Constipation, diarrhoea, hunger, nausea, vomiting, stomach pain, bloating, abdominal cramps, hot flushes, cold shivers, drowsiness, insomnia, excessive salivation, dry mouth, euphoria, anxiety, depression, confusion, headaches, blurred vision, itchy skin, rashes, hives, weals, sweating, flushing, numbness – just a fraction of the potential side-effects we are told may arise from taking a variety of common prescription medications.
And those are the short term side-effects. What are the long term risks to the human body of taking these medications, often in combination with several others, over many years?
That is the quandary faced by many people living with chronic pain. Taking the medication can make daily living just a little more bearable, but what is being stored up for the future?
The medical profession
The medical profession usually have a reasonable understanding of long term risk factors for individual drugs. They also necessarily have an appreciation of drug interaction; that is where one drug can increase or decrease the effect of another, or produce an effect that neither produces on its own. However, where two or more drugs are prescribed concurrently, the combined long term effect on the body can never truly be known.
The problem is further complicated by the addition of regular non-prescription medication. People suffering chronic pain often top up their prescribed medication with that available over the counter such as paracetamol and NSAIDs. In the UK, low-dose codeine is available without a prescription as Co-Codamol (codeine and paracetamol). For people already taking opioid medications such as Tramadol, Oramorph and Fentanyl (patches), taking Co-Codamol further increases the opioid load on the body.
For those living with other chronic conditions prior to the onset of their chronic pain, the situation is often even more complex. Medications to help control high blood pressure, cholesterol, diabetes, blood clotting issues – the list goes on – add to the mix and therefore to the uncertainty.
But it’s not just other medication, prescription or otherwise, that can interact with a particular drug or combination of drugs. Factors such as alcohol intake and even diet play a role. Your body really is constantly processing a shifting cocktail of substances. The phrase ‘you are what you eat’ should more properly be ‘you are what you consume’.
No easy answer
There is, of course, no easy answer to the problem. As one client put it to me, “before this I didn’t even like taking anything for a cold. Now, god knows what I’m polluting my body with. Sometimes I feel like a ticking time bomb.”