As you head to bed after a wild night at the office Christmas party, you pop some paracetamol to prevent that humongous morning-after hangover.
Right? Wrong.
The belief that taking paracetamol on top of a lot of alcohol helps you avoid that killer headache and queasy stomach the next morning is one of the many myths and misconceptions which surround the use of painkillers.
"If you've taken alcohol, it needs to be metabolised by the liver," explains Darragh O'Loughlin, secretary general of the Irish Pharmacy Union.
“But so does paracetamol. So you’re essentially giving your already overworked liver even more work – and putting yourself at risk of liver problems down the line.”
And, since paracetamol is only effective for four to six hours, by the time you wake up, its effects may have worn off: “The logical thing to do is to drink plenty of water over the evening, and again before bed – and consume a moderate amount of alcohol,” he advises.
The belief that we can safely share painkillers prescribed for somebody else is another myth. Just because a particular medication works for someone else does not mean it will be of benefit to you – and it could even be dangerous.
“The drug you’re being offered may interact negatively with a drug you are already taking for a different condition,” says O’Loughlin.
Another misconception is that people with classic, long-term pain need only take a painkiller when the pain becomes severe.
However, as Portarlington GP Dr Sumi Dunne warns: "In the case of muscle pain, for example, a painkiller can give relief if taken regularly for a short course over three to five days. However, sometimes people only take it when they get the pain and don't take it regularly, when taking it regularly would allow it to give a therapeutic effect.
“As GPs we see a lot of incorrect use of painkillers – some people use too many, and conversely, some may not use enough,” says Dunne, who also lectures on general practice at third level.
Her comments are underlined by the findings of a recent survey which found that 67 per cent of respondents tried to avoid taking painkillers unless the pain was extremely severe.
Relief
The study, carried out on more than 1,000 adults last August, also found that one in three preferred not to take painkillers at all, unless they were recommended by their health professional.
The belief that it’s best to take the strongest painkiller you can find when first experiencing pain, is another common misconception, according to Limerick-based pharmacist Sinéad Ryan – and in fact 17 per cent of Irish adults take the strongest available painkillers when they initially experience pain, because they believe the strongest will be most effective, according to the research.
Instead it’s recommended that patients start by taking “the lowest form of suitable over-the-counter pain relief for your needs, such as a paracetamol or ibuprofen-based painkiller,” says Ryan. “Stronger does not necessarily mean more effective.”
This approach, she observes, is in line with guidance from the World Health Organisation, which recommends that patients always begin with the lowest form of appropriate pain relief for their symptoms.
Another widespread misconception is that it’s safe to take more than the recommended dose of painkiller. Dr Dunne says it’s “not uncommon” to hear that patients are taking higher doses than they should, because the correct dose is not providing adequate relief.
“We will advise that taking more than the recommended daily dose is not advisable and we will look at alternative ways that pain can be controlled – along with investigating whether there may be a more sinister underlying cause for the pain,” she comments.
"Rebound headaches" can be an issue for patients who have developed a sensitivity to codeine but who often incorrectly assume that a new headache is simply the same old problem, explains Dr Andrew Jordan, Chairman of the National Association of GPs and a GP practising in Terenure and Tallaght.
“A patient may take an analgesic painkiller containing codeine for a headache. They may subsequently continue to use the codeine for the occasional headache, but some will have an inherent sensitivity to codeine and if they continue to use it, it may cause ‘rebound headaches’ which in turn increase their use of the drug.
“Ultimately people can end up addicted to the codeine. People don’t realise that the feeling of well-being they are getting from the codeine is a sign that they may be developing a dependence on it.”
Read patient information leaflets carefully, he emphasises, and be aware of the possibility of rebound headaches. “Some people tend not to read the instructions on the packaging and as a result they are ill informed about all aspects of the drug they are taking.”
Finally, warns O’Loughlin, don’t presume that painkillers can “fix” a problem simply by suppressing it – this is another myth:
“If you’re getting regular headaches talk to your pharmacist or GP.
“Don’t just buy painkillers to suppress the headache as there may be an underlying cause that needs to be addressed.”
PAINKILLERS – MYTH v REALITY
Myth: Take the strongest painkillers you can when initially treating pain as these will be most effective.
Reality: Stronger does not equal better, warns pharmacist Sinéad Ryan. "Different active ingredients work in slightly different ways and depending on the source of your pain, one might be more suitable than another."
Consult your pharmacist or doctor regarding the most suitable pain relief for your symptoms.
Myth: Over-the-counter pain medication can fix your pain.
Reality: Over-the-counter medication cannot fix your pain, explains Ryan, although it can help alleviate symptoms. Even if the pain is relieved by the medication, consult with your healthcare professional if the pain is severe, returns after you've taken pain medication, lasts longer than the number of days listed in the patient information leaflet or gets increasingly worse over time.
Myth: I can take someone else's painkillers.
Reality: Always take the correct painkiller for your symptoms, urges Ryan. Don't take somebody else's painkillers as the incorrect use of medications for prolonged periods can cause unwanted side effects.
Myth: I can take over-the-counter painkillers for a long time.
Reality: We should only take painkillers for the recommended amount of time, says Ryan. Prolonged and incorrect use of painkillers can cause more problems. Generally speaking, painkillers shouldn't be used for more than three days in a row or longer than the number of days listed in the patient information leaflet.
Myth: Avoid painkillers altogether.
Reality: Used responsibly, these products can help you manage short-term mild to moderate pain caused by conditions such as headaches, backache, toothache, muscle ache, sore throat, and also for the relief of fever and the aches and pains of colds and influenza.