Please ensure Javascript is enabled for purposes of website accessibility
We Are Closed

Medications for long term pain

Pain Medication


Pain medication can be very effective for short-term or ‘acute’ pain that comes after an injury, operation or accident. 

We thought they were also useful for pain that goes on for months or years.  We now know that this isn’t true and they are not safe to take for longer periods of time as they can lead to side effects, addiction or early death. 

There are three main groups of pain medication: paracetamol, non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen and naproxen, and opioids that include codeine, tramadol and morphine.  Each group work differently but unfortunately there isn’t a medication that will remove all pain.

What is the difference between short & long-term pain?

Short term pain is usually due to an injury or damage to the body such as broken limbs, operations, nerve damage etc.

However after 3-6 months the body has usually healed or settled as much as it is going to unless it is due to an inflammatory condition such as rheumatoid arthritis.  The pain that is felt after this time is because the body is becoming very sensitive and is giving off pain signals in an uncontrolled way.  This is called long-term or persistant pain.

Long-term pain is a common condition that affects more than 1 in 5 of us, however we don’t know why this happens to some people and not others.  This kind of pain is still very real, however treatments that focus on the original injury are unlikely to work and it needs managing in a different way to acute pain.

Although pain medication can play a part in managing long-term pain they only reduce pain for about 10 percent of people, and even if you get some benefit they are unlikely to remove all of the pain.

People also find that the side effects, which can occur in up to 4 out of 5 people taking pain medication, can be more of a problem than the pain.

So 90 out of 100 people get no benefit long term, but they still get the side effects.

Problems with pain medications

Side effects with opioid pain medications are relatively common and when first starting or increasing a dose can include nausea, vomiting, constipation, itching, dizziness, dry mouth and sedation which in the most part improve after a short while. 

However, longterm there are more serious concerns such as:

  • Respiratory system – opioids can affect breathing causing erratic breathing and gasping particularly at night.  This is of particular concern in patients who are overweight and snore loudly, with obstructive sleep apnoea or are taking other medications which can affect breathing such as benzodiazepines, certain antidepressants, alcohol etc.  Sadly people have died from the combination of these medications and alcohol. 
  • Poor concentration, memory loss and falls – it is recognised that opioids affect the brain and impact day to day living. 
    • 17-35% of people feel dizzy and sick, 
    • 14-29% of people feel confused or sleepy
    • 24% of people experience memory loss
  • Hormones – 1 in 4 patients on opioids will experience reduced sexual drive, erectile disfunction and infertility.  They can also affect periods, cause hot flushes and affect bone strength (osteoporosis)
  • Weight gain – patients often gain weight with opioids which can make other side effects worse
  • Immune system – patients on opioids are often at higher risk of serious infections 
  • Skin sensitivity and itch – pruritis or itch, can continue longterm when taking opioids and doesn’t improve with time.  Skin can also become very sensitive and give pain signals from things that wouldn’t be expected to give high levels of pain.
  • Increased levels of pain – despite taking pain medication, the pain experienced gets worse.  Sometimes this is because your body has got used to the pain-relieving effect of the medicine, known as tolerance.  

In this video, Mark explains how opioids have affected his life 

What about addiction?

People who are addicted to opioids can feel out of control about how much or how often they take their medication, crave the drug, take higher than prescribed doses, buying it illegaly or taking medications that been prescribed for others.

More commonly your body becomes dependent on opioids.  This means if you were to suddenly stop the medication, miss or be late with a dose, or lower the dose too quicky you get symptoms of withdrawl such as:

  • sweating
  • tiredness
  • stomach cramps
  • aching muscules
  • a runny nose
  • diarrhoea

How can I reduce or stop my pain medication?

As your body may have formed a dependence to the pain medications it is important not to stop taking your medication suddenly as you may experience withdrawl symptoms. 

Contact the practice so we can support you to gradually reduce the amount you are taking.

How do you manage pain without medication?

Living with persistant or long-term pain can be exhausting and things like anxiety and stress can make your ability to manage your pain worse and vice versa.  While it may not be possible to completely remove your pain, you can be supported to cope better with it.

Everyone is different, and everyone’s pain is different so there is no one solution.  Each person will develop their own way for managing their pain which may change with time as they learn new ways to help.  Some people become so good at managing their pain that it fades completely into the background much of the time.

It can involve learning how to do things differently as well as helpful treatments that do not involve medications, as well as thinking and reacting differently to the pain and life events in general.  For many people a pain management programe can be very helpful to teach you how best to cope with your pain and live a more active life.  We can refer you to the pain clinic to be enrolled on a pain management programme.


Where can I get further information?

If you want to start reducing your opioid medication you can contact the practice to make an appointment with our pharmacy team or complete the form at the end of the page.

You can also find lots of useful information on persistant pain and pain medication on the links below

LiveWell with pain

Flippin’ Pain

Painkillers Don’t Exist

The Pain Toolkit