Aspirin Really Is Kind of a Wonder Drug, Studies Continue to Show

http://www.theatlantic.com/health/archive/2012/04/aspirin-really-is-kind-of-a-wonder-drug-studies-continue-to-show/256495/

by evo_9 • 14 years ago

137 91 14 years ago

theatlantic.com

protomyth• 14 years ago

It does make one wonder what other plant products would have done if they had got in before the whole "war on drugs".

Alex39173• 14 years ago

Here is a pretty good list:

http://www.scribd.com/renaxgade81/d/63057989-Granny-s-List-J...

drivebyacct2• 14 years ago

Oh you mean like the one that the government spends millions and ruins lives over every year that is being turned into yet another expensive prescription drug?

Yeah. http://www.foxnews.com/health/2012/01/23/pot-based-prescript...

chimeracoder2• 14 years ago

The funny thing is, I'm not sure it would be that different.

I'm being tongue-in-cheek. That is, the effectiveness of the medicines would be very different, but the actual substances available in some way would barely be different.

With the exception of marijuana, almost every drug with medicinal use is either available medically in some form or unavailable, but with very related 'cousins' readily available.

Marijuana is available as Marinol - it just doesn't work, because it's synthesized without the full set of ~70 cannabinoids. MDMA isn't available (outside of very restricted research), but it's closely related to methamphetamine, which is available with a prescription. (People are often surprised to hear that one). GHB is available with a prescription. Heroin is really just a synthesized and concentrated form of morphine (available with prescription), and peyote is available for some religious ceremonies. [Psilocybin is not, but oddly enough, I believe mushroom spores are legal, even though the mushrooms are not (because the spores don't contain any psylocybin - I believe this may depend on your jurisdiction, though, and as always, IANAL.).]

So what's the end result? We've criminalized drugs not based on their underlying chemistry - there is almost no Schedule I drug that doesn't have a closely related (and oftentimes identical!) counterpart in Schedules II-IV or not scheduled at all.

If I were the conspiracy-theory type, I'd say that this is a way of saying that drugs can only be useful if a pharmaceutical company is profiting off of it. Though I'm inclined to side with Hanlon's razor on this one - that's not really how it came about historically, even if 'Big Pharma' does benefit off of it now. I don't really care - I just wish we'd start drafting laws based on science, not fear.

Produce3• 14 years ago

>Heroin is really just a synthesized and concentrated form of morphine

The pharmacology nerd inside me is reeling. Heroin is a semi-synthetic, since it's derived from the naturally occuring opiate Morphine. Concentrated is the wrong word - vodka is more concentrated than beer because it contains more ethanol per ml. Heroin has a (slightly) different chemical structure to Morphine, though it is more potent by weight. You can't say that it's more concentrated without changing the meaning of the word.

>I just wish we'd start drafting laws based on science, not fear.

Completely agree and to add to that, I wish we'd start drafting laws which protect people instead of harming them.

yayadarsh• 14 years ago

The skeptic within would tend to agree with the conspiracy-type within you.

It would seem that the simplest solution be to step back and change legislation on various chemicals/compounds to be in accordance with scientific findings/changes in cultural perception. The logical question is then, what exists to prevent this? I think a careful shave with Occam's razor uncovers the possibility/probability of corporate interests being too high to ignore, rendering Hanlon's razor a little too blunt.

CWuestefeld• 14 years ago

If aspirin were being considered as a drug today, would it ever pass FDA tests? It does lots of great stuff, but it's also got lots of nasty side effects (I'm not allowed to take it, due to its effect on my Crohn's disease).

georgieporgie2• 14 years ago

I always get a chuckle when reading up on prescription-only drugs that are (often significantly) safer than Tylenol. :-)

vacri• 14 years ago

Plenty of FDA-approved drugs have nasty side effects. Isotretinoin will cause such massive birth defects that usually a doctor will get a female user to sign an agreement that she won't get pregnant while taking it.

