Researchers say treating chronic pain in people under the age of 25 is essential, but warn that regular use of painkillers could lead to over-reliance.
The study, by scientists at St George’s, University of London, and the University of Liverpool, looked at the anonymous medical records of 853,625 people aged between two and 24.
Of the group, 115,101 were diagnosed with chronic pain, defined as pain lasting more than three months.
Some 20,298 were given a repeat prescription for painkillers without a diagnosis, while 11,032 were both diagnosed and given a repeat prescription.
The patients were followed for an average of five years after they turned 25.
During this time, the researchers found that 11,644 people had a recorded ‘substance misuse event’, 143,838 were found to have poor mental health and 77,337 received at least one opioid prescription during follow-up.
Professor Reecha Sofat, Breckenridge Chair in Clinical Pharmacology and Therapeutics at the University of Liverpool, said the findings, published in The Lancet Regional Health – Europe, were “concerning” as those under 25 were “particularly vulnerable”.
“This means that regular use of painkillers to relieve chronic pain may lead to an unintended over-reliance on painkillers in adulthood,” she added.
“Investigating when it is the right time to refer these young people to specialist pain services for more targeted support will also be a critical factor in redesigning pain management practice.”
It was highlighted that patients with learning disabilities and autism were over-represented in the cohort receiving repeat prescriptions without a diagnosis of chronic pain, which the researchers said could indicate over-prescribing in a vulnerable group.
The team also said that the trends identified in their work could be due to a number of factors, including that those prescribed painkillers from a young age may have had more severe or frequent pain.
“It’s clear that the management of chronic pain in young people needs to be optimised,” said Dr Andrew Lambarth, academic clinical fellow in clinical pharmacology and therapeutics at St George’s, University of London.
“We know that under-treatment of pain can cause harm in both the short and long term, but it’s also important to avoid over-reliance on medication that could lead to dependence on prescription or non-prescription drugs later in life,” Lambarth said.
“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 to encourage consideration of other recognised and effective non-drug approaches to pain management.”
