Painkillers Don’t Exist

For many people, managing pain with prescribed medications is a routine part of life. However, it’s essential to understand that our bodies’ response to pain changes over time, and long-term opioid use is not as safe and effective for chronic non-cancer pain as originally thought.  

Although opioids provide effective pain relief for acute pain and in palliative care, there is little evidence of benefit for long-term opioids in patients with persistent non-cancer pain with regards to pain, quality of life or functioning. Further, there is now a better understanding of the risks, including dependence and opioid-related mortality. 

The Painkillers Don’t Exist campaign helps explain the difference between managing short-term and long-term pain and making informed choices about pain management. 

Understanding short-term and long-term pain 

Short-term pain, or acute pain, is often in response to injury or trauma. In these cases, medications can be effective, helping to reduce pain while the body heals. Generally, this pain lasts a few days or weeks, subsiding as the body recovers. 

However, after 3 to 6 months, if pain continues, it may no longer be due to the original injury. Instead, the body can become more sensitive, continuing to send pain signals even after healing. This persistent or long-term pain (chronic pain) is complex, and medications that once helped may no longer be effective. 

The scope of pain medication uses in mid and south Essex 

Data shows that more than 35,000 individuals in Essex depend on strong opioid medications to manage chronic pain, yet only 1 in 4 experiences any substantial relief.  

In mid and south Essex alone, approximately 22,000 people are prescribed strong opioids, of which 1,267 receive high doses, equivalent to 120mg or more of morphine daily. 

Managing persistent pain can feel overwhelming, and the fact that between a third to a half of the UK population (about 28 million adults) live with chronic pain shows how widespread the issue is. Despite this, long-term pain medications typically benefit only 1 in 4 individuals, usually only offering a 30% reduction in pain. 

Why “painkillers” is a misleading term 

“Painkillers” suggests that medication can completely remove or cure pain. However, no medication can fully “kill” pain, especially chronic pain. While pain medications can provide temporary relief, their effectiveness in managing long-term pain is limited, and prolonged use can lead to side effects and dependency issues. 

For example: Opioid medications like codeine, tramadol, and morphine carry high addiction risks, especially with extended use. Over time, these drugs may become less effective, leading to increased dosages and side effects. 

Side effects of long-term use include drowsiness, constipation, nausea, and sleep disruptions, which can impact quality of life. 

Is it time for a pain review? 

If you’ve been taking pain medication for more than three months, consider a pain review with a member of your GP team. During this review, you can discuss: 

• Changes in effectiveness: Is your medication still relieving pain? 

• Side effects: Are there any unwanted effects impacting your daily life? 

• Dependency concerns: Are you worried about reliance on your medication? 

• Exploring alternatives: Effective ways to manage long-term pain 

Managing chronic pain often requires a holistic approach. Many find relief through a mixture of therapies that can improve quality of life: 

• Physical therapies: Physiotherapy, exercise, and targeted rehabilitation can help with strength, mobility, and pain tolerance. 

• Psychological support: CBT, mindfulness, and talking therapies help reduce the impact of chronic pain on mental wellbeing. 

• Community resources and support groups: Online and in-person groups provide lifestyle advice and social support, valuable for those living with long-term pain.