'Generally safe' NSAIDs?

TOO THE EDITOR: When will we ever learn? Physicians, patients and society have become so used to over-the-counter and prescription nonsteroidal anti-inflammatory drugs (NSAIDs) as an everyday fact of life that we have become numbed to the devastation they cause. In "Cyclooxygenase-2 Enzyme Inhibitors: Place in Therapy,"1 the authors, in an otherwise excellent article, state: "Although generally safe, 'traditional' NSAIDs account for almost one fourth of all reported adverse drug events. Approximately 15 percent of NSAID users have gastrointestinal tract symptoms such as dyspepsia, heartburn, nausea or vomiting. Each year, 1 to 4 percent of NSAID users have serious gastrointestinal tract complications such as hemorrhage, with an estimated cost of $15,000 to $20,000 per hospitalization. An estimated 16,500 NSAID-related deaths occur annually among patients with osteoarthritis or rheumatoid arthritis. Medical costs of complications associated with NSAID use exceed $4 billion annually."1