Aspirin a day may push death away, says study | CNN

Ibuprofen —

Ibuprofen falls into the class of drugs known as NSAIDs (nonsteroidal anti-inflammatory drugs). Sold under brand names including Motrin or Advil, it's used to treat minor aches and pains and reduce fever. It may be prescribed in stronger doses. It comes in tablet form as well as in chewable tablets, liquid suspensions and concentrated liquid drops. People who take NSAIDs may have a higher heart attack or stroke risk than those who do not, according to the National Institutes of Health. The medication can also cause ulcers, bleeding or holes in the stomach and intestine for some people. The risk may be higher if you take NSAIDs for a long time, are older or in poor health, and have three or more alcoholic drinks per day.

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Acetaminophen —

This compound can ease minor muscle, back, tooth and joint pain and reduce fever. Sold under brand names such as Tylenol, Liquiprin and Panadol, it works by regulating the part of your brain that controls your body's temperature and inhibits the synthesis of prostaglandin in the central nervous system. A study has found that it could reduce pleasure as well. Too much of the drug can cause rashes, liver failure and even death.

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Aspirin —

Aspirin is one of the cheapest and oldest manufactured painkillers on the market. German-born scientist Felix Hoffman is credited with creating and popularizing what was then known as acetylsalicylic acid in 1899 to help ease his dad's arthritis pain. Today, it is used to ease minor aches and headaches. It works by reducing the substance in the body that causes inflammation and fever. Doctors also tell some adults to take an aspirin daily to help prevent a heart attack or stroke. People with bleeding conditions like ulcers or cardiovascular troubles like asthma are often advised to take another painkiller, as it may make those conditions worse. Some Americans are also allergic to aspirin. Americans consume more than 15 billion aspirin tablets a year. Here's a guide to some of the most commonly used pain relief medications:

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Marijuana —

There's been a growing acceptance of marijuana as a legitimate pain reliever. The American Medical Association supports making marijuana a Schedule I controlled substance in order to promote research into its therapeutic abilities. Doctors in some states may prescribe it to ease chronic pain that comes from arthritis, migraines, Crohn's disease or other ongoing pain issues where other medicines have failed. It works by blocking the pain sensations felt by peripheral nerves. The cannabinoids in marijuana bind to endocannabinoid receptors throughout the body and can reduce pain (but also give the feeling of being high). Some research shows that it can also slow cancer development and increase appetite. Forty states and the District of Columbia allow some legal uses of marijuana, mostly for medicinal purposes.

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Hydrocodone —

Hydrocodone is available only in combination with other ingredients, with different products prescribed for different uses. Some products are used to relieve moderate to severe pain, while others combat a cough, according to the National Institutes of Health. An opiate (narcotic) analgesic, hydrocodone relieves pain by changing the way the brain and nervous system respond to it. It may be habit-forming, and abuse of drugs, including hydrocodone, has become a concern in recent years. In 2014, hydrocodone was moved from Schedule III to Schedule II. Now, in order to use these drugs, patients will have to get a written prescription from a doctor -- instead of one submitted orally by phone. And refills are prohibited; patients would have to check in with their doctors to get another prescription.

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Fentanyl —

Fentanyl is a prescription-only pain medication often given to cancer patients. They must be at least 18 years old to take it, or at least 16 for lozenges branded as Actiq, and they should also be taking regular doses of another narcotic pain medication. Patients must also be accustomed to the effects of narcotics. Fentanyl itself is a narcotic and changes the way the brain and nervous system respond to pain, according to the National Institutes of Health. This drug comes in the form of a lozenge, a tablet under the tongue, a film and a buccal (between the gum and cheek) tablet, as well as in injectable form. It is designed for sudden episodes of pain and should not be used more than four times a day. Overdose can cause drowsiness, dizziness, confusion, breathing problems or smaller pupils. The FDA has said there is growing concern about illicit fentanyl use, particularly in conjunction with heroin.

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Morphine —

Patients take morphine for moderate to severe pain. It is an opiate (narcotic) analgesic and changes the way the brain and nervous system react to pain. Forms of morphine include tablet and solution, which are taken every four hours, as needed. Controlled- or extended-release tablets and controlled- or sustained-release capsules are for patients who need around-the-clock pain relief. Morphine can also be found as a morphine sulfate injection, as added to an IV fluid that drips through a needle or catheter, or injected into a large muscle. Morphine overdose can cause serious consequences such as breathing problems, loss of consciousness, sleepiness, slow heartbeat, blurred vision, nausea and fainting, according to the National Institutes of Health. Morphine may also be habit-forming.

