Chronic pain – what drugs should not be used? Paracetamol, ibuprofen, and aspirin are not suitable for treating chronic pain

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Paracetamol, ibuprofen, aspirin, opioids should not be prescribed to treat chronic pain, say representatives of the National Health Service (the British equivalent of the Polish National Health Fund). In their view, these drugs can do “more harm than good”. Why? The Guardian wrote about it.

  1. Chronic primary pain is a spontaneous condition, not a symptom of a specific disease. The problem here is the pain itself
  2. National Health Service (NHS): Paracetamol, ibuprofen or opioids should not be prescribed to patients with primary pain. Indeed, they can do “more harm than good”, including addiction
  3. The British draft guidelines suggest that psychological therapy, acupuncture should be included in the treatment of chronic pain treatment, antidepressants should be considered

UK National Health Service (NHS) officials believe that drugs often used to treat chronic primary pain, such as paracetamol, ibuprofen and opioids, should not be prescribed to patients with this condition. Indeed, they can do “more harm than good”, including addiction.

  1. Dependence on pain medications

Moreover, the National Institute for Health and Clinical Excellence (NICE) – the UK’s health agency responsible for reviewing medical procedures and recommending their funding from the NHS – also says there is “little evidence” that these measures improve patients’ quality of life. with chronic pain.

On August 3, a draft of the guidelines for the treatment of this group of patients was published. Until August 14, it is subject to public consultations (NICE does not decide on the problem until it knows the opinion of the public).

Primary chronic pain – what it is, UK health service recommendations

Chronic primary pain is a spontaneous condition, not a symptom of a specific disease. The problem here is the pain itself. This condition is associated with significant emotional stress, limitation of activity, and a decrease in the quality of life.

The National Institute for Health and Clinical Excellence emphasizes that in the UK, this problem may affect up to a third of the population. Almost half of people with this disease are diagnosed with depression, and two-thirds of pain are unable to work.

  1. Depression – who does it affect and why? How to cure depression?

The draft guidelines suggest that some types of psychological therapy, such as acupuncture, should be included in the treatment of chronic pain. In people with chronic primary pain, it is also worth considering the use of certain antidepressants.

Chronic pain therapy. What drugs not to use – NICE opinion

The document also states that patients with chronic pain should not be given paracetamol, non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen, benzodiazepines or opioids. According to officials, there is no evidence that they affect the quality of life of patients, their pain ailments, or problems related to the psyche. It is known that these drugs can cause harm, including addiction.

The draft guideline also states that antiepileptic drugs (including gabapentinoids), local anesthetics, ketamine, corticosteroids and antipsychotics should not be used to treat chronic primary pain. The reason is the same as before – officials say there is little evidence that these methods work, but they are known to be harmful.

  1. Psychotropics. How is depression treated?

– When many treatments are ineffective or poorly tolerated, it is important to understand how pain affects the patient’s life and those around him. Knowing what’s important to you is the first step in developing an effective care plan, says Dr. Paul Chrisp, director of the guidance center at the National Institute for Health and Clinical Excellence. Importantly, the draft guideline also recognizes the need for further research into possible treatment options, he added.

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