It has a number of other significant side effects - for me, marked loss of physical strength, plus delicate skin susceptible to sunburn while taking it. But the 6-month course was worth it - cleared up my facial acne to an incredible degree. I had simply gotten used to the fact that my face was always in pain. Now I still get the odd pimple (like most people), but nothing like the boils I used to get.

josefresco• 14 years ago

The question is; Should I, a relatively healthy 31 year old male start taking Aspirin daily?

TomGullen• 14 years ago

This is what I want to know!

mhurron2• 14 years ago

Maybe you should ask a real doctor. Right now you're just going to get people who play doctor on the internet.

tomg• 14 years ago

Yes, please ask your doctor. Daily aspirin use can cause some problems in some people, such as stomach bleeding, which can be deadly.

aespinoza4• 14 years ago

I think at this point, even doctors don't know. See I have talked to several, and the answers are always mixed.

Some believe the results, some are just waiting for a more definitive study.

In the end one doctor said "..not to take it even if it has SOME benefits. Aspirin, like any other pill can cause gastrointestinal bleeding. So if there is no reason to take it avoid it..."

Alex39173• 14 years ago

Keep in mind that what matters is total mortality and total morbidity, not risk of cancer.

carbocation3• 14 years ago

This is absolutely right from the perspective of a primary prevention task force. Individuals might have slightly different values, so perhaps they would accept some tradeoff. (E.g., reducing a 20% lifetime cancer risk down to 10%, while increasing a lifetime fatal bleed risk from 1% to 5%, might be acceptable to some.)

Unfortunately, I readily admit that (1) we can't yet do a reasonable job of giving people their lifetime risk of X; and (2) people (doctors included) aren't great, generally, at statistical thinking.

So yeah, the goal should be to reduce total morbidity and mortality.

aespinoza4• 14 years ago

That is exactly my question as well. I have been reluctant to take it every day, even though I see so many articles talking about the benefits.

I did some research and I found this as well:

http://kill-or-cure.heroku.com/#term34

http://www.drweil.com/drw/u/id/QAA326650

It is very disappointing that we cannot reach a conclusion, but let's be honest the question everybody is asking is if Aspiring can prevent ALL types of cancer. I think we should start narrowing it down.

jimmyvanhalen• 14 years ago

saw this last month:

Daily Aspirin May Help Prevent and Treat Cancer.

Taking aspirin every day may significantly reduce the risk of many cancers and prevent tumors from spreading, according to two new studies published on Tuesday.

http://www.nytimes.com/2012/03/21/health/research/studies-li...

http://www.webmd.com/cancer/news/20120320/daily-aspirin-may-...

spoiledtechie3• 14 years ago

Oh god no. Please keep in mind, Aspirin also kills over 20,000 people annually from both gastrointestinal problems and Reye Syndrome.

It might do wonders for the many, but it also has harmful side effects. Me personally knowing and feeling the anguish of those who has lost loved ones to Aspirin.

I personally will NEVER take aspirin opting for other forms of medication.

http://www.wddty.com/aspirin-it-kills-20-000-americans-every...

http://en.wikipedia.org/wiki/Reyes_syndrome

duncanj• 14 years ago

"NSAIDS such as asprin" (wddty.com). So that means that 20,000 is ascribed also to ibuprofen, naproxen, ketoprofen, ketorolac, etc. While there is risk from all of them, the risk is dose-dependent.

carbocation3• 14 years ago

Reye syndrome affects children under 19 (some say under 16) with a median age of 6 who ingest aspirin after a (typically) viral infection. It is not something that adults should be worried about.

jsprinkles2• 14 years ago

You'd probably ridicule Jenny McCarthy for what she says about vaccines, but your comment is roughly the same thing.

aantix2• 14 years ago

See my numbers cited above. 1 incident of GI bleeding per year out of 833 people taking a once daily, low-dose aspirin. I find those numbers acceptable and will continue to take aspirin. If there are any other medications involved, this further complicates the risk numbers and must be considered. You may not find them acceptable.

astrofinch2• 14 years ago

Isn't G.I. bleeding grounds for a trip to the emergency room?

