painThe finding that NSAIDs can cause heart attacks and strokes in certain patientsĀ  has disrupted the lives of millions of arthritis patients as well as throwing a scare into the pharmaceutical industry.

But it needs to be put in perspective. There is no better place to start than with the famous dictum of the Swiss Renaissance physician Paracelsus: “All things are poison, and nothing is without poison. It is the dose alone that makes a thing not a poison.” In the case of the painkillers, it is likely that lower doses and limits on the duration of therapy would avoid most problems. Quite possibly, some of the people who suffered heart damage belonged to high risk categories for whom most or all prescription painkillers would be dangerous. In fact, NSAIDs and other pain relief drugs have shown themselves to be very effective and safe for certain groups of patients in modest doses for limited periods of time, so it is unreasonable to withdraw them from the market. Of course, they should compete there on the basis of their merits compared to other drugs. Continue reading »

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