Warning on use of over the counter drugs for chronic pain

PAINKILLERS SUCH as paracetamol, ibuprofen, aspirin and opioids can do “more harm than good” and should not be prescribed to treat chronic pain, health officials have said.

Draft guidance from the National Institute for Health and Care Excellence (Nice) said that there was “little or no evidence” the commonly used drugs for chronic primary pain made any difference to people’s quality of life, pain or psychological distress.

But the draft guidance, published yesterday, said there was evidence they can cause harm, including addiction.

Chairman of the guidance committee Nick Kosky said that, while patients expected a clear diagnosis and effective treatment, the complexity of the condition means GPs and specialists can find it very “challenging” to manage.

The consultant psychiatrist at Dorset HealthCare NHS University Foundation Trust added: “This mismatch between patient expectations and treatment outcomes can affect the relationship between healthcare professionals and patients, a possible consequence of which is the prescribing of ineffective but harmful drugs.

“This guideline, by fostering a clearer understanding of the evidence for the effectiveness of chronic pain treatments, will help to improve the confidence of healthcare professionals in their conversations with patients.

“In doing so it will help them better manage both their own and their patients’ expectations.”

Chronic primary pain is a condition in itself which cannot be accounted for by another diagnosis or as a symptom of an underlying condition, Nice said.

It is characterised by significant emotional distress and functional disability with examples including chronic widespread pain and chronic musculoskeletal pain, it added.

Nice said an estimated third to half of the population may be affected by chronic pain while almost half of people with the condition have a diagnosis of depression and two-thirds are unable to work because of it.