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Painkiller addiction

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James Elander shares his new research on painkiller addiction and how to spot the warning signs

A DIFFERENT pain

Addiction to prescribed pain relief is a serious and growing problem . With 4.7m people in the US dependent on painkiller medication and numbers in the UK rising quickly , it is being described as a potential public health disaster .

Many people take painkillers to help them live with pain , with some becoming addicted to the medication – making their pain even harder to control . Other people are so afraid of addiction they don ’ t take painkillers and suffer unnecessarily from pain .

It is hard to get the balance right between the benefits of painkillers and the risk of addiction , so a quick way to tell if you are at risk could help people manage their pain better , as well as help the health professionals who work with them .

With a team of researchers at the University of Derby , I have carried out some new research into painkiller addiction . Our study identified two key questions that people can ask themselves to find out whether they are at really at risk of addiction to painkillers , or if they are worrying unnecessarily . They are :

• Would you be unwilling to reduce your pain medication ?

• Do you feel you depend on your pain medication ?

If your answer to both those questions is ‘ yes , definitely ’, you can take steps to reduce your risk of addiction to painkillers . On the other hand , if it is ‘ definitely not ’, then perhaps you are more concerned about addiction to painkillers than you need to be .

Our research used information from 683 people with different types of pain , the most common of which were headaches , back pain , joint pain , muscle pain and period pain .

The painkillers that were the most commonly used by people in the study were strong opiates such as morphine , fentanyl , and tramadol ; weaker opiates such as dihydrocodeine and codeine-based compounds such as co-codamol ; and non-opiates , mainly nonsteroidal anti-inflammatory drugs such as naproxen , diclofenac , and ibuprofen .

One aim of the study was to find key signs of how likely a person is to get addicted to painkillers . We produced a short questionnaire to measure different aspects of people ’ s concerns about painkillers , and their answers to those two key questions were the best predictors of how addicted or psychologically dependent they were on painkillers .

The research combined data from three studies by myself , Dr Frances Maratos , reader in emotion science , Derby PhD students Omimah Said and Malcolm Schofield , and undergraduate psychology students Ada Dys and Hannah Collins .

The studies were funded by a university research for learning and teaching fund grant , a British Psychological Society undergraduate research assistantship bursary and a university undergraduate research scholarship scheme bursary .

In the first study , people completed a pain medica - tion attitudes questionnaire with 47 questions and had their painkiller dependence measured . The links between their answers to each of the 47 questions and their dependence score were then examined to produce a version with just 14 carefully selected questions .

In the other two studies , different groups of people with pain completed the version with just 14 questions . This short version worked as well as the one with 47 questions , and in all three studies those two key questions consistently predicted how dependent on painkillers people were .

These findings build on previous University of Derby research , published in 2014 in the journal Pain Medicine , which showed people were more likely to become dependent on painkillers if they took more prescription painkillers more often , had a prior history of substance-related problems , or were less accepting of pain .

This showed that there was more than one way to become dependent on painkillers , so people who answer ‘ yes ’ to the two questions identified in the most recent study might then use these questions to reflect on how the way they use painkillers may be developing into an addiction :

• Am I using strong painkillers more often than I used to ?

• Am I using painkillers a bit like I used to use drugs or alcohol ?

• Am I getting more sensitive to pain , or having more trouble living with it , than I used to ?

We hope to use the findings to develop better information and education for people about painkiller addiction .

For the moment , anyone who is worried about how they use painkillers should talk to their doctor , or phar - m a cist , or even a friend or family member about how their relationship with painkillers may be changing . They could also use the information that is already available , including the website of Cathryn Kemp , author of Painkiller Addict – From Wreckage to Redemption at www . painkiller-addict . com .

James Elander is head of psychological research at the University of Derby

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