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Propofol —

Propofol, also known as Diprivan, became infamous when pop star Michael Jackson died after overdosing on the drug while using it as a sleep aid. The drug is typically administered intravenously by medical professionals for anesthetic purposes, such as when a patient is undergoing surgery. It's not approved to treat sleep disorders, according to the Food and Drug Administration. The drug itself does not provide pain relief but renders a patient unconscious. A patient wakes up almost immediately after an infusion is stopped, experts say. Propofol lowers blood pressure and suppresses breathing, so patients' heart function and breathing need constant monitoring, according to the Harvard Health Blog. Abuse of propofol in medical circles, however, has been a concern in recent years.

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A guide to (legal) pain relief

Story highlights

U.S. Preventive Services Task Force publishes new recommendation that daily aspirin might help prevent cardiovascular disease and colon cancer

There has been much controversy on whether benefits of aspirin outweigh the harms

CNN —

New recommendations on daily aspirin use will likely stir the pot in the ongoing aspirin debate. The U.S. Preventive Services Task Force published a final recommendation statement on Monday saying that taking an aspirin a day might help prevent cardiovascular disease and colon cancer.

The task force found that people ages 50 to 59 who have an increased risk for cardiovascular disease can lower their risk for heart attacks, stroke and colon cancer by taking an aspirin a day. They also found that those ages 60 to 69 can benefit as well, but should discuss the treatment with their health care provider first. They concluded there is not enough evidence to determine the benefits and harms of aspirin use in people younger than 50 or older than 69.

“These new findings from the task force provide a good evidence-based approach for managing a disease with therapy that has risks,” said Dr. Biswajit Kar, medical division chief at the Center for Advanced Heart Failure at Memorial Hermann Heart and Vascular Institute-Texas Medical Center. “Low-dose aspirin therapy has many proven benefits, including preventing heart attacks, strokes, and colorectal cancer.”

This is the first time the task force has issued a recommendation on aspirin to prevent both cardiovascular disease and colon cancer for those age ranges.

“Since our last recommendation in 2009, there has been a significant amount of science that allowed us to make a better recommendation,” said former task force chairman Dr. Michael LeFevre. “What’s new is our recommendation that incorporates reduction of colon cancer. We combined the potential benefits for cancer with the potential benefits for cardiovascular disease. That’s new and I don’t think it is either widely known or certainly not widely incorporated into a decision that balances benefits and harms.”

LeFevre also said that in 2009 there were concerns that men and women were different in terms of their aspirin benefit profile. “With the advance of science, we have decided that is not the case,” he said. “The new recommendation applies to both men and women equally.”

The recommendation applies to people who are not at an increased risk for gastrointestinal bleeding, who have at least a 10-year life expectancy, and who are willing to take low-dose aspirin daily for at least 10 years. It is also based on recent reviews that reaffirmed previous evidence about the benefits of aspirin for prevention of heart attack, stroke and colon cancer.

Two sides to the equation

There has been much back-and-forth on the benefits of daily aspirin use.

A 2015 study in the Annals of Internal Medicine found that people who used a daily low dose of aspirin were less likely to have colon cancer. But another study that same year in the Journal of the American College of Cardiology found that people who were taking aspirin for preventive measures were at an increased risk for serious health problems, such as gastrointestinal bleeding and ulcers.

In this study, there was about a 60% increase in serious gastrointestinal bleeds in people who took aspirin regularly, said LeFevre. But LeFevre said the benefit outweighs the risk.

“The deal with aspirin is we know we can help some people, and we also know we can hurt some people,” he said. “We are moderately certain that the benefits outweigh the harms for men and women ages 50 to 59 who have a 10-year cardiovascular risk of 10% or greater. That is the group we are most confident about.”

He also said men and women ages 60 to 69 with a 10% greater risk of cardiovascular disease will have benefits that outweigh the harms, but only by a small amount. Kar of the Center for Advanced Heart Failure said this study supports a longtime understanding of the importance of balancing the benefits of daily aspirin use with the potential complications.

“We now have good data to back up the importance of identifying patients best suited to receive this treatment and target the patient population that is at highest risk,” said Kar. “These recommendations underscore the need to use aspirin judiciously in our patient population. This guidance gives us the clinical tools we need to recognize which men and women are most susceptible to heart attack and stroke, and most likely to benefit from low-dose aspirin treatment.”

LeFevre agreed; he said patients need to speak with their physicians to find the right balance.

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“It’s not as easy as just saying, ‘I need to take an aspirin.’ You have to look at both sides of the equation. If personal risk for bleeding goes up, that erases the net benefit. The good news is that taking low-dose aspirin can help prevent heart attacks and strokes, and if you take it for five to 10 years it can help prevent colorectal cancer. That’s the good news. The bad news is we are also certain taking aspirin on a daily basis increases the risk of bleeds. So it’s important to have a conversation with your physician about what’s right for you,” said LeFevre.

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Aspirin a day may push death away, says new study

A guide to (legal) pain relief

Story highlights

Two sides to the equation

Follow CNN Health on Facebook and Twitter