NEW DELHI: In an exclusive interview with The Sunday Guardian, Dr. Suresh Sankar, Senior Vice President, Global Clinical Affairs at NephroPlus, sheds light on a growing but often overlooked health crisis — the misuse of over-the-counter painkillers and prescription opioids in India. He warns that chronic self-medication, especially among older adults, is leading to a surge in kidney-related complications, many of which go unnoticed until it’s too late. With easy access to these drugs and limited awareness about their long-term effects, experts are urging stronger regulations and timely medical oversight to prevent irreversible kidney damage.
Q. Are you seeing a rise in patients misusing over-the-counter painkillers or prescription opioids? What’s driving this trend?
A. Yes, we are seeing a rise in this trend in our clinical practice. One of the major reasons for this trend is easy access to medications from regular pharmacies and off late online channels too. Secondly, many individuals self-medicate for chronic pain, headaches, or joint issues without consulting a doctor, often unaware of how long these drugs can be used safely. The concern is especially significant in the elderly population. They are more likely to experience chronic pain and may unknowingly continue these medications for extended periods, increasing the risk of serious health complications.
Currently in India, there is limited structured data on the extent of painkiller misuse, but anecdotally, the increase in such cases is evident in outpatient and hospital settings. This calls for more public awareness and stronger regulation around long-term use of such drugs.
Q. How does chronic painkillers lead to kidney damage or kidney failure? Is the damage always irreversible?
A. Chronical use of painkillers, especially Non-steroidal Anti-inflammatory agents or NSAIDS, can affect blood supply to the kidney, the filters in the kidney or the tubes and supportive tissue over time. It can be acute and temporary in nature or slow and irreversible damage to the kidney function in nature. In some cases, it can affect the way the kidney handles salt and water, and long term use also raises the risk of malignancy of the urinary tract.
While some damage can be reversed if caught early and the medication is stopped, long-term or repeated use often leads to permanent kidney damage, especially in people with other health conditions like diabetes or high blood pressure. Hence it is advisable to regularly monitor the usage and seek medical guidance when using pain medication for long periods of time.
Q. Do these drugs suppress symptoms to such an extent that they can mask early warning signs of more serious conditions, like kidney cancer?
A. Long term use of painkillers can mark underlying symptoms and delay diagnostics and can cause kidney damage very indolently and silently. There are no warning signs in the early phase and the kidney disease is not evident until an advanced stage. The golden rule when using these drugs is to undergo evaluation and treat the cause of pain, rather than relying on painkillers long term.
Q. Is there a typical “patient profile” you see among those at risk — for example, older adults, athletes, or chronic pain patients?
A. The most common profile includes individuals over the age of 50, from either gender, with existing medical issues such as diabetes, hypertension or arthritis.
These patients are often challenged by access to medical care and limited support, leading them to rely on easily available painkillers for quick relief. They look for short term solutions for chronic pain, often unaware of the long term negative implications for kidney health.