This seems like a bigger risk than dying in a car accident by a decently large margin.

iso8859-1• 14 years ago

you'll get a lot of bruises if you take too much

astrofinch2• 14 years ago

I'm not too sure about aspirin, but long-term use of NSAIDs seems like a good way to screw up your stomach.

http://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory...

Happened to me, and I'm only 20. Apparently doctors prescribe these as painkillers all the time, and the gastrointestinal bleeding that sometimes results is one of the main ways prescription drugs kill people.

DanBC2• 14 years ago

No.

You expose yourself to known and unknown risks for slight (if any) known benefits and unknown benefits.

Should you, as a relatively healthy 31 year old male, eat better, get more exercise, stop smoking, drink alcohol sensibly, drive safer, etc? I have no idea about you personally, but most people could make reasonably simple lifestyle choices and dramatically reduce their risks of a bunch of stuff and increase their quality of life.

(As always, I'm not a doctor, I have no medical training, etc etc. Disclaimers aren't needed for HN, are they?)

aantix2• 14 years ago

As for the internal bleeding "risks", I was wondering what the actual numbers were. This is based on one low dose aspirin a day.

http://www.medscape.com/viewarticle/545101_3

"These results translate into an absolute rate increase with aspirin above placebo (the incidence of cases of major GI bleeding attributable to low-dose aspirin) of 0.12% per year (95% CI: 0.07–0.19% per year).[20] Based on this value, 833 patients (95% CI: 526–1429 patients) would need to be treated with low-dose aspirin instead of placebo to cause one major GI bleeding episode during a 1-year period (i.e. the NNH is 833)"

Anyone else care to share quantitative risk numbers?

DavidAbrams2• 14 years ago

I don't know about bleeding, but what about the hearing loss that's associated with regular aspirin and other NSAID use?

http://www.news-medical.net/news/20100301/Regular-use-of-asp...

georgieporgie2• 14 years ago

Another recent article about Aspirin:

http://www.abc.net.au/science/articles/2012/04/20/3481356.ht...

"scientists have now discovered that aspirin also activates an enzyme that burns fat, a finding that could unlock its cancer fighting properties, according to a new study."

(I've read before about aspirin -- or white willow bark -- being a critical element in an Ephedra-Caffeine-Aspirin stack's so-called thermogenic effect)

kjhughes• 14 years ago

The critical reader would be well served to observe the "really is" and "wonder drug" lexical red flags and read Jonah Lehrer's "Trials and Errors: Why Science Is Failing Us" in the January issue of Wired: http://www.wired.com/magazine/2011/12/ff_causation/all/1

mcollinsblog• 14 years ago

Hasn't aspirin been shown to cause tinnitus too?

parasubvert• 14 years ago

Two recent personal aspirin anecdotes.

Late 2011, I contracted acute idiopathic pericarditis. The medication was fairly simple - a ton of aspirin. 4x 650mg Aspirin daily, to be precise, along with colchicine. It healed after a couple of months.

This month, I recently had a cardiac catheterization in my right radial artery (wrist) - my (now healed, but thickened) pericardium likely was constricting my heart. The wrist pain got worse during the healing process - apparently my whole forearm was clotted. 2x 650mg aspirin was the recommendation due to both the blood thinning as well as the anti-inflammatory nature. Pain became manageable the next day, and my arm seems to be healing. Not clear if I've recovered my radial artery yet, though.

I was an Ibuprofen fan for a long time, but Aspirin for me seems to have been what the doctors keep recommending, and has been indispensable these past 4 months. No stomach bleeding, as they usually prescribe Pantoprazole along with it to reduce acid buildup.

carbocation3• 14 years ago

Aspirin is an irreversible ('suicide') platelet inhibitor, whereas ibuprofen is reversible. Basically, you don't want those platelets in that thrombus to ever become active again.

endtime• 14 years ago

This is consistent with the notion that many (most?) neolithic diseases are caused by inflammation, often expressed by people with paleo/primal/archevore/etc. diets.

