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. 1998 Jan;23(1):13–34.

Use and abuse of over-the-counter analgesic agents.

F V Abbott 1, M I Fraser 1
PMCID: PMC1188892  PMID: 9505057

Abstract

Pain and discomfort in everyday life are often treated with over-the-counter (OTC) analgesic medications. These drugs are remarkably safe, but serious side effects can occur. Up to 70% of the population in Western countries uses analgesics regularly, primarily for headaches, other specific pains and febrile illness. It is not known whether the patterns of use are consistent with good pain management practices. OTC analgesics are also widely used to treat dysphoric mood states and sleep disturbances, and high levels of OTC analgesic medication use are associated with psychiatric illness, particularly depressive symptoms, and the use of alcohol, nicotine and caffeine. More than 4 g per day of acetylsalicylic acid (ASA) or acetaminophen over long periods is considered abuse. People using excessive amounts of OTC analgesics may need more effective treatments for chronic pain, depression or dysthymia. The possibility that these drugs have subtle reinforcing properties needs to be investigated. Certainly phenacetin, which was taken off the market in the 1970s, had intoxicating effects. A better understanding of patterns of use is needed to determine the extent of problem use of OTC analgesics, and whether health could be improved by educating people about the appropriate use of these drugs.

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Selected References

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  1. Abbott F. V., Etienne P., Franklin K. B., Morgan M. J., Sewitch M. J., Young S. N. Acute tryptophan depletion blocks morphine analgesia in the cold-pressor test in humans. Psychopharmacology (Berl) 1992;108(1-2):60–66. doi: 10.1007/BF02245286. [DOI] [PubMed] [Google Scholar]
  2. Abbott F. V., Gray-Donald K., Sewitch M. J., Johnston C. C., Edgar L., Jeans M. E. The prevalence of pain in hospitalized patients and resolution over six months. Pain. 1992 Jul;50(1):15–28. doi: 10.1016/0304-3959(92)90108-N. [DOI] [PubMed] [Google Scholar]
  3. Adams E. H. Prevalence of prescription drug abuse: data from the National Institute on Drug Abuse. N Y State J Med. 1991 Nov;91(11 Suppl):32S–36S. [PubMed] [Google Scholar]
  4. Ahonen R., Enlund H., Klaukka T., Martikainen J. Consumption of analgesics and anti-inflammatory drugs in the nordic countries between 1978-1988. Eur J Clin Pharmacol. 1991;41(1):37–42. doi: 10.1007/BF00280103. [DOI] [PubMed] [Google Scholar]
  5. Akwagyriam I., Goodyer L. I., Harding L., Khakoo S., Millington H. Drug history taking and the identification of drug related problems in an accident and emergency department. J Accid Emerg Med. 1996 May;13(3):166–168. doi: 10.1136/emj.13.3.166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Anderson R. J., Potts D. E., Gabow P. A., Rumack B. H., Schrier R. W. Unrecognized adult salicylate intoxication. Ann Intern Med. 1976 Dec;85(6):745–748. doi: 10.7326/0003-4819-85-6-745. [DOI] [PubMed] [Google Scholar]
  7. Barker J. D., Jr, de Carle D. J., Anuras S. Chronic excessive acetaminophen use and liver damage. Ann Intern Med. 1977 Sep;87(3):299–301. doi: 10.7326/0003-4819-87-3-299. [DOI] [PubMed] [Google Scholar]
  8. Basara L. R., Juergens J. P. Patient package insert readability and design. Am Pharm. 1994 Aug;NS34(8):48–53. doi: 10.1016/s0160-3450(15)30339-1. [DOI] [PubMed] [Google Scholar]
  9. Bradley C. P., Bond C. Increasing the number of drugs available over the counter: arguments for and against. Br J Gen Pract. 1995 Oct;45(399):553–556. [PMC free article] [PubMed] [Google Scholar]
