But while opioids are now prominent in the national cross hairs, they are only one of many drug-related problems associated with pain management. In fact, opioids aside, the vast majority of medical difficulties pain patients encounter result from the use and abuse of pain-reducing medications that are sold over the counter.

“We’ve seen in recent years that each class of drugs used to treat pain has its downsides as well as upsides,” Dr. Campbell said. “Patients – and doctors – need to be mindful of the risks, especially when drugs are taken long term and in large doses.”

Some people assume that if one pill is good, two must be better. And it’s not uncommon for older people, who may have an acute pain problem on top of chronic pain, say, from arthritis, to be taking more than one pain medication at a time.

Many people think pain medications like NSAIDs (nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen) that they can buy without a prescription are safe. As George Gershwin wrote, “It ain’t necessarily so.”

A 2013 analysis of data from the National Ambulatory Medical Care Survey revealed that NSAIDs were used by 95 percent of the nearly seven million patients in the study who took at least one chronic pain medication. Athletes, from recreational to elite, also often take these drugs to counter muscle aches and joint pain.

“These are powerful medications for a whole variety of acute pain problems, and when taken for a few days or a week, they are very safe for most people,” Dr. Campbell said. “But for people with a history of coronary artery disease, even when taken short term, NSAIDs can precipitate clogging of the vessels.”

In addition to cardiovascular risks, NSAIDs can cause gastrointestinal problems, damaging the lining of the digestive tract, especially when they are not taken with food. Their most serious side effects include ulcers, bleeding, kidney failure and, in rare cases, liver failure.