Pain and medication

Pain affects everyone at some point in their life. Perhaps because of an accident or an injury, but pain can also come from other conditions like diabetes, arthritis or something that has healed, like shingles. Some people get pain for no obvious reason.

When you have pain, you might take analgesic medicine or ‘painkillers’ as they are better known.

The term ‘painkiller’ can make you think that by taking them, the pain will go away completely. Occasionally, this might be the case. However, analgesics are unlikely to take the pain away completely for most people, most of the time. There are a number of different analgesic medicines that you might be offered:

Paracetamol and non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen
Opioids such as codeine, dihydrocodeine, buprenorphine, tramadol, morphine, oxycodone and fentanyl
Drugs to treat nerve pain such as amitriptyline and duloxetine which, are anti-depressant medicines as well and gabapentin and pregabalin which can also be used to treat epilepsy and anxiety

A picture of pills

For persistent pain, the main aim of treatment is to have an improved quality of life. Analgesics might reduce the intensity of the pain to improve a person’s ability to engage in life. However, there are many concerns that these medicines, opioids and gabapentinoids in particular, are not actually very helpful for long-term pain conditions. Analgesics can cause side effects and other long-term health problems. There is evidence that using these medicines can lead to dependence and sometimes addiction. If you are worried that you (or someone you know) could be dependent on pain medication, contact your GP / encourage them to contact their GP, to discuss alternative ways to manage the pain.

Medications prescribed for pain will have different effects on different people. Therefore, they should be reviewed early and monitored closely. 'Starting low' and 'going slow' is a good approach for newly prescribed pain medications to help minimise side effects. The dosage may be gradually increased depending on effectiveness.

Whether medication is effective depends on the balance of benefits and side effects for each individual. If you have been using analgesic medicines for more than three months and do not think they have changed life for the better, please speak to your pharmacist or another healthcare professional about having a review of your medicines. They can also discuss the many other ways that you can get support to live better with pain.

It's important to remember that lots of things can influence pain and long-term pain medication isn’t the only option. See the video above, developed by Hunter Integrated Pain Service to find out more.

For more information on pain medication, please see the Live Well with Pain website. At the bottom of the website you will find a variety of useful links, including resources for key self-management skills that people with pain find most valuable. Go here to visit the Live Well With Pain website which offers excellent advice, help and support.

Good practice of reviewing pain medication

Even if you feel your medication is improving your quality of life, it is still important to review all your medication regularly to ensure it remains safe and appropriate. Asking for a review with your healthcare professional is particularly important if your pain hasn’t been reviewed recently or has changed. Ongoing review should occur at least every six to twelve months or more frequently if needed due to worsening symptoms, changes in other medical conditions or the addition of new medication. Routine check-ups are beneficial to ensure the medication is still needed and continues to be effective, to monitor any side effects and make dose adjustments when required.

If I am taking long-term pain medication, what can I do to make sure it is still appropriate for my pain and me?

Make an appointment with your GP (or practice pharmacist) to discuss your pain management and current medication.
During your appointment, you could ask your GP about the risks (e.g., side effects) and benefits associated with the pain medication you are taking. This doesn’t mean your pain medication will be automatically stopped or changed, but it may help you make decisions about your medication in the future.
Before your appointment think about what matters to you. Gather your concerns and any questions you may have for your healthcare professional. This could include your type of pain, your pain medication, the way you are feeling or any changes in your life as a result of your pain.

Pain Concern UK have a useful tool that can guide you to make the most of your GP appointment. Go here to find out more from a document on the Pain Concern UK website.

Do not try to reduce or stop pain medicines by yourself as this could lead to withdrawal side effects. Please speak to your GP (or Practice Pharmacist) first.