About pain medication

About pain medication

You will probably have taken lots of different pain medications. These can be very effective in certain situations. In acute problems such as immediately after an injury or operation they can be used in high doses to take pain away almost completely. You may well have found, however, that in long-term pain this is rarely the case. This is because ongoing pain is more complex.   

The aim of medication in long-term pain is to take the edge off your pain to allow you to do more in your life. You do not need it in the same way as, for example, someone that has diabetes needs insulin. Some people decide that in the long term the problems associated with it outweigh the benefits of taking it. 

PLEASE NOTE: There is no evidence that opioid medication is effective for the use of long term persistent non-cancer related pain. 

Pain management medication

All medications have possible side effects, so you need to weigh up the advantages of taking them against the disadvantages. Painkillers should only be taken if they will help improve your quality of life.

With long term pain we find that medications may have started off helping but as the body gets used to these the effect wears off. They can be helpful for some people, however if you still have significant pain with poor quality of life, having tried several medications, it is worth asking if this medication is still working for you.  

Opioids particularly can be very helpful for acute and cancer pain, but they have very little evidence in long term pain and significant difficulties with tolerance. Further information can be found on the Faculty of Pain Medicine ‘opioids aware’ website: https://www.fpm.ac.uk/opioids-aware.

There are five main classes of medications used in the management of pain; these include:

1. Opiates (e.g., morphine and tramadol)
2. Non-steroidal anti-inflammatory medications (e.g., ibuprofen, diclofenac)
3. Antidepressants (e.g., amitriptyline, duloxetine)
4. Anticonvulsants (e.g., gabapentin, pregabalin)
5. Sleeping tablets (e.g., zopiclone, temazepam, melatonin)

It is important to take note that higher doses do not work better and may be harmful and excessive doses of even paracetamol and aspirin are toxic to your liver and stomach and can be fatal.

Take the temperature of opioid pain medicines: https://livewellwithpain.co.uk/wp-content/uploads/2022/09/Opioid-Thermometers-2025.pdf