Medications for chronic pain

pain meds filteredI have been reluctant to write about medications, as a social worker I do not have medical training. But a recent video about opioid medication (below) and an inservice from my hospice doc, as well as the video I posted recently gave me enough input. This topic is especially important, as fewer doctors are willing to prescribe opioids, and many are trying to wean their patients off, if they still are on them.

This may be a good thing- because newer research suggests that opioid can actually make pain worse. This is called opioid-induced hyperalgesia. While opioids are a godsend after surgery, in acute situations and at the end of life, for managing chronic pain they just are not that great.

An important note: never stop using your medications without discussing this first with your doctor.

In fact not using pain medications correctly and as prescribed, and working with your doctor to achieve the right balance can be part of not breaking but actually supporting a pain cycle. Especially if you are using short-acting medications that leave you in significant pain prior to the next scheduled dose (every 4 or 6 hours), discuss this with your doctor. Write things down so it is easier to discuss them during your office visit. Here are some tips and a form you can modify.


There are a number of non-opioids prescription medications that can be quite effective, depending on what kind of pain condition you have. Do find a practitioner who is knowledgeable, and is willing to listen, look at your individual need, and help adjust medications so they will work for you. In my experience some of these are started at doses that are too high, especially for women. Always pay attention to your own body and how YOU respond.

On a personal note, I never used opioid medication when I had chronic pain. But even my use of over-the-counter pain relievers has changed dramatically in past years. After a disc herniation almost 20 years ago, I was used to taking three ibuprofen at a time, several times a day. When my doctor warned me about the risk of stomach bleeds, I switched to tylenol, routinely taking three of those. But with warnings about not exceeding 4,000 mg in 24 hours, I cut tylenol to just one at a time– and to my surprise found this to be quite effective, as my pain these days is pretty much related to stress, lifestyle, and lack of movement. I now pay closer attention to pain coming on, take the one tylenol and do some movement or go for a walk.  Catching the pain before it gets too bad is key for me, as well as continuing to move, walk and do yoga.

I know this may not sound helpful to you, but I would encourage you to look at your medication use with some curiosity and willingness for a positive change.