DanielBMarkham2• 14 years ago

Please forgive a tiny bit of snark. I've long heard that if aspirin had been discovered today, the FDA would have never allowed it to be sold OTC to people. Along those lines, in aviation there's a saying: Wilbur and Orville would have never gotten permission to build the Wright flyer if they applied last year.

I'm a vitamin junkie (Don't pick on me, it's my FSM), so I've been taking low-dose aspirin for over a decade now. If I remember my health-nut mythology correctly, the theory is that inflammation (and especially inflammation related to blood sugar spikes) is believe to be a contributing factor to a lot of bad stuff: diabetes, cancer, aging, and so on.

Interesting to see aspirin continuing to make the news. Amazing drug.

jakeonthemove• 14 years ago

I had the impression that any drug that is not addictive is generally available without prescription?

Also, it's killing me: what does FSM stand for in your sentence? Flying Spaghetti Monster? Fuel Supply Manifold? Free Speech Movement? Something else?

DanielBMarkham2• 14 years ago

Flying Spaghetti Monster. The point is that my obsession with vitamins is irrational and I am aware of that fact.

Nope, all sorts of things that are not addictive are controlled by the FDA [insert long rant here]

wmil• 14 years ago

That's absolutely not true. Antibiotics require a prescription and aren't addictive.

OTC medications are only approved if the drug and condition are mild enough that a doctor doesn't need to be involved.

And it gets a little bit silly -- 200mg ibuprofen are OTC, 400mg require a prescription.

baddox• 14 years ago

Plenty of prescription drugs are not addictive, and plenty of OTC drugs are addictive. Your impression is incorrect.

aristus• 14 years ago

Heh. I need a prescription to buy Vitamin K because it is in "prescription-strength" doses. Lovely self-circular logic.

drzaiusapelord• 14 years ago

Of course the Wright brothers wouldn't be able to do what they do today because the tehcnology has changed some much it would be incredibly foolish to put human beings on the original wright flyer. Why would you even want that? That's like saying "I want to build a tent and a fire pit and hunt and skin animals but my condo association won't let me do that in the yard!"

I'm really getting sick of the manufactured bogeyman of government regulation. These scenarios are at best fantasy and the advantages of proper regulation are obvious to see.

Retric3• 14 years ago

Also, Asprain and related drugs kill ~40,000 people a year so I don't know it the pain relief is worth it. http://adjusthealth.info/health-news/89-40000-deaths-in-usa-...

felipemnoa• 14 years ago

>>Of course the Wright brothers wouldn't be able to do what they do today because the tehcnology has changed some much it would be incredibly foolish to put human beings on the original wright flyer.

Considering that some people replicated what the wright brothers did I think the whole point is moot: http://www.youtube.com/watch?v=qo0kpCU03-U

funthree• 14 years ago

>> Why would you even want that?

Because it's the first manned flight?

>> That's like saying ...

No it isn't at all like that.

>> I'm really getting sick of the manufactured bogeyman of government regulation.

And I'm really getting sick of this place turning into reddit.

sliverstorm2• 14 years ago

If I remember my health-nut mythology correctly, the theory is that inflammation (and especially inflammation related to blood sugar spikes) is believe to be a contributing factor to a lot of bad stuff: diabetes, cancer, aging, and so on.

Is daily inflammation a normal thing...? Maybe I'm just not observant enough, but I notice inflammation most often when I cut, bruise, scrape, or otherwise accidentally abuse my body - in which cases, memory tells me that (in the mild case) that's the right response.

lunchbox• 14 years ago

Inflammation is extraordinarily common. It underlies hundreds of diseases, from asthma to arthritis (in fact, any disease that ends in "-itis"). It often occurs inside the body (not just on the skin), so you could have inflammation right now and not know it.

http://en.wikipedia.org/wiki/Inflammation#Inflammatory_disor...