  10. Branthwaite A., Cooper P. Analgesic effects of branding in treatment of headaches. Br Med J (Clin Res Ed) 1981 May 16;282(6276):1576–1578. doi: 10.1136/bmj.282.6276.1576. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Breslau N., Davis G. C., Schultz L. R., Peterson E. L. Joint 1994 Wolff Award Presentation. Migraine and major depression: a longitudinal study. Headache. 1994 Jul-Aug;34(7):387–393. doi: 10.1111/j.1526-4610.1994.hed3407387.x. [DOI] [PubMed] [Google Scholar]
  12. Brown G. K. A causal analysis of chronic pain and depression. J Abnorm Psychol. 1990 May;99(2):127–137. doi: 10.1037//0021-843x.99.2.127. [DOI] [PubMed] [Google Scholar]
  13. Carro-Ciampi G. Tolerance to a lethal dose of phenacetin in phenacetin-pretreated albino rats. Toxicol Appl Pharmacol. 1971 Feb;18(2):269–273. doi: 10.1016/0041-008x(71)90118-9. [DOI] [PubMed] [Google Scholar]
  14. Catania A., Arnold J., Macaluso A., Hiltz M. E., Lipton J. M. Inhibition of acute inflammation in the periphery by central action of salicylates. Proc Natl Acad Sci U S A. 1991 Oct 1;88(19):8544–8547. doi: 10.1073/pnas.88.19.8544. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Chrischilles E. A., Lemke J. H., Wallace R. B., Drube G. A. Prevalence and characteristics of multiple analgesic drug use in an elderly study group. J Am Geriatr Soc. 1990 Sep;38(9):979–984. doi: 10.1111/j.1532-5415.1990.tb04419.x. [DOI] [PubMed] [Google Scholar]
  16. Chrischilles E. A., Lemke J. H., Wallace R. B., Drube G. A. Prevalence and characteristics of multiple analgesic drug use in an elderly study group. J Am Geriatr Soc. 1990 Sep;38(9):979–984. doi: 10.1111/j.1532-5415.1990.tb04419.x. [DOI] [PubMed] [Google Scholar]
  17. Christie D. 'The analgesic abuse syndrome': an epidemiological perspective. Int J Epidemiol. 1978 Jun;7(2):139–143. doi: 10.1093/ije/7.2.139. [DOI] [PubMed] [Google Scholar]
  18. Clive D. M., Stoff J. S. Renal syndromes associated with nonsteroidal antiinflammatory drugs. N Engl J Med. 1984 Mar 1;310(9):563–572. doi: 10.1056/NEJM198403013100905. [DOI] [PubMed] [Google Scholar]
  19. Colpaert F. C., De Witte P., Maroli A. N., Awouters F., Niemegeers C. J., Janssen P. A. Self-administration of the analgesic suprofen in arthritic rats: evidence of Mycobacterium butyricum-induced arthritis as an experimental model of chronic pain. Life Sci. 1980 Sep 15;27(11):921–928. doi: 10.1016/0024-3205(80)90101-0. [DOI] [PubMed] [Google Scholar]
  20. Cook A. J., Thomas M. R. Pain and the use of health services among the elderly. J Aging Health. 1994 May;6(2):155–172. doi: 10.1177/089826439400600202. [DOI] [PubMed] [Google Scholar]
  21. Cook A. J., Thomas M. R. Pain and the use of health services among the elderly. J Aging Health. 1994 May;6(2):155–172. doi: 10.1177/089826439400600202. [DOI] [PubMed] [Google Scholar]
  22. Craig R. S. Women as home caregivers: gender portrayal in OTC drug commercials. J Drug Educ. 1992;22(4):303–312. doi: 10.2190/2NHN-NUY7-Q88U-CDJH. [DOI] [PubMed] [Google Scholar]
  23. Day R. O., Graham G. G., Williams K. M., Brooks P. M. Variability in response to NSAIDs. Fact or fiction? Drugs. 1988 Dec;36(6):643–651. doi: 10.2165/00003495-198836060-00001. [DOI] [PubMed] [Google Scholar]
  24. Dickenson A. H. Central acute pain mechanisms. Ann Med. 1995 Apr;27(2):223–227. doi: 10.3109/07853899509031963. [DOI] [PubMed] [Google Scholar]
  25. Diener H. C., Dichgans J., Scholz E., Geiselhart S., Gerber W. D., Bille A. Analgesic-induced chronic headache: long-term results of withdrawal therapy. J Neurol. 1989 Jan;236(1):9–14. doi: 10.1007/BF00314210. [DOI] [PubMed] [Google Scholar]
