Ibuprofen, such as Advil and Motrin, is the most common over-the-counter (OTC) pain and inflammation medication found in most homes. In fact, it is one of the most commonly prescribed medications in the world. And for active duty military and veterans, among others, it doesn’t require a doctor’s prescription to get it. Abuse is possible, however, and treatment is recommended to deal with possible psychological dependence. Read on to learn more about ibuprofen misuse and dependence.
What Is Ibuprofen and How Is It Used?
Ibuprofen belongs to the class of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). A 2021 survey by the Consumer Healthcare Products Association (CHPA) found that ibuprofen is the #1 choice for muscle aches and pains among consumers. It’s also a top choice for headache, backache, and menstrual pain.
Ibuprofen inhibits the expression of enzymes (especially COX-1 and COX-2) and through subsequent processes, lessens the degree of response to pain stimuli. It also impacts the temperature control center in the brain’s hypothalamus. Through this mechanism, non-selective NSAIDs such as ibuprofen derive their pain-reducing, fever-reducing, and anti-inflammatory properties [1].
15% of the US population regularly takes an NSAID, whether over the counter or prescription strength. Along with sporadic users, more than 30 billion doses are taken each year [2]. One study found that over 19% of American adults reported using an OTC NSAID (like ibuprofen or naproxen) at least three times per week [3].
Main uses of ibuprofen include [1]:
- Inflammatory diseases such as lupus
- Rheumatoid disorders such as arthritis
- Mild to moderate pain
- Fever
- Menstrual cramps
- Osteoarthritis
- Dental surgery pain
- Headache/migraine
- Sore throat
- Cold/flu
Understanding Ibuprofen Misuse: How it Happens
Although NSAIDs such as ibuprofen have a long history of safe use, and are not physically addictive themselves, their widespread OTC availability opens them up for abuse, albeit on a very limited scale. While not as common as abuse of opioids or stimulants, ibuprofen abuse does occur and is dangerous.
Ibuprofen can be misused or abused for many reasons:
- Intentional Overdose: This is the most common form of abuse, often as a means of self-harm or by a suicide attempt because it’s so easily obtained.
- Exceeding the recommended daily dose.
- Chronic use by self-medicating without medical advice.
- Misguided Pain Management: Some individuals with back pain or dental pain may believe that “more is better,” unknowingly risking overdose.
- Co-occurring Mental Health Conditions: Due to mental health conditions, including depression and anxiety, among other reasons.
- Athletic and Performance Misuse: Many athletes may abuse it to push through pain and injury during training or competition, believing it will enhance performance by masking pain, which can lead to worse injuries.
- Substance Use Disorder (SUD): Individuals with a history of SUD may try to manage symptoms of withdrawal from other substances or as a substitute when their primary drug of choice is unavailable.
Who Abuses Ibuprofen?
Ibuprofen misuse is primarily a question of psychological dependence. Most often, it starts with physical pain, perhaps a military or sports injury or arthritis flare-up. Meant for short-term relief, a typical dose ranges from 400mg to 800mg, four times per day.
It’s not recommended to be taken on a daily basis for more than 30 days. One study reported that 11% of those taking NSAIDs exceed the prescribed dose, and this is more common among men [4].
“Misuse” is taking more than directed, or for reasons other than intended. “Abuse” is a more severe pattern with negative consequences. Those who abuse ibuprofen do so for many reasons [5]:
- Young Adults (18-25): Self-medicating for pain (e.g., from military duties or sports injuries), academic stress, experimentation, and co-use with alcohol or other drugs.
- Adults (26-49): Highest prevalence of use of OTC analgesics overall due to a higher incidence of pain conditions (e.g., back pain, chronic pain).
- Women: Have higher reported rates of common pain conditions (e.g., migraines, fibromyalgia, arthritis, menstrual pain) and tend to seek treatment more than men.
- People with Chronic Pain: Those with debilitating back pain and arthritis are at significantly higher risk of misuse.
- Individuals with Low Income or Limited Healthcare Access: Since many people can’t afford doctor visits or prescription co-pays with insurance companies, they may self-medicate with ibuprofen as a cheaper and more accessible OTC alternative.
- Uninsured Adults: For financial reasons they may rely more heavily on OTC medications, increasing the risk of misuse.
- People with Mental Health Conditions: People who experience anxiety, depression, or high levels of stress are much more likely to misuse pain relievers to cope with emotional distress and physical pain.
