As European, it's mind-boggling when I see those 1,000 tab containers at Walgreens, given that I usually buy them in a pack of 12 and only take them very selectively as a last instance. You know, side-effects and stuff.
Took me a week to a see a dentist, I popped more pills than last 10 years to keep going for a week before I could get prescriptions that actually solved the problem.
The Europeans have it wrong on this one.
There's no reason not to have regular dose variations at the drug store.
https://bgr.com/science/nsaids-like-ibuprofen-may-actually-b...
(Original paper: https://www.science.org/doi/10.1126/scitranslmed.abj9954)
I do think maybe some things, he 'first time you buy' you should have the pharmacist spell it out for you. Or it's even 'behind the counter' and you just have to ask for it i.e. 'controlled substance'.
But I'm not sure if effectively it would make a change, other than the way it's sold in 'huge quantities' makes people believe they can just eat it up willy nilly.
Also when the body signals with pain, that needs attention and treatment, taking painkillers frequently may make one ignore a real problem, which perhaps had it been taken more seriously and treated earlier may save lives.
A while ago there was a very relevant article about this on HN, an American woman moved to Germany and had some surgery done. She had pain after the surgery, and from her American experiences she expected to be given heavy painkillers.
Instead the doctors prescribed her ibuprofen and told to rest well. At first she felt that was barbaric, but the article described how actually taking a rest to heal up, completely changed her view and how ultimately she was very glad not having had to depend on opiates to get trough that.
I wish I could find that article again, but sadly I couldn't, maybe somebody else remembers it and can share the link.
It's not a panacea--and more recent data suggests that it's probably overused--but the idea itself isn't bonkers.
https://www.uptodate.com/contents/nsaids-acute-kidney-injury
I don't have any 100% proof of it being caused by painkillers, however years ago I took Ibuprofen based painkillers on unusual higher dosage for some time to fight against pretty nasty back pains (driving exclusively bikes for 38 years comes at a price). After some time I developed some strong anemia, which scared me a lot for having a bad family history (some cancer cases, and my father died of leukemia); by my doctor's advice I did repeated blood tests and stopped taking painkillers for a while (and later never get again to that dosage) while starting a cure with iron and folate. Red blood cells took a while to fully recover but ultimately they did.
About backpains, I later learned with immense relief that in many cases postural training will lead to results that painkiller can only dream of: I still have my back problems, and after a motorcycle accident also a stabilized column with screws et al, but no need for painkillers: I keep them for headaches or other things, but my back has never been so damaged and so pain free (touches various things...:).
What if I use it more than a two days straight there is something really wrong with me, so I should drop everything and start emergency recovery procedures, involving a visit to a doc or seek an emergency care