  26. Doan B. D., Wadden N. P. Relationships between depressive symptoms and descriptions of chronic pain. Pain. 1989 Jan;36(1):75–84. doi: 10.1016/0304-3959(89)90113-9. [DOI] [PubMed] [Google Scholar]
  27. Dubach U. C., Rosner B., Levy P. S., Baumeler H. R., Müller A., Peyer A., Ehrensperger T., Ettlin C. Epidemiological study in Switzerland. Kidney Int. 1978 Jan;13(1):41–49. doi: 10.1038/ki.1978.6. [DOI] [PubMed] [Google Scholar]
  28. Eade N. R., Lasagna L. A comparison of acetophenetidin and acetaminophen. II. Subjective effects in healthy volunteers. J Pharmacol Exp Ther. 1967 Feb;155(2):301–308. [PubMed] [Google Scholar]
  29. Edmeads J., Findlay H., Tugwell P., Pryse-Phillips W., Nelson R. F., Murray T. J. Impact of migraine and tension-type headache on life-style, consulting behaviour, and medication use: a Canadian population survey. Can J Neurol Sci. 1993 May;20(2):131–137. doi: 10.1017/s0317167100047697. [DOI] [PubMed] [Google Scholar]
  30. Edwards R., Oliphant J. Paracetamol toxicity in chronic alcohol abusers--a plea for greater consumer awareness. N Z Med J. 1992 May 13;105(933):174–175. [PubMed] [Google Scholar]
  31. Eggen A. E., Andrew M. Use of codeine analgesics in a general population. A Norwegian study of moderately strong analgesics. Eur J Clin Pharmacol. 1994;46(6):491–496. doi: 10.1007/BF00196103. [DOI] [PubMed] [Google Scholar]
  32. Eggen A. E. The Tromsø Study: frequency and predicting factors of analgesic drug use in a free-living population (12-56 years). J Clin Epidemiol. 1993 Nov;46(11):1297–1304. doi: 10.1016/0895-4356(93)90098-l. [DOI] [PubMed] [Google Scholar]
  33. Elkind A. H. Drug abuse and headache. Med Clin North Am. 1991 May;75(3):717–732. doi: 10.1016/s0025-7125(16)30445-x. [DOI] [PubMed] [Google Scholar]
  34. Eng E. L., Lachenmeyer J. Codeine self-medication in a headache patient. Headache. 1996 Jul-Aug;36(7):452–455. doi: 10.1046/j.1526-4610.1996.3607452.x. [DOI] [PubMed] [Google Scholar]
  35. Franklin K. B., Abbott F. V., English M. J., Jeans M. E., Tasker R. A., Young S. N. Tryptophan-morphine interactions and postoperative pain. Pharmacol Biochem Behav. 1990 Jan;35(1):157–163. doi: 10.1016/0091-3057(90)90221-3. [DOI] [PubMed] [Google Scholar]
  36. Furey S. A., Waksman J. A., Dash B. H. Nonprescription ibuprofen: side effect profile. Pharmacotherapy. 1992;12(5):403–407. [PubMed] [Google Scholar]
  37. GRIMLUND K. PHENACETIN AND RENAL DAMAGE AT A SWEDISH FACTORY. Acta Med Scand. 1963;174:SUPPL405–SUPPL40526. doi: 10.1111/j.0954-6820.1963.tb12584.x. [DOI] [PubMed] [Google Scholar]
  38. Gault M. H., Rudwal T. C., Engles W. D., Dossetor J. B. Syndrome associated with the abuse of analgesics. Ann Intern Med. 1968 Apr;68(4):906–925. doi: 10.7326/0003-4819-68-4-906. [DOI] [PubMed] [Google Scholar]
  39. Gault M. H., Rudwal T. C., Redmond N. I. Analgesic habits of 500 veterans: incidence and complications of abuse. Can Med Assoc J. 1968 Mar 30;98(13):619–626. [PMC free article] [PubMed] [Google Scholar]
  40. Gault M. H., Wilson D. R. Analgesic nephropathy in Canada: clinical syndrome, management, and outcome. Kidney Int. 1978 Jan;13(1):58–63. doi: 10.1038/ki.1978.8. [DOI] [PubMed] [Google Scholar]
  41. Gelgor L., Cartmell S., Mitchell D. Intracerebroventricular micro-injections of non-steroidal anti-inflammatory drugs abolish reperfusion hyperalgesia in the rat's tail. Pain. 1992 Sep;50(3):323–329. doi: 10.1016/0304-3959(92)90038-D. [DOI] [PubMed] [Google Scholar]
  42. George F. R., Collins A. C. Prostaglandin synthetase inhibitors antagonize the depressant effects of ethanol. Pharmacol Biochem Behav. 1979 Jun;10(6):865–869. doi: 10.1016/0091-3057(79)90059-5. [DOI] [PubMed] [Google Scholar]