- People with Substance Use Disorders (SUD): As they seek to self-manage withdrawal symptoms, or substitute for other drugs, some individuals are at a much higher risk of misusing OTCs such as ibuprofen.
- Non-Hispanic White Individuals: Surveys show greater OTC pain relief drug misuse among these individuals.
- Rural Populations: Facing greater barriers to access healthcare, people in rural areas often self-medicate with OTC products like ibuprofen.
Can Your Body Become Dependent on Ibuprofen?
Due to their widespread availability and the good safety record of NSAIDs, it’s easy to misuse them. Ibuprofen does not cause euphoric effects or psychological addiction like opioids, but physical dependence and maladaptive behavioral patterns can occur in rare cases.
Ibuprofen misuse can lead to physical dependency as it doesn’t trigger the brain chemistry changes that create addiction, like opioids or stimulants, for example. However, overuse may result in tolerance, compulsive behaviors, and failed attempts to cut back, which fits some criteria for substance use disorder [6].
However, many people gradually become used to the pain relief and bump up their doses, if whatever causes the pain has not truly resolved. Gradually, a psychological dependence and tolerance develops. Reducing the dose brings on withdrawal symptoms.
Some individuals may experience behavioral changes, like needing to take larger amounts for pain relief, planning life around ibuprofen use, or exhibiting emotional distress when unable to access the drug with withdrawal symptoms primarily with reoccurring or rebound pain.
Health Risks of Ibuprofen Overuse
The severe risks of associated with higher doses of NSAIDs such as ibuprofen include:
- Digestive problems
- Ulcers
- Gastrointestinal tract bleeding
- Heart attack
- Kidney failure, which is the primary danger of abuse/misuse [7] [8]
Safer Alternatives to Ibuprofen
Safer alternatives to ibuprofen for pain relief are available, but should be discussed with your medical provider.
Safer Alternatives to Ibuprofen
- Acetaminophen (Tylenol): Safer for people with kidney or gastrointestinal issues
- Topical NSAIDs: Creams and gels like Voltaren
- Other NSAIDs with less risk: Naproxen (Aleve) with fewer heart complications
Non-drug approaches:
Physical therapy, acupuncture, heat/cold therapy, or exercise can help manage pain without medication.
Natural remedies and supplements: Turmeric, arnica, curcumin, and bromelain (to discuss with medical provider)
When to Seek Help
If there are signs of misuse or health complications from ibuprofen use, It’s important to seek help. Prompt support should be sought if complications arise.
- Seeing Signs of misuse: Seek help if you use ibuprofen in larger amounts or for longer than advised, can’t cut down, or need increasing doses for the same effect.
- Withdrawal or health complications: See a medical provider if you have headaches, gastrointestinal bleeding, kidney or liver issues, or any concerning physical/mental changes after reducing or stopping the use of ibuprofen.
- Support is widely available: Primary care providers and addiction specialists can provide individualized support if medication misuse is suspected. Miramar Health treatment centers offer withdrawal management and residential treatment for active duty military and veterans.
Healing from Medication Dependence at Miramar Health, California
As a veteran-owned treatment facility focused exclusively on support for active-duty military and veterans, Miramar Health offers years of experience helping military members recover from substance abuse and co-occurring mental health conditions. We know and understand military culture. We use the trauma-informed therapy approaches referred to above and customize treatment to each member’s needs. We also provide related support to military family members.
Get in touch with our Admissions team today!
Sources
[1] Ngo VTH, Bajaj T. Ibuprofen. [Updated 2024 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan
[2] Shmerling R. 2020. Are you taking too much anti-inflammatory medication? Harvard Health.
[3] Brennan, R. et al. A Scoping Review of Non-Medical and Extra-Medical Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Drug Saf 44, 917–928 (2021)
[4] Kaufman D. et al. 2018. Exceeding the daily dosing limit of nonsteroidal anti-inflammatory drugs among ibuprofen users. Pharmacoepidemiology & Drug Use. Volume27, Issue3. March 2018,Pages 322-331
[5] NSDUH. 2021 National Survey on Drug Use and Health (NSDUH) Releases.
[6] Fletcher S. 2025. Acetaminophen vs Ibuprofen: Addiction Risks and Long Term Effects. CanadianCentreforAddictions.org
[8] Ershad M, Ameer MA, Chen RJ, et al. Ibuprofen Toxicity. [Updated 2024 Apr 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan