Pain Relief and Dependence: Understanding Risks and Safe Use

Pain is one of the most common reasons people seek medical advice. Pain relief medications can be helpful in many situations, particularly for short-term or acute pain. However, some pain medicines carry a risk of dependence, tolerance, and harm if used long term.

This page explains how GPs approach pain relief in primary care, which medicines carry higher risk, and how safe use is monitored.

These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.

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Different types of pain relief

Pain relief medicines are not all the same. In primary care, they are usually considered in stages.

These may include:

simple painkillers such as paracetamol
anti-inflammatory medicines such as ibuprofen or naproxen
combination painkillers
medicines used for nerve-related pain
stronger opioid medications

The choice depends on the type of pain, duration, underlying cause, and individual risk factors.

Short-term versus long-term pain management

Short-term pain relief is often appropriate after injury, surgery, or acute flare-ups. In these situations, stronger painkillers may be used for a limited period.

Long-term pain management is more complex. For chronic pain conditions, medicines may provide only partial relief. Non-drug approaches such as physiotherapy, exercise, pacing strategies, and psychological support are often important parts of treatment.

GPs consider both effectiveness and long-term safety when recommending pain relief.

Short courses of oral steroids

Short courses of oral steroids are often prescribed for acute flare-ups, such as severe asthma symptoms, allergic reactions, or inflammatory conditions.

When used for a short period, steroids can be effective and are generally well tolerated. GPs prescribe the lowest effective dose for the shortest necessary duration.

Short courses are different from long-term steroid use and carry a lower risk of serious side effects.

Opioids and dependence

Opioids such as codeine, tramadol, morphine, and oxycodone can be effective for short-term severe pain. However, they carry a risk of dependence, tolerance, and side effects.

With longer use:

the body may become used to the medication
higher doses may be needed for the same effect
stopping suddenly can cause withdrawal symptoms

For these reasons, opioids are prescribed cautiously, usually at the lowest effective dose and for the shortest necessary duration.

Sedative medicines and risk

Some medicines used for anxiety, sleep, or muscle relaxation can also cause dependence. These include certain benzodiazepines and related medicines.

These treatments are usually intended for short-term use. Long-term use increases the risk of tolerance, withdrawal symptoms, and impaired concentration or alertness.