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We draw today from Murphy D, "Article Review: Nonsteroidal Anti-Inflammatory Drugs," American Journal of Clinical Chiropractic, Vol. 19 (3), 2009.

As stated elsewhere in this WEB site, it was British Biochemist John Vane who finally unlocked Aspirin's mysterious secrets in 1971. He figured out that ASA, as Aspirin is also called, (it is also the world's most popular NSAID) has an ability to block the synthesis of prostaglandins. These are hormone like secretions given off at an injury site that enhance the pain experience. ASA has been the conventional pain killing "wonder drug" for well over a century now. Along with its benefits came side effects. Chiefly, gatro-intestinal (GI) bleeding and kidney damage. More recently, ASA has been linked to increased cardio-vascular damage and, incredibly, increased risk for Alzheimer's Dementia.

As drug manufacturers are want to do, new classes of drugs are manufactured that do what the earlier generation of the same drug did but without a certain side effect. Thus, a new class of NSAIDs hit the market several years ago known as the COX-2 inhibitors. These drugs are also known as cyclo-oxygenease 2 inhibitors or "coxibs" for short. Their brand names are Celebrex and Vioxx.

Dan Murphy, DC investigated the following article and the results are deeply troubling: Vaithianathan R, et.al., "Iatrogenic Effects of COX-2 Inhibitors in the U.S. Population," Drug Safety, 2009; 32: 335-343. Important points from the above referenced article:

1) Selective coxibs, specifically Vioxx and Celebrex increase cardiovascular risk
2) This study evaluated the incidence of acute Myocardial Infarction (MI), Stroke, GI Heamorrhage in the year following being given 2 or more scripts of Vioxx, Celebrex or traditional NSAIDs: the findings were clear - coxibs increase the risk of Cardiovascular events from myocardial infarction (MI) to Stroke. As well, due to the overwhelming backlash of public indignation as well as deaths; Vioxx has been removed from the marketplace. A "black box" warning has been applied to Celebrex.
3) Celebrex is used by more than 3.7 million Americans and direct to consumer advertising suggests that the Celebrex market will expand.

Nsaids-24) For the U.S. Population (approx. 190 Million), the cumulative risk from coxibs over a four year period (1999 - 2004) was 46, 783 acute MIs, 21,832 strokes, 100,842 excess GI hemorrhagaes.
5) Traditional NSAIDs were associated with an excess of 87,327 GI bleeds.
6) In the author's analysis, in a four year period of time, coxibs resulted in 26,603 excess deaths and traditional NSAIDs were associated with 9,606 deaths.
7) The risk of acute MI increases with the longer one consumes coxibs.
8) The risk of GI bleeding also increases with the lenght of time one continues to consume traditional NSAIDs.
9) The study did not count the problems associated with those who took only one script fo coxibs or NSAIDs, or those who took traditional NSAIDs such as ASA. Thus, "This leads to an underestimate of the exposure levels in the population and consequently the overal disease burden."
10) "Rofecoxib (VIOXX) wsa identified as the 14th most commonly implicated drug in causing death over the period from 1998-2005."
11) In the period from 1998-2005, Celebrex "was in 10th place for causing disability or other serious outcomes. These data, dervied from voluntary reports, are likely to under-estimate the true scale of the problem."
12) "Drugs that were rapidly accepted for assumed safety advantagaes proved instead to have caused substantial injury and death."

This study only considered a short time-line for a specific drug danger to American citizens and it is an alarmingly morbid summation of what is wrong with just a handful of the titanic amount of legally prescribed drugs consumed by the American Public. In light of these findings, among many others describing all that is wrong with the medical world, it is farcical to continue to treat chiropractic manipulation as a big threat to the public safety of this nation. Consider the following:

A) A significant portion of the population can reduce or stop their intake of scripted medications (meds) for DJD by ingesting Omega-3 Fatty Acids for 75 days. (Maroon JC, et.al., Surgical Neuro, 2006; 65: 326-331)
B) For treatment of chronic neck and back pain, chiropractic manipulative treatment (CMT) was >5 times as effective as Celebrex or Vioxx, the benefits of 9 weeks of CMT was still present a year later. There were no known side effects from the chiropractic care. Giles, LGF, et. al. SPINE, 2003; 28 (14).
C) In a study of 50,276 consecutive chiropractic adjustments involving 19,722 patients, there were no serious side effects noted. Thiel HW, et.al., SPINE, 32 (21), 2007.
D) The largest study to date on chiropractic manipulation of the cervical spine concluded that CMT is NOT associated with adverse vascular effects. Cassidy JD, et.al., SPINE, 2008: 33(4S).


When it comes to muculoskeletal issues and problems, first try Omega-3 Fatty Acids (fish oil) and chiropractic care first. We urge you.



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