Survey Finds Americans Routinely Ignore Over-the-Counter Pain Medication Labels Interview with:

Charles Melbern (Mel) Wilcox, MD, MSPH Director of the division of Gastroenterology and Hepatology University of Alabama-Birmingham

Dr. Wilcox

Charles Melbern (Mel) Wilcox, MD, MSPH
Director of the division of Gastroenterology and Hepatology
University of Alabama-Birmingham What is the background for this survey? What are the main findings?

Response: Nearly every person experiences pain at some point in their life – for many, the pain is acute and occasional, but for others, the pain is chronic and can be debilitating. Research shows that more than 25.3 million Americans suffer from daily pain and, every year, consumers purchase more than $20 billion per year on over-the-counter (OTC) pain medicines. In my work with the American Gastroenterological Association, we set out to explore the behaviors, beliefs, and misunderstandings that Americans have when it comes to OTC pain medicines. We surveyed 1,015 U.S. adults and 251 gastroenterologists to gain insight on how they were approaching pain management and OTC pain medicine use.

The survey found that Americans are routinely ignoring OTC pain medicine labels and are not consulting their health-care professionals about their pain before taking OTC pain medicines. As a direct result, gastroenterologists are noticing their patients experiencing complications and unintentional overdose symptoms. They see an average of 90 overdose cases each year, about two a week, due to OTC pain medicine overdose.

Ninety percent of gastroenterologists believe their patients require more and better education on how to use OTC pain medicine safely. They find that patients are not fully understanding the harms associated with taking too much. When asked why patients take more than the recommended dose, Americans say that they are confident in their ability to manage their medication (32 percent) or they wanted to feel better faster, mistakenly thinking more medicine would be the solution (73 percent). What types of problems bring patients with complications from over-the-counter pain medications to a gastroenterologist? Who is more likely to develop complications?

Response: Patients who visit a gastroenterologist due to overdosing on OTC pain medicines are usually experiencing serious gut health problems, such as stomach bleeding, stomach ulcers, harm to the liver, or liver failure.

The survey found that 39 percent of Americans admit they have taken more than the recommended dose. Surprisingly, it takes just one instance of taking too much OTC pain medicine for a patient to experience overdose complications. Symptoms may not be immediately recognizable.

The survey also highlighted the fact that there are some patients who may be at an even greater risk for overdose than others. These include Americans who suffer from chronic pain, patients with depression and women. According to survey findings:

  • More than two in five patients with chronic pain admit they have taken more than the recommended dose of OTC pain medication, and almost 30 percent said they have experienced overdose complications.
  • 45 percent of patients suffering from depression admit they have taken more than the recommended dose.
  • Women are more likely to take OTC pain medicines than men — 81 percent, compared to 72 percent of men. And, most female patients who experience gut health complications related to OTC pain medicine are over age 40.

Other risk factors for OTC pain medicine overdose include age, a change in medical history, alcohol intake, and use of other medicines. What should patients and clinicians take away from your report?

Response: For many, unintentional overdose is the result of not knowing the active ingredients, dose limits or warnings of their over-the-counter pain medicines.

Because many patients don’t see a gastroenterologist until they are already experiencing gut complications from OTC pain medicine overdose, health-care professionals (HCPs) need to play an active role in educating patients about safe use, early on.

AGA offers these tips for HCPs to help patients avoid complications due to OTC pain medicine overdose:

  • Encourage patients to read and follow all medicine labels — every time they reach for something in the medicine cabinet.
  • Educate patients on the two main types of oral OTC pain medicines and make sure they know to only take one product at a time containing the same type of active ingredient.
  • Ask about all medicines your patients take at each appointment, including OTC medicines, as they may not know to tell you.
  • Help your patients choose products that work for their current health situation, age and medical history. Let them know that products that worked in the past may no longer be the right choice for them now.
  • Initiate the conversation on safe OTC medicine use with your patients at every visit and encourage them to do the same with you. Is there anything else you would like to add?

Response: OTC pain medicines are safe when used appropriately. As health-care professionals, we are not asking patients to stop using their medicines, instead, we are encouraging patients to work collectively with us to determine the appropriate OTC pain medicine for their individual situation.


Dr. Wilcox serves as a chair to the Gut Check: Know Your Medicine campaign and receives honorarium from the American Gastroenterological Association for his role as an adviser. The campaign was developed with support provided by Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division, which manufactures over-the-counter pain medicines. Thank you for your contribution to the community.


Gut Check: Know Your Medicine Survey:

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on November 28, 2017 by Marie Benz MD FAAD