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Long term side effects of pain killers are usually seen in patients who are taking pain killers on daily basis for many months to years together and these are the patients who suffer from chronic joint problems or chronic pain issues. So in these patients they should consult their doctors and they should be using these pain killers only on the advice of these doctors. Problem happen only when they are using pain killers beyond the prescribed limits. So if you have prescribed pain killers for 30 days, you are taking for 3 months or 3 years without talking to doctor then you get prone to the long term side effects. Second thing is you are showing to one doctor for one ailment and another ailment to another doctor and both are giving you pain killers and both the doctors don’t know that you are getting another pain killers. So you are taking combination of pain killers that are double or triple the dose that you should be using normally. If such a thing happens, it causes the long term damage or long term side effects or the judicious use of pain killers does not cause any major risk as far as the long term side effects are concerned.