373: That's the average number of painkillers we each take in a year. Is it too many?

Doctors say yes. They fear the nation is becoming addicted to pills sold over the counter, with many people taking six every time they feel ill

One in 20 adults takes at least six painkillers every time they are feeling ill, according to a new survey.

The British Medical Association (BMA) said patients were "misusing" pills and urged doctors and pharmacists to be on the look-out for patients who take too many.

Pharmacologists warned that people would become addicted if they took such levels of paracetamol, ibuprofen or aspirin. Britons are taking an average of 373 painkillers every year, the study revealed. The figure alarmed doctors, who said it was "staggering".

A study published in the British Medical Journal earlier this year suggested that men and women over 50 should consider taking an aspirin a day to reduce the risk of heart attacks and strokes. A daily dose of aspirin is already routinely prescribed to patients who have suffered heart attacks. But doctors said such advice alone does not account for the large average number of painkillers consumed. Many people under the age of 50 take such drugs far less often.

Dr Fabrizio Schifano, senior lecturer and clinical pharmacologist at St George's Medical School, London, said: "These figures are staggering. Whenever you have an average it means some people are taking an acceptable amount of pills, but there will be a significant number of people across the country who are consuming a very large number, and that is a big concern."

The BMA said there was a danger that people believed '"over-the-counter" medicines such as aspirin, paracetamol and ibuprofen were "risk-free".

Dr Vivienne Nathanson, the BMA's head of science and ethics, said: "Educational programmes and improved labelling will help people to understand how to make the best use of over-the- counter medicines and take control of their illness."

The BMA urged doctors and pharmacists to keep an eye on patients who were regularly taking large amounts of painkillers. Dr Nathanson said: "It is important for doctors, especially GPs, to know if their patients are regularly taking any over-the- counter drugs. Doctors and pharmacists need to be aware that there are a minority of people who are at risk of misusing and becoming addicted to some over-the-counter medicines."

Doctors also expressed concern at the large number of people who admitted taking painkillers at the same time as alcohol. Nearly half of all respondents said they had taken both at the same time.

The potential danger of drinking alcohol while aspirin, paracetamol or ibuprofen are in the bloodstream is nothing like that caused by drinking while on antibiotics. However, pharmacologists said that over the long term such pills could damage the liver and there was an increased chance of damage if combined with alcohol.

The survey, carried out on behalf of UKTV which is airing a documentary tonight to mark the 100th anniversary of aspirin, also revealed that women are more than twice as likely to take painkillers as men. Two-thirds of women admitted to taking aspirin, paracetamol or ibuprofen on a regular basis, compared to 31 per cent of men.

Dr Geoffrey Brandon, director of the industry-funded Paracetamol Information Centre, said the high figures were not necessarily problematic.

"We have no problem with apparently large amounts of paracetamol being taken. It proves its usefulness. If you take it at the recommended levels there should be no side-effects."

However, one potential side effect, warned Dr Schifano, is that people may take pills to alleviate pain without dealing with the actual problem that is causing the pain. "When you read these figures the real concern is that so many people are taking pills and simply ignoring the warning signs of ill health," Dr Schifano said.

"Pain tells us that something is wrong. People should see their GP or a specialist. By ignoring the pain and taking pills, people are not dealing with the real issue - what is causing the pain. By consistently taking painkillers they could be covering up far more serious problems."

THE PILLS WE POP

Paracetamol

Taken each year: 2.7bn

Benefits: Relieves pain and fever in adults and children. The most widely accepted medicine for this purpose

Possible dangers: Studies have warned that pregnant women who frequently use paracetamol could increase the chance of a child suffering from wheezing

Ibuprofen

Taken each year: 1.4bn

Benefits: Used for aches and pains caused by inflammation, especially of the joints

Possible dangers: Could be linked to an increased risk of heart attack

Aspirin

Taken each year: 700m

Benefits: Doctors believe it can reduce the risk of heart attacks and strokes

Possible dangers: Aspirin has been linked to an increased chance of bleeding in both the stomach and brain

Cox-2 Inhibitors (Celebrex, Vioxx)

Taken each year: 200m

Benefits: Less likely to cause internal bleeding than Cox-1s such as aspirin, ibuprofen and paracetamol

Possible dangers: Vioxx was banned in March 2004 after being blamed for up to 60,000 deaths worldwide. It was associated with an increased risk of coronary arterial disease.