatives.

The most popular is acetaminophen,
sold under the brand-names Tylenol and Datril (among others).
Acetaminophen reduces fever and pain, but doesn’t ease inflammation.
On the other hand, acetaminophen causes less stomach upset.

Ibuprofen, sold under the brand-names
Advil and Nuprin, was introduced as a nonprescription pain reliever
in 1984. It works like aspirin to block both fever and swelling
and may work better against certain types of pain, like menstrual

But even aspirin alternatives
aren’t entirely safe.

Both can cause overdose — and,
in recent years, each has surpassed aspirin as a cause of hospitalization.
And both acetaminophen and ibuprofen appear to damage kidneys
with regular use.

Some reports have even linked
ibuprofen to a reversible, temporary form of kidney failure in
as many as a quarter of patients studied.

Should none of these over-the-counter
drugs satisfactorily reduce discomfort, pain may be a sign of
a more serious problem warranting a doctor’s attention. For more
severe pain, a physician can prescribe other preparations, including
narcotics and synthetic pain relievers.

..Consumer, Be Wise

Pointing out its possible risks
isn’t meant to turn people away from moderate aspirin use.

Aspirin really is a wonder drug
— as effective at stopping pain as many prescription analgesics,

and its beneficial effects on health only make it that much more
of a boon than it has been all along.

Just about the only thing aspirin
lacks is the “magic” that occurs when a doctor writes
a prescription for an expensive prescription drug. This “magic”
relieves pain about half the time — even when the contents of
the capsule are only sugar.

But unlike the “magic”
of placebos, the magic of aspirin resides in the aspirin molecule
itself. And all aspirin is alike. It has to be to be aspirin.

No matter what some brand-name
aspirin makers say in their TV ads, there’s no real difference
between brand-name and no-name aspirin. When you buy expensive
brands, the extra money pays for advertising — not “faster”
or “better” pain relief.

Aspirin is aspirin, and it works
and it’s safe — if you’re careful — whether it costs 99 cents
or $9.99.

..Sidebar | Rx
for the Heart

After a century on the job, aspirin’s
still working wonders — and in wondrous new ways.
Beyond its role as a pain reliever, aspirin is showing value
in preventing ischemic (clotting) strokes and in slowing the
formation of cataracts.

Perhaps even more important is
the drug’s role in preventing heart attack by slowing development
of blood clots in arteries leading to the heart.

Researchers at Harvard Medical
School concluded a six-year study by saying that healthy men
over age 50 can cut their heart attack risk in half by taking
a single aspirin, every other day.

But don’t head for the medicine
cabinet just yet. Head to the doctor, if you think you might
benefit. And even then, you should be aware of two key points:

More is not better. There’s no
evidence that gulping more aspirin more often will improve your
chances of avoiding a heart attack.

Aspirin is not a substitute for
other preventive measures, such as losing weight and stopping

In addition, regular aspirin
use may increase risks of bleeding stroke, which is more often
fatal than ischemic stroke.

Best advice? Check with your
doctor to see if benefits outweigh possible risks in your case.
The alternative can be every bit as deadly as a heart attack.

This is one in a series of publications
on drugs, behavior, and health by Do It Now Foundation.
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