If you have been taking painkillers for a long-time please read below:
We are particularly talking about a type of painkiller called an opioid; like co-codamol, co-dydramol, codeine, dihydrocodeine, and tramadol.
Recent medical evidence questions the benefit of opioids (which are in the morphine family) for long-term pain. Strange as it might sound – we don’t think that they are very good at killing pain at all when taken for more than a few months.
There are risks too – they can:
- sometimes make pain worse
- cause side effects to the intestines and the stomach
- make the body feel dependent on them so if you miss a dose you feel jittery and anxious
- increase the risk of fall
- reduce sexual function in both men and women
- there’s even a risk of overdose and death, especially if taken with alcohol or with some other medicines such as benzodiazepines (like diazepam) or pregabalin
For these reasons we suggest you try a “drug holiday”. This means you gradually reduce and stop your painkillers over a month or so to see for sure whether they’re helping or not. It’s not unusual for pain to flare up a bit when doses are reduced and discontinued but that’s to be expected. Many people take these “withdrawal pains” as a sign that the opioids had been working and need to be continued (or even increased) but that is not the case and most people will start to feel better after a week or two. It can be tough getting through this time but it’s worth it.
Once you’re off the opioids for a month you’ll have a good idea as to whether they were making a positive difference to your life. If they were, feel free to gradually restart them – but try to find the lowest dose that works.
Modern management of chronic pain is geared away from drug therapy and more towards self-management where the patients take control of their lives and their pain with the use of physical therapies, emotional / mindfulness type practice plus pacing strategies.
The following links provide more information:
If you’ve got any questions about this, or if you are also taking other opioid type medicines along with the ones listed above; feel free to talk to your community pharmacist or to make an appointment with your practice pharmacist or a doctor of your choice to discuss.