  43. Gillies M. A., Skyring A. P. The pattern and prevalence of aspirin ingestion as determined by interview of 2,921 inhabitants of Sydney. Med J Aust. 1972 May 6;1(19):974–979. doi: 10.5694/j.1326-5377.1972.tb108036.x. [DOI] [PubMed] [Google Scholar]
  44. Goldstein A., Kalant H. Drug policy: striking the right balance. Science. 1990 Sep 28;249(4976):1513–1521. doi: 10.1126/science.2218493. [DOI] [PubMed] [Google Scholar]
  45. Graham D. Y., Smith J. L., Dobbs S. M. Gastric adaptation occurs with aspirin administration in man. Dig Dis Sci. 1983 Jan;28(1):1–6. doi: 10.1007/BF01393353. [DOI] [PubMed] [Google Scholar]
  46. Grover S. M., Thomas S. P. Substance use and anger in mid-life women. Issues Ment Health Nurs. 1993 Jan-Mar;14(1):19–29. doi: 10.3109/01612849309006888. [DOI] [PubMed] [Google Scholar]
  47. Hauser A. C., Derfler K., Balcke P. Progression of renal insufficiency in analgesic nephropathy: impact of continuous drug abuse. J Clin Epidemiol. 1991;44(1):53–56. doi: 10.1016/0895-4356(91)90200-s. [DOI] [PubMed] [Google Scholar]
  48. Hemminki E., Ferdock M. J., Rahkonen O., McKinlay S. S. Clustering and consistency of use of medicines among mid-aged women. Med Care. 1989 Sep;27(9):859–868. doi: 10.1097/00005650-198909000-00002. [DOI] [PubMed] [Google Scholar]
  49. Henry D., Dobson A., Turner C. Variability in the risk of major gastrointestinal complications from nonaspirin nonsteroidal anti-inflammatory drugs. Gastroenterology. 1993 Oct;105(4):1078–1088. doi: 10.1016/0016-5085(93)90952-9. [DOI] [PubMed] [Google Scholar]
  50. Hoffmeister F., Wuttke W. Self-administration of acetylsalicylic acid and combinations with codeine and caffeine in rhesus monkeys. J Pharmacol Exp Ther. 1973 Aug;186(2):266–275. [PubMed] [Google Scholar]
  51. Hoftiezer J. W., O'Laughlin J. C., Ivey K. J. Effects of 24 hours of aspirin, Bufferin, paracetamol and placebo on normal human gastroduodenal mucosa. Gut. 1982 Aug;23(8):692–697. doi: 10.1136/gut.23.8.692. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Holden M. D. Over-the-counter medications. Do you know what your patients are taking? Postgrad Med. 1992 Jun;91(8):191-4, 199-200. doi: 10.1080/00325481.1992.11701373. [DOI] [PubMed] [Google Scholar]
  53. Honig P. K., Gillespie B. K. Drug interactions between prescribed and over-the-counter medication. Drug Saf. 1995 Nov;13(5):296–303. doi: 10.2165/00002018-199513050-00003. [DOI] [PubMed] [Google Scholar]
  54. Horne J. A. Aspirin and nonfebrile waking oral temperature in healthy men and women: links with SWS changes? Sleep. 1989 Dec;12(6):516–521. doi: 10.1093/sleep/12.6.516. [DOI] [PubMed] [Google Scholar]
  55. Horne J. A., Shackell B. S. Slow wave sleep elevations after body heating: proximity to sleep and effects of aspirin. Sleep. 1987 Aug;10(4):383–392. doi: 10.1093/sleep/10.4.383. [DOI] [PubMed] [Google Scholar]
  56. Johnson R. E., Pope C. R. Health status and social factors in nonprescribed drug use. Med Care. 1983 Feb;21(2):225–233. doi: 10.1097/00005650-198302000-00009. [DOI] [PubMed] [Google Scholar]
  57. KRUMHOLZ W. V., SHEPPARD C., MERLIS S. STUDIES WITH ASPIRIN: PSYCHOPHARMACOLOGIC AND METHODOLOGIC CONSIDERATIONS. Clin Pharmacol Ther. 1964 Nov-Dec;5:691–694. doi: 10.1002/cpt196456part1691. [DOI] [PubMed] [Google Scholar]
  58. Keller F., Schwarz A. Analgesic dilemma in chronic hemodialysis patients. Pain. 1983 Sep;17(1):99–101. doi: 10.1016/0304-3959(83)90132-X. [DOI] [PubMed] [Google Scholar]
  59. Kudrow L. Paradoxical effects of frequent analgesic use. Adv Neurol. 1982;33:335–341. [PubMed] [Google Scholar]
