A painful pill to swallow

Pain relief has become synonymous with popping a pill.

The pain relief that these medications provide when used appropriately and managed together with healthcare professionals can be invaluable. However, our society’s overuse of pain killers may be causing more harm than good.

Medications used to manage pain may include:

• Analgesics (e.g. paracetamol)
• NSAIDs (e.g. ibuprofen)
• Opioids (e.g. codeine)
• Anti-epileptics (e.g. pregabalin)
• Anti-depressants (e.g. selective serotonin reuptake inhibitors (SSRIs))

The overuse and misuse of legal prescription opioid medications is reaching crisis point in Australia. Pharmaceutical opioids were once reserved for treating pain that was short-term, terminal or related to cancer. In the 1990s, pharmaceutical companies began marketing them for chronic pain. Since then, the use of these prescription opioids has substantially increased in many countries, including Australia.

It has the second highest level of use globally, second only to the United States. Whilst this illustrates that more and more people are living with pain, it also highlights the addictive nature of opioids. Dangerous overuse and misuse can cause accidental overdose, hospitalisation or death.

To counter the crisis, the Australian government is reviewing opioid pack sizes, indications, warnings and accessibility, as well as supporting education around pain management and opioid alternatives. At the same time, it’s also important to work towards reducing the stigma associated with opioid medication use. By working closely with your healthcare practitioner, there’s a lot that can be done for pain management and to improve your wellbeing.

Although pharmaceutical pain medications can provide relief, some people may experience side effects. These are more likely to occur with higher doses, long term use and where other medications are also being used. For potential side effects from analgesic medications, refer to the pack.

Legal pharmaceutical opioids (including codeine and oxycodone) are responsible for more deaths and poisoning hospitalisations than illegal opioids such as heroin.

• Nearly 150 hospitalisations occur daily in Australia due to opioid misuse, and
• 14 emergency department presentations per day involve opioid harm.
• In 2016, opioids – most commonly pharmaceutical opioids, rather than illegal opioids – accounted for 62% of all drug-induced deaths.

Issues associated with pharmaceutical pain medications, particularly opioids:

Side effects: May cause addiction, breathing difficulties and even death

Efficacy: May only be partially effective in relieving pain

Duration: Long term use may result in harmful effects

Drug interactions: Interactions with other medications may occur