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Let’s hear what Pain has to say

Sometimes the name of an academic periodical is just so “right� it needs no further explanation. In this case, we are interested in the August issue of Pain. Told you so! Anyway, Boston University has been researching the number of people in the U.S. who take opioid painkillers including Ultram. Their results show a higher rate of usage than found in earlier studies. This may be explained by differences in research methods or a change in the honesty of those surveyed or the actual usage may have increased. As it is, the random telephone survey of more than 19,000 adults finds that more than 4m Americans regularly take opioids. In any given week, some 10m adults are likely to take a strong painkiller.

This implies that a significant percentage of the adult population believes it suffers from chronic pain of sufficient intensity to justify using one of the stronger painkillers. It is hard to say which is the more worrying. That so many people think they have serious pain, or that so many people routinely rely on opioids to control their pain. The other inference may be that many people are actually abusing their painkillers. It is entirely possible that the true level of opioid abuse is underreported because it is illegal to obtain the drugs without a prescription.

Whatever the level of abuse, the survey finds that the symptoms treated were mainly classified as headache, back pain, arthritis, and so on. Only about 5% admitted to using ultram or one of the other painkillers for anxiety or a condition not directly related to physical pain. It is also significant that people taking painkillers were more likely to be taking other medications. It is not surprising that painkillers should be combined with anti-inflammatories, but it is of some concern that some 30% were also taking antidepressants and more than 25% were taking anticonvulsants. There is also evidence of a link to cardiovascular disease and other chronic conditions. It seems probable that those with such problems find pain more of a problem and so take an opioid.

The researchers conclude that, although there is an obvious place for opioids like ultram, there is a general need to put more effective pain management services in place to reduce the incidence of abuse.

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