  60. LASAGNA L., VON FELSINGER J. M., BEECHER H. K. Drug-induced mood changes in man. I. Observations on healthy subjects, chronically ill patients, and postaddicts. J Am Med Assoc. 1955 Mar 19;157(12):1006–1020. doi: 10.1001/jama.1955.02950290026009. [DOI] [PubMed] [Google Scholar]
  61. LEONARDS J. R. The influence of solubility on the rate of gastrointestinal absorption of aspirin. Clin Pharmacol Ther. 1963 Jul-Aug;4:476–479. doi: 10.1002/cpt196344476. [DOI] [PubMed] [Google Scholar]
  62. Ladewig D., Miest P. C., Dubach U. C., Ettlin C., Hobi V. Use and abuse of non-narcotic analgesics. Drug Alcohol Depend. 1978 Nov;3(6):435–442. doi: 10.1016/0376-8716(78)90016-9. [DOI] [PubMed] [Google Scholar]
  63. Lanas A., Serrano P., Bajador E., Esteva F., Benito R., Sáinz R. Evidence of aspirin use in both upper and lower gastrointestinal perforation. Gastroenterology. 1997 Mar;112(3):683–689. doi: 10.1053/gast.1997.v112.pm9041228. [DOI] [PubMed] [Google Scholar]
  64. Landis C. A., Robinson C. R., Helms C., Levine J. D. Differential effects of acetylsalicylic acid and acetaminophen on sleep abnormalities in a rat chronic pain model. Brain Res. 1989 May 29;488(1-2):195–201. doi: 10.1016/0006-8993(89)90709-9. [DOI] [PubMed] [Google Scholar]
  65. Langman M. J. Ulcer complications and nonsteroidal anti-inflammatory drugs. Am J Med. 1988 Feb 22;84(2A):15–19. doi: 10.1016/0002-9343(88)90249-5. [DOI] [PubMed] [Google Scholar]
  66. Lanza F. L. Endoscopic studies of gastric and duodenal injury after the use of ibuprofen, aspirin, and other nonsteroidal anti-inflammatory agents. Am J Med. 1984 Jul 13;77(1A):19–24. doi: 10.1016/s0002-9343(84)80014-5. [DOI] [PubMed] [Google Scholar]
  67. Lee W. M. The selling of acetaminophen. Gastroenterology. 1995 Dec;109(6):2043–2045. doi: 10.1016/0016-5085(95)90778-5. [DOI] [PubMed] [Google Scholar]
  68. Leibowitz A. Substitution between prescribed and over-the-counter medications. Med Care. 1989 Jan;27(1):85–94. doi: 10.1097/00005650-198901000-00008. [DOI] [PubMed] [Google Scholar]
  69. Li D. Y., Abran D., Peri K. G., Varma D. R., Chemtob S. Inhibition of prostaglandin synthesis in newborn pigs increases cerebral microvessel prostaglandin F2 alpha and prostaglandin E2 receptors, their second messengers and vasoconstrictor response to adult levels. J Pharmacol Exp Ther. 1996 Jul;278(1):370–377. [PubMed] [Google Scholar]
  70. Looker A. C., Dallman P. R., Carroll M. D., Gunter E. W., Johnson C. L. Prevalence of iron deficiency in the United States. JAMA. 1997 Mar 26;277(12):973–976. doi: 10.1001/jama.1997.03540360041028. [DOI] [PubMed] [Google Scholar]
  71. Magni G., Moreschi C., Rigatti-Luchini S., Merskey H. Prospective study on the relationship between depressive symptoms and chronic musculoskeletal pain. Pain. 1994 Mar;56(3):289–297. doi: 10.1016/0304-3959(94)90167-8. [DOI] [PubMed] [Google Scholar]
  72. Malmberg A. B., Yaksh T. L. Hyperalgesia mediated by spinal glutamate or substance P receptor blocked by spinal cyclooxygenase inhibition. Science. 1992 Aug 28;257(5074):1276–1279. doi: 10.1126/science.1381521. [DOI] [PubMed] [Google Scholar]
  73. Marks R. M., Sachar E. J. Undertreatment of medical inpatients with narcotic analgesics. Ann Intern Med. 1973 Feb;78(2):173–181. doi: 10.7326/0003-4819-78-2-173. [DOI] [PubMed] [Google Scholar]
  74. Mathew N. T. Chronic refractory headache. Neurology. 1993 Jun;43(6 Suppl 3):S26–S33. [PubMed] [Google Scholar]
  75. McCormack K. The spinal actions of nonsteroidal anti-inflammatory drugs and the dissociation between their anti-inflammatory and analgesic effects. Drugs. 1994;47 (Suppl 5):28–47. doi: 10.2165/00003495-199400475-00006. [DOI] [PubMed] [Google Scholar]
