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Nobody wants to live in pain, and fortunately these days we have effective treatments for most of the many different types of pain. But many of them carry a risk of serious addiction if you take them for too long. How do you know if you’re addicted, and what can you do?

We all have a picture in our minds of heroin addicts, usually sad homeless people who live only for their next 'fix'. But most people don't realise that painkillers we can buy from our chemists can cause addiction too.

Headache, backache, osteoarthritis, stomach ache - your body is very good at telling you when you're in pain, and it's your nervous system that's responsible. 

Your brain is connected to every bit of your body via a complex network of nerves: below the neck, all these messages travel through your spinal cord. 

'Motor' nerves carry messages from your brain telling each muscle to move; while sensory nerves carry messages back from your skin, limbs and body organs, telling your brain about touch, heat and pain.

Most parts of our body have pain sensors at one end of these 'sensory nerves'. Without them, you wouldn't move your hand away (quickly!) from a burning flame, or seek help if you had tummy ache.

Numb the pain

The aim of most painkillers is to damp down the sensation your brain gets from these nerve signals, or to reduce inflammation. Complicated chemical pathways in your body result in chemicals being released if there's inflammation or damage in any one part of your body.

Pain signals from muscles and joints, as well as cancer pain, usually respond well to painkillers like stronger opioid painkillers such as codeine or tramadol, or to medicines which work on the nervous system, like pregabalin and gabapentin.

But some painkillers can be highly addictive. We all know about heroin addiction - in fact, diamorphine(the medical term for heroin) has been the standard treatment for the pain of heart attack for decades. And heroin is part of the opioid family.

The medical definition of an addictive medication is that you need more and more as time goes on to have the same effect, and you crave it if you don't have it. Withdrawal symptoms include sweating and dizziness, anxiety and breathlessness, but also severe pain.

Even more worrying, some painkillers may make your body more sensitive to pain. If you're taking painkillers and you get pain, your instinct is to take more painkillers, which can end up feeding the addiction.

It's thought as many as one in three people with chronic headaches are actually suffering from 'medication overuse headaches' (also called medication-induced headaches). Your body adjusts to the painkillers, and you get withdrawal symptoms when levels in your blood drop. 

This causes a 'rebound' headache, and the obvious response is to reach for more painkillers. It's a particular issue for those who have migraine, who seem to be more prone to medication-overuse headaches.

Even 'simple' painkillers like paracetamol, or anti-inflammatory tablets like ibuprofen or naproxen, can become addictive if you take them at least three times a week for three months at a time.

 However, codeine-containing tablets are much worse. They can cause these headaches if taken just twice a week for three months or more, and it takes much longer to get over the headaches and aching that come with stopping them.

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