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Painkillers Such As Paracetamol And Ibuprofen Should Not Be Prescribed For Chronic Pain – Health Officials

Painkillers such as paracetamol and ibuprofen can do 'more harm than good' and should not be prescribed to treat chronic pain, health officials have said.

The National Institute for Health and Care Excellence claims that there is 'little or no evidence' the drugs, as well as aspirin and opioids, work.  

But in draft guidance, published on Monday, Nice said there was evidence painkillers can cause harm, including addiction.

It says it would be 'inappropriate' for them to offer to patients anymore, despite the NHS saying paracetamol is safe when taken over many years.

Nice suggests people with chronic pain are instead offered exercise classes, therapy, acupuncture or even antidepressants. 

Chronic primary pain is a condition in itself which cannot be accounted for by another diagnosis or as a symptom of an underlying condition, Nice said.

Doctors often define chronic pain as any pain that lasts for three to six months or more.  

It is notoriously difficult to treat and is characterized by significant emotional distress and functional disability.

Nice said an estimated third to half of the population may be affected by chronic pain while almost half of the people with the condition have a diagnosis of depression and two-thirds are unable to work because of it.

The draft guidance, which is open to public consultation until August 14, said that paracetamol, non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin and ibuprofen, benzodiazepines or opioids should not be offered to people with chronic pain. 

There is little or no evidence that they made any difference to people's quality of life, pain or psychological distress, the guidance said, and in some cases are harmful.

Studies have suggested that patients who took benzodiazepines and NSAIDS had poorer psychological and physical functioning. 

The guidance did not give details about how paracetamol is harmful. However, it is known that overdosing on paracetamol can cause serious side effects.