  76. Migliardi J. R., Armellino J. J., Friedman M., Gillings D. B., Beaver W. T. Caffeine as an analgesic adjuvant in tension headache. Clin Pharmacol Ther. 1994 Nov;56(5):576–586. doi: 10.1038/clpt.1994.179. [DOI] [PubMed] [Google Scholar]
  77. Mitchell A. G., Saville D. J. The dissolution of aspirin and aspirin tablets. J Pharm Pharmacol. 1967 Nov;19(11):729–734. doi: 10.1111/j.2042-7158.1967.tb08024.x. [DOI] [PubMed] [Google Scholar]
  78. Mitchell A. G., Saville D. J. The dissolution of commercial aspirin. J Pharm Pharmacol. 1969 Jan;21(1):28–34. doi: 10.1111/j.2042-7158.1969.tb08126.x. [DOI] [PubMed] [Google Scholar]
  79. Murphy P. J., Badia P., Myers B. L., Boecker M. R., Wright K. P., Jr Nonsteroidal anti-inflammatory drugs affect normal sleep patterns in humans. Physiol Behav. 1994 Jun;55(6):1063–1066. doi: 10.1016/0031-9384(94)90388-3. [DOI] [PubMed] [Google Scholar]
  80. Murray R. M. Dependance on analgesics in analgesic nephropathy. Br J Addict Alcohol Other Drugs. 1973 Oct;68(3):265–272. doi: 10.1111/j.1360-0443.1973.tb01254.x. [DOI] [PubMed] [Google Scholar]
  81. Murray R. M. Genesis of analgesic nephropathy in the United Kingdom. Kidney Int. 1978 Jan;13(1):50–57. doi: 10.1038/ki.1978.7. [DOI] [PubMed] [Google Scholar]
  82. Murray R. M. Minor analgesic abuse: the slow recognition of a public health problem. Br J Addict. 1980 Mar;75(1):9–17. doi: 10.1111/j.1360-0443.1980.tb00189.x. [DOI] [PubMed] [Google Scholar]
  83. Murray R. M. The origins of analgesic nephropathy. Br J Psychiatry. 1973 Jul;123(572):99–106. doi: 10.1192/bjp.123.1.99. [DOI] [PubMed] [Google Scholar]
  84. Murray R. M., Timbury G. C., Linton A. L. Analgesic abuse in psychiatric patients. Lancet. 1970 Jun 20;760(1):1303–1305. doi: 10.1016/s0140-6736(70)91906-9. [DOI] [PubMed] [Google Scholar]
  85. Myers W. C., Otto T. A., Harris E., Diaco D., Moreno A. Acetaminophen overdose as a suicidal gesture: a survey of adolescents' knowledge of its potential for toxicity. J Am Acad Child Adolesc Psychiatry. 1992 Jul;31(4):686–690. doi: 10.1097/00004583-199207000-00016. [DOI] [PubMed] [Google Scholar]
  86. Neugebauer V., Schaible H. G., He X., Lücke T., Gündling P., Schmidt R. F. Electrophysiological evidence for a spinal antinociceptive action of dipyrone. Agents Actions. 1994 Mar;41(1-2):62–70. doi: 10.1007/BF01986396. [DOI] [PubMed] [Google Scholar]
  87. Onghena P., Van Houdenhove B. Antidepressant-induced analgesia in chronic non-malignant pain: a meta-analysis of 39 placebo-controlled studies. Pain. 1992 May;49(2):205–219. doi: 10.1016/0304-3959(92)90144-Z. [DOI] [PubMed] [Google Scholar]
  88. Perneger T. V., Whelton P. K., Klag M. J. Risk of kidney failure associated with the use of acetaminophen, aspirin, and nonsteroidal antiinflammatory drugs. N Engl J Med. 1994 Dec 22;331(25):1675–1679. doi: 10.1056/NEJM199412223312502. [DOI] [PubMed] [Google Scholar]
  89. Pommer W., Glaeske G., Molzahn M. The analgesic problem in the Federal Republic of Germany: analgesic consumption, frequency of analgesic nephropathy and regional differences. Clin Nephrol. 1986 Dec;26(6):273–278. [PubMed] [Google Scholar]
  90. Portenoy R. K., Foley K. M. Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain. 1986 May;25(2):171–186. doi: 10.1016/0304-3959(86)90091-6. [DOI] [PubMed] [Google Scholar]
  91. Prescott L. F. Analgesic abuse and renal disease in North-East Scotland. Lancet. 1966 Nov 26;2(7474):1143–1145. doi: 10.1016/s0140-6736(66)90469-7. [DOI] [PubMed] [Google Scholar]
