Painkillers widely used but risky

Over-the-counter painkillers such as paracetamol, ibuprofen, and aspirin are commonly used for pain relief but can cause serious harm if misused or taken in large doses. These medications are among the most frequently used self-medication products in France, where more than 80% of people use self-medication regularly.

WHO classifies painkillers by risk

The World Health Organization (WHO) classifies painkillers into three levels based on risk and regulation. Level 1 includes non-opioid drugs like paracetamol and some non-steroidal anti-inflammatory drugs (NSAIDs), which are available without a prescription. Level 2 and 3 include opioid medications, which require a doctor's prescription for moderate to severe pain.

French regulations now apply

Since January 2020, over-the-counter painkillers in France are no longer freely available. They must be obtained from a pharmacist upon request, following guidelines from the French National Agency for Medicines Safety (ANSM). This change aims to reduce the risk of misuse and accidental overdose.

Paracetamol's popularity and dangers

Paracetamol is one of the most popular painkillers in France due to its low side effects and good tolerance. However, it carries a high risk of liver damage if taken in excess. Adults should not exceed 3,000 mg per day, and doses above 10,000 mg can be life-threatening, especially if spread over 24 to 48 hours.

Chronic headaches from overuse

Chronic headaches caused by overuse of painkillers affect 1 to 2% of the population. Medications containing caffeine, codeine, or paracetamol can trigger daily headaches, especially in people with a history of migraines or tension headaches. Experts recommend limiting crisis medication to no more than 2 days per week.

Combining medications increases risk

Accidental overdose from combining medications is common, as more than 200 medications contain paracetamol. These include over-the-counter drugs for allergies, colds, or flu. Since 2020, warning labels on paracetamol-containing medications now advise against taking other medications with the same ingredient.

Alcohol and paracetamol are a dangerous mix

Combining alcohol with paracetamol can significantly increase liver damage. People who drink alcohol regularly should limit their paracetamol intake to 500 mg per day. Taking large doses after a hangover can be particularly risky, as the liver is already stressed.

NSAIDs have significant risks

NSAIDs such as ibuprofen and diclofenac are recommended only as a second option if paracetamol is ineffective. These drugs carry serious side effects, including stomach ulcers, kidney damage, and an increased risk of heart attack. They should be dispensed only with a prescription due to their potential for harm.

NSAIDs can delay proper treatment

The European Committee for risk assessment concluded that NSAIDs may mask symptoms like fever or pain, delaying proper medical care. This can lead to more severe complications, including life-threatening infections. Doctors now advise caution when using these medications.

Aspirin's wide range of side effects

Aspirin, or acetylsalicylic acid, has a broad range of effects, including anti-inflammatory and blood-thinning properties. However, these benefits come with serious side effects, including allergies in people with asthma and the risk of metabolic acidosis. It is not recommended for self-medication due to its complexity and potential for harm.

NSAIDs may worsen chronic pain

A 2022 study in Science Translational Medicine suggests that NSAIDs may increase the risk of chronic pain by interfering with the healing process. Inflammation is a natural part of recovery, and suppressing it may make pain treatment more difficult in the long term.

Topical NSAIDs have limited effectiveness

Topical NSAIDs, such as Voltarène and Advilmed, can contribute to the total daily dose if not used correctly. Their absorption into the bloodstream depends on the area treated, the amount used, and the frequency of application. Users are advised to read the leaflet carefully before use.

Pain-relief creams offer little benefit

Pain-relief creams and gels are not much more effective than a simple massage and can cause side effects such as skin irritation or photosensitivity. Experts advise consulting a pharmacist or doctor before using these products, as their effectiveness is limited.

Aspirin should be prescribed, not self-used

Aspirin is not recommended for self-medication due to its wide range of side effects and potential for serious complications. Experts argue that it would likely not be approved for sale today due to its risks. It should only be used under a doctor's supervision.