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Where has all the Aspirin gone?

When I was a kid the universal pain-killer was Aspirin.

There was none of these fancy things like Paracetamol or Ibuprofen, it was Aspirin or nothing.

Every household had a packet of the stuff and it tasted like crap but it did the job.

Of course Aspirin was a branded form of acetylsalicylic acid a compound first synthesized back in 1899 by pharmaceutical company Bayer.

After its discovery a patent was issued but that has long-since expired and the only protections that remain in place are trademarks on the name "Aspirin". Interestingly enough, the trademark protection was lost in 1921 wen a court ruled that the name had become "generic" and thus had passed into the public domain. In a strange twist however, Bayer managed to reinstate the trademark protection in the 1990s and that protection remains intact to this day.

With no patent to protect its formulation many companies other than Bayer began manufacturing Aspirin in the learly 20th century and it was an important medication used in treating the symptoms of the Spanish flu which reached pandemic status around that time.

As the years passed and right up until the 1970s, Aspirin was a front-line "over the counter" pain killer.

At the recommended dosages it was considered safe with few, if any, side effects in otherwise healthy individuals.

However, one effect of Aspirin was that it acted as a blood-thinner by reducing the ability of blood platelets to clump together and clot. This did have potential to cause internal bleeding when taken to excess or in susceptible individuals. There was also a risk of kidney damage if taken regularly over a longer period of time.

For these reasons and as a result of more modern analgesics such as acetaminophen (Panadol) and Ibuprofen which tend to have fewer side-effects among healthy individuals, Aspirin fell from favour and was no longer considered a safe front-line medication. Never the less it was still available in pharmacies and even supermarkets.

The big benefit of Aspirin (for many) was its very low cost. The lack of patent protection saw the product sold under a wide range of brand names such as Dispro, Aspro, Disprin, etc. and each 300mg tablet cost just a few cents. This kept it a staple in people's medicine cabinets right through to the early 21st century.

About this time other very positive health effects were uncovered in long-term studies.

It was discovered that the anti-clotting effect of Aspirin could play a role in providing a statistically significant reduction in the risk of ischemic strokes and heart attacks when administered regularly in low doses (around 80-90mg daily). This "baby Aspirin" was seen as a great preventative medication for individuals with a proven greater risk of such events.

A little later, more studies showed another interesting correlation between those taking this regular small dose of Aspirin and cancer figures. It turns out that Aspirin also has a statistically significant effect on reducing some forms of cancer within the general population and most specifically in those genetically predisposed or previously diagnosed with the condition.

Now as someone who has always preferred plain Aspirin to other forms of pain relief, I've noticed something very interesting in recent years and that is the disappearance of generic Aspirin from supermarket shelves.

Used to be that you could buy a packet of store-branded Aspirin tablets for just a couple of dollars at Countdown/Woolworths but today those packets have disapeared completely. Even finding a far more expensive soluble form of the medication can be difficult at times. What's more, I *hate* those soluble forms of the stuff... they have an awful grittiness and (when I could taste stuff) flavour.

What can be found however, is the "baby Aspirin" in 80mg or 90mg doses -- but at an astonishingly high price, although as I type this I see that even these are no longer available from the supermarket and seem to have become pharmacy-only medication at a ludicrous price.

As someone who's done my homework and weighed up the risks versus rewards, I've been taking the low-dose Aspirin for about five years now and have suffered no ill-effects. It's nice to know that my risk of ischemic stroke or heart attack is reduced and that I'm also less likely to suffer from a range of cancers that seem to be on the rise for unknown reasons (even though I'm outside the high-risk group, age-wise).

The absence of Aspirin from supermarket shelves could be down to concerns over the side-effects if misused but then again, both Paracetamol and Ibuprofen also have severe side effects if mis-used and they're still readily available (albeit with quantity limits per sale). I'm picking however, that the main reason we're not seeing plain old Aspirin on shelves at super-low prices, like it used to be, is that pharmaceutical companies have spotted a way to turn huge profits from botique versions (such as the low-dose variant) of a highly generic drug.

Just a tip for those who may be thinking of jumping on the baby-Aspirin bandwagon, check it out with your GP. If they agree that the benefits may outweigh the risks in your case then it's fully subsidised by Pharmac so you won't be paying the god-awful prices that your local chemist will charge for the branded versions.

Carpe Diem folks!

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