  92. Prescott L. F., Steel R. F., Ferrier W. R. The effects of particle size on the absorption of phenacetin in man. A correlation between plasma concentration of phenacetin and effects on the central nervous system. Clin Pharmacol Ther. 1970 Jul-Aug;11(4):496–504. doi: 10.1002/cpt1970114496. [DOI] [PubMed] [Google Scholar]
  93. Preshaw P. M., Meechan J. G., Dodd M. D. Self-medication for the control of dental pain: what are our patients taking? Dent Update. 1994 Sep;21(7):299-301, 304. [PubMed] [Google Scholar]
  94. Rex D. K., Kumar S. Recognizing acetaminophen hepatotoxicity in chronic alcoholics. Postgrad Med. 1992 Mar;91(4):241–245. doi: 10.1080/00325481.1992.11701256. [DOI] [PubMed] [Google Scholar]
  95. Ross M. W., Stowe A., Loxley W., Wodak A. "Home bake" heroin use by injecting drug users. Med J Aust. 1992 Aug 17;157(4):283–284. doi: 10.5694/j.1326-5377.1992.tb137155.x. [DOI] [PubMed] [Google Scholar]
  96. Salmon P., Manyande A. Good patients cope with their pain: postoperative analgesia and nurses' perceptions of their patients' pain. Pain. 1996 Nov;68(1):63–68. doi: 10.1016/S0304-3959(96)03171-5. [DOI] [PubMed] [Google Scholar]
  97. Saper J. R., Jones J. M. Ergotamine tartrate dependency: features and possible mechanisms. Clin Neuropharmacol. 1986;9(3):244–256. doi: 10.1097/00002826-198606000-00003. [DOI] [PubMed] [Google Scholar]
  98. Savage P. P. Abuse and addiction--man or drug? Br J Addict Alcohol Other Drugs. 1971 Dec;66(4):289–292. doi: 10.1111/j.1360-0443.1971.tb02398.x. [DOI] [PubMed] [Google Scholar]
  99. Sawynok J., Yaksh T. L. Caffeine as an analgesic adjuvant: a review of pharmacology and mechanisms of action. Pharmacol Rev. 1993 Mar;45(1):43–85. [PubMed] [Google Scholar]
  100. Schiødt F. V., Rochling F. A., Casey D. L., Lee W. M. Acetaminophen toxicity in an urban county hospital. N Engl J Med. 1997 Oct 16;337(16):1112–1117. doi: 10.1056/NEJM199710163371602. [DOI] [PubMed] [Google Scholar]
  101. Schwarz A., Faber U., Borner K., Keller F., Offermann G., Molzahn M. Reliability of drug history in analgesic users. Lancet. 1984 Nov 17;2(8412):1163–1164. doi: 10.1016/s0140-6736(84)91608-8. [DOI] [PubMed] [Google Scholar]
  102. Schwarz A., Keller F., Kunzendorf U., Kühn-Freitag G., Heinemeyer G., Pommer W., Offermann G. Characteristics and clinical course of hemodialysis patients with analgesic-associated nephropathy. Clin Nephrol. 1988 Jun;29(6):299–306. [PubMed] [Google Scholar]
  103. Segall A. A community survey of self-medication activities. Med Care. 1990 Apr;28(4):301–310. doi: 10.1097/00005650-199004000-00002. [DOI] [PubMed] [Google Scholar]
  104. Seifert C. F., Lucas D. S., Vondracek T. G., Kastens D. J., McCarty D. L., Bui B. Patterns of acetaminophen use in alcoholic patients. Pharmacotherapy. 1993 Jul-Aug;13(4):391–395. [PubMed] [Google Scholar]
  105. Sherman R. A., Sherman C. J., Gall N. G. A survey of current phantom limb pain treatment in the United States. Pain. 1980 Feb;8(1):85–99. doi: 10.1016/0304-3959(80)90092-5. [DOI] [PubMed] [Google Scholar]
  106. Silagy C. A., McNeil J. J., Donnan G. A., Tonkin A. M., Worsam B., Campion K. Adverse effects of low-dose aspirin in a healthy elderly population. Clin Pharmacol Ther. 1993 Jul;54(1):84–89. doi: 10.1038/clpt.1993.115. [DOI] [PubMed] [Google Scholar]
  107. Simons L. A., Tett S., Simons J., Lauchlan R., McCallum J., Friedlander Y., Powell I. Multiple medication use in the elderly. Use of prescription and non-prescription drugs in an Australian community setting. Med J Aust. 1992 Aug 17;157(4):242–246. [PubMed] [Google Scholar]
  108. Smith G. M., Smith P. H. Effects of doxylamine and acetaminophen on postoperative sleep. Clin Pharmacol Ther. 1985 May;37(5):549–557. doi: 10.1038/clpt.1985.87. [DOI] [PubMed] [Google Scholar]
