They discourage the use of analgesics for the treatment of primary pain

UK specialists claim to have evidence that acetaminophen, ibuprofen and opioids can cause addiction. How they recommend treating people with chronic pain without another underlying diagnosis

Despite the fact that the consequences of self-medication are known and doctors advise against people taking medications without the indication of a professional, painkillers could be said to be at the forefront of those consumed without being advised by a health professional. .

Even television commercials show ordinary people going to the drugstore for something to ease their back, head, or neck pain, to name a few examples.

Now specialists from the National Institute of Excellence in Health and Care (Nice) say there is “little or no evidence” that the drugs commonly used for chronic primary pain have made any difference in quality of life , the pain or psychological distress of people.

Pain relievers like acetaminophen, ibuprofen, aspirin, and opioids can do “more harm than good” and should not be prescribed to treat chronic primary pain, experts agreed. Even the guide’s draft, released Monday, says there is evidence that they can cause harm, including addiction.

Chronic primary pain is a condition in itself that cannot be explained by another diagnosis or as a symptom of an underlying condition, they described from Nice. It is characterized by significant emotional distress and functional disability with examples including chronic generalized pain and chronic musculoskeletal pain.

Guidance committee chairman Nick Kosky said that while patients expected a clear diagnosis and effective treatment, the complexity of the condition means that GPs and specialists may find it very difficult to manage.

Dorset Healthcare NHS University Foundation Psychiatrist Consultant added: “This mismatch between patient expectations and treatment outcomes may affect the relationship between healthcare professionals and patients, a possible consequence of which is the prescription of ineffective but harmful medications. “

“This guide, by fostering a clearer understanding of the evidence of the effectiveness of treatments for chronic pain, will help improve the confidence of health professionals in their conversations with patients,” he added. “By doing so, it will help them to better manage their and their patients’ expectations. “

Nice said that about a third to half of the population can be affected by chronic pain, while almost half of people with the condition are diagnosed with depression and two thirds cannot work because of it.

The draft of the guide, which is open for public consultation until August 14, says that people with chronic primary pain should be offered supervised group exercise programs, some types of psychological therapy, or acupuncture.

He also recommends that some antidepressants be considered for people with chronic primary pain.

But they insisted that acetaminophen, nonsteroidal anti-inflammatory drugs like aspirin and ibuprofen, benzodiazepines, or opioids should not be offered because there is “little or no evidence that they had any difference in quality of life, pain, or psychological distress of people”.

Furthermore, the draft guideline also says that antiepileptic drugs, including gabapentinoids, local anesthetics, ketamine, corticosteroids, and antipsychotics, should not be offered to people to control chronic primary pain because, once again, ” there is little or no evidence that these treatments work, but they could have potential harm. ”

According to the director of the Nice guidelines center, Paul Chrisp, “when many treatments are ineffective or not well tolerated, it is important to understand how pain is affecting the life of a person and those around them because knowing what it is. The important thing for the person is the first step to develop an effective care plan. “

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