London, UK – A new study by researchers at St George’s, University of London and the University of Liverpool suggests that the long-term use of painkillers in children and young adults under the age of 25 could be associated with poor mental health outcomes and addiction later in life.
The findings highlight the need for optimised chronic pain management in youth to avoid over-reliance on pain medications.
Key Details of the Study
The study, published in The Lancet Regional Health β Europe, looked at anonymous medical records of 853,625 individuals aged 2-24 years.
Of this group:
- 115,101 were diagnosed with chronic pain, defined as pain lasting over 3 months
- 20,298 were given repeat painkiller prescriptions without a diagnosis
- 11,032 had both a diagnosis and repeat prescription
The patients were followed up for an average of 5 years after turning 25. In that time, researchers found:
- 11,644 had a documented substance misuse event
- 143,838 had poor mental health
- 77,337 received at least one opioid prescription
According to the researchers, the findings are concerning as those under 25 are especially vulnerable and the regular use of painkillers could lead to over-reliance later in life.
They highlighted that patients with learning disabilities and autism were over-represented among those receiving repeat prescriptions without a diagnosis, indicating potential overprescribing in this vulnerable group.
While the trends could be attributed to several factors, it underscores the need to optimise chronic pain treatment in young people to avoid medication dependence down the road.
Quotes by Researchers
Professor Reecha Sofat, University of Liverpool:
βThis is concerning because those under 25 are particularly vulnerable, which means a regular use of painkillers to ease chronic pain may lead to an unintentional over-reliance on pain medication in adult life. Exploring when the right time is to refer these young people to specialised pain services for more targeted support will also be a vital factor when revamping pain management practice.β
Dr Andrew Lambarth, St Georgeβs, University of London:
βItβs clear that chronic pain management in young people needs to be optimised. We know under-treating pain can cause harm in both the short and long term, but itβs also essential to avoid over-reliance on medicines that could lead to dependence on prescription or non-prescription drugs in later life. We now need to work with all healthcare providers to help them weigh up the risks and benefits of prescribing painkillers at a young age, and encourage the consideration of other recognised and effective non-drug management approaches.β
Potential Implications and Recommendations
- Highlights the need to strike a balance between managing chronic pain and avoiding over-reliance on medications in children and young adults.
- Non-drug approaches should be considered as first-line treatment before prescribing painkillers to youth with chronic pain.
- Prescribers need to carefully weigh risks vs benefits when considering painkiller prescriptions for those under 25.
- Clear guidelines needed on appropriate pain management in young people to optimise care.
- Specialist pain services could provide targeted support for children and young adults with chronic pain.
- Further research warranted to confirm findings and firmly establish cause-and-effect relationship.
- Study reinforces calls for avoiding overprescribing opioids and painkillers amid the addiction epidemic.
The Growing Issue of Painkiller Addiction
The study comes amid rising concerns about over-reliance on prescription opioids and pain medications, which has contributed significantly to the addiction epidemic in recent decades.
According to the CDC, overdoses involving prescription opioids have quadrupled since 1999, killing over 200,000 people in the US between 1999-2019.
In the UK, opioid prescribing has doubled in the last decade. An estimated half a million people are dependent on prescription opioids in England alone.
This had led to tighter restrictions and warnings around prescribing opioids and painkillers. However, chronic pain remains a major issue affecting millions of people.
This study is a reminder that a nuanced, balanced approach is needed – one that manages pain appropriately while avoiding unnecessary prescriptions that could lead to long-term harm.
The findings underscore the particular importance of optimising pain treatment in children and young adults to avoid engendering medication dependence early in life. More research is needed to clarify the long-term impacts of painkiller use in youth and provide evidence-based guidelines for prescribers.