  109. Staudacher H. L., Müller H. Bestimmungen des Salicylat-Spiegels im Plasma nach Verabreichung von Acetylsalicylsäure sowie einer Kombination von Acetylsalicylsäure und Ascorbinsäure. Arzneimittelforschung. 1969 Sep;19(9):1612–1613. [PubMed] [Google Scholar]
  110. Steele K., Mills K. A., Gilliland A. E., Irwin W. G., Taggart A. Repeat prescribing of non-steroidal anti-inflammatory drugs excluding aspirin: how careful are we? Br Med J (Clin Res Ed) 1987 Oct 17;295(6604):962–964. doi: 10.1136/bmj.295.6604.962. [DOI] [PMC free article] [PubMed] [Google Scholar]
  111. Strom B. L. Adverse reactions to over-the-counter analgesics taken for therapeutic purposes. JAMA. 1994 Dec 21;272(23):1866–1867. [PubMed] [Google Scholar]
  112. Suzuki T., Shiozaki Y., Misawa M. [Relationships between ethanol-induced sleep and aspirin, indomethacin or PGE2 in inbred rats]. Arukoru Kenkyuto Yakubutsu Ison. 1989 Dec;24(6):480–489. [PubMed] [Google Scholar]
  113. Tordjman C., Coge F., Andre N., Rique H., Spedding M., Bonnet J. Characterisation of cyclooxygenase 1 and 2 expression in mouse resident peritoneal macrophages in vitro; interactions of non steroidal anti-inflammatory drugs with COX2. Biochim Biophys Acta. 1995 May 17;1256(2):249–256. doi: 10.1016/0005-2760(95)00026-9. [DOI] [PubMed] [Google Scholar]
  114. Turk D. C., Rudy T. E. Neglected topics in the treatment of chronic pain patients--relapse, noncompliance, and adherence enhancement. Pain. 1991 Jan;44(1):5–28. doi: 10.1016/0304-3959(91)90142-K. [DOI] [PubMed] [Google Scholar]
  115. Vaerøy H., Abrahamsen A., Førre O., Kåss E. Treatment of fibromyalgia (fibrositis syndrome): a parallel double blind trial with carisoprodol, paracetamol and caffeine (Somadril comp) versus placebo. Clin Rheumatol. 1989 Jun;8(2):245–250. doi: 10.1007/BF02030081. [DOI] [PubMed] [Google Scholar]
  116. Von Korff M., Dworkin S. F., Le Resche L., Kruger A. An epidemiologic comparison of pain complaints. Pain. 1988 Feb;32(2):173–183. doi: 10.1016/0304-3959(88)90066-8. [DOI] [PubMed] [Google Scholar]
  117. Warner L. A., Kessler R. C., Hughes M., Anthony J. C., Nelson C. B. Prevalence and correlates of drug use and dependence in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1995 Mar;52(3):219–229. doi: 10.1001/archpsyc.1995.03950150051010. [DOI] [PubMed] [Google Scholar]
  118. Wasylak T. J., Abbott F. V., English M. J., Jeans M. E. Reduction of postoperative morbidity following patient-controlled morphine. Can J Anaesth. 1990 Oct;37(7):726–731. doi: 10.1007/BF03006529. [DOI] [PubMed] [Google Scholar]
  119. Whitcomb D. C., Block G. D. Association of acetaminophen hepatotoxicity with fasting and ethanol use. JAMA. 1994 Dec 21;272(23):1845–1850. doi: 10.1001/jama.1994.03520230055038. [DOI] [PubMed] [Google Scholar]
  120. Wolff H. G., Hardy J. D., Goodell H. MEASUREMENT OF THE EFFECT ON THE PAIN THRESHOLD OF ACETYLSALICYLIC ACID, ACETANILID, ACETOPHENETIDIN, AMINOPYRINE, ETHYL ALCOHOL, TRICHLORETHYLENE, A BARBITURATE, QUININE, ERGOTAMINE TARTRATE AND CAFFEINE: AN ANALYSIS OF THEIR RELATION TO THE PAIN EXPERIENCE. J Clin Invest. 1941 Jan;20(1):63–80. doi: 10.1172/JCI101196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  121. Zimmerman H. J., Maddrey W. C. Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure. Hepatology. 1995 Sep;22(3):767–773. [PubMed] [Google Scholar]
  122. de Broe M. E., Elseviers M. M. Analgesic nephropathy--still a problem? Nephron. 1993;64(4):505–513. doi: 10.1159/000187392. [DOI] [PubMed] [Google Scholar]

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