ZeroGravitas• 14 years ago

Another layer of irony: the wright brothers at the time used a different government bureaucracy (namely patents) to stop other people from building planes.

http://en.wikipedia.org/wiki/The_Wright_brothers_patent_war

boxein• 14 years ago

There's explicit provision in the law allowing for people without a pilot's license to fly an experimental aircraft. I'm sure you can still get in massive trouble for flying through the upside-down layercake above airports, but it's not flat-out forbidden everywhere.

iamgopal• 14 years ago

low-dose aspirin for over a decade now. --> please enlighten me. I am curious why would you do that ?

Angostura• 14 years ago

If I recall correctly, the health benefits of aspirin aren't primarily anti-inflammatory. Ibuprofen is a much better anti-inflammatory at moderate doses.

ekianjo3• 14 years ago

Correct, Ibuprofen is much stronger for anti-inflammation. Aspirin is a blood thinner and a painkiller, at least these are its main accepted functions so far.

makmanalp• 14 years ago

This is also a pharma company's nightmare. Built and sold cancer reducing drug for dirt-cheap? Ooops.

DavidAbrams2• 14 years ago

Could cost you your hearing, though:

http://www.news-medical.net/news/20100301/Regular-use-of-asp...

ekianjo3• 14 years ago

It's a bit improper to mix results from observational studies and controlled studies together to show a reduction of cancer rate and so on. Such studies are made in completely different conditions, it's like mixing apples and oranges and telling you the total in bananas.

Plus, we'd need to seriously look at how patients were sampled and all in both arms of the control study. This kind of article is obviously written by someone who knows nothing about the science of clinical trials, which is a bit of a shame. Tabloid level, really.

kvh• 14 years ago

You're joking right? The fact that it even mentions the terms randomized and observational puts it in the 99th percentile of medical science reporting.

And why can't you combine results from observational studies and controlled studies? Surely they both provide evidence (albiet very weak evidence in the former's case) of the effect.

ekianjo3• 14 years ago

Observational is not considered as evidence. At best, it gives you cues to conduct a next research (randomized, double-blind, controlled) in order to actually do Science.

There are tons of observational studies that tell sh*t like there are correlations between eating cabbage and having great long hair, but most of the time it's pure luck, sample bias, or just error range.

Observational studies are NEVER accepted as sufficient to claim anything with authorities. At the most you can exercise caution based on risks observed in Safety observational studies, but when it comes to proving efficacy ... you will raise major criticism.

And just putting "observational" and "randomized" does not mean he understands the terms. When you write "Aspirin Really Is Kind of a Wonder Drug" without substantial evidence in your article, without dissociating observational and randomized results, I have a hard time believing this is from a science-educated person.

DanBC2• 14 years ago

People in this thread have mentioned gastric bleeds.

I haven't seen anyone mention the increased risk of hemorrhagic stroke. Heart attacks are serious and they kill many people, but so do strokes.

The end of the article mentions CVD. Here's a Cochrane review of aspirin for CVD:

(http://www.imbi.uni-freiburg.de/OJS/cca/index.php?journal=cc...)

tl;dr: 5% or greater risk of CVD over 5 years the risks are there but less than the risk of CVD. 5% to 1% risk of CVD over 5 years the risks are there, and probably about equal to CVD, so you need to talk to a doctor to assess. Risk lower than 1% of CVD over 5 years means the risks are more severe than the risk of CVD.

The article is pretty lousy. There's no direct link to the original research, so it's harder for people to see if the science is good or hopeless.

> One type of cancer called metastatic adenocarcinoma, which can affect the prostate, lungs, and colon, was reduced by 46 percent in people who took aspirin.

Most people have no idea how to interpret this sentence. Most people have no idea how many people - out of say 100,000 - will get adenocarcinoma. (Am I reducing my risk from 2 in 100,000 to 1 in 100,000? Or from 300 in 10,000 to 150 in 10,000?)

Aspirin Really Is Kind of a Wonder Drug, Studies Continue to Show

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