Over the years there has been a great deal of research and practical experience around the issue of how best to take one’s pain medication. Understanding a few issues might assist you with having the best response to your medications.

Society and Medication

We live in a society that has mixed feelings about the use of medications. On the one hand we “expect” that physicians should be able to prescribe medications that will provide quick and effective “magical cures” that will solve all our problems. In fact, the media, through television and news, is always talking about “new discoveries” for medications and procedures that keep us excited in how we can overcome problems. At the same time, we also live in a society that seems to express a belief that taking medications is not helpful.

We believe in the idea that we should be able to overcome problems without having to rely on outside help, or pills. This is especially true for “Macho Males” who believe that they have to be “tough” and to handle it all on their own! Further, we feel that if someone takes something for a long period of time that they must be “addicted to it.” So we tend to see pain medications and addictions as something that goes together.

Pain-Contingent Medication Use

Most pain medications are taken “when we need them.” That is, they are “contingent” (or depend upon) our needs for them. The person, therefore, waits until they “need them” or are in “enough pain” before having to rely on them. Sometimes this works for acute pain problems where we have just had a problem and do not need to have the medication at other times. In fact, when having surgery, or following an injury, we will use medications at first, hoping to taper them off as one improves. The problem is that when one suffers a “chronic condition” this approach to medication usage does not work very well at all.

Time-Contingent Medication Use

With chronic pain problems, those lasting over 3-6 months, “chasing the pain with pills” does not work very well at all. What has been found to be the most helpful is “taking the medication on a regular schedule as prescribed” by your physician. In fact, waiting until one has “more pain” only seems to insure that the person will always have more pain as they “chase the pain away with another pill.”

So it is always better to take prescribed pain medication on a regular, specific, time-specific, basis. In this manner, the person does not get so tense and overwhelmed by the pain. So, most off the time, it is best to take medications on a regular basis as they will work better and you will have less pain.

There will also be a tendency for you to NOT over utilize medications in this manner. When you are using it on a “pain-contingent basis” you will, many times, need more medication to control the pain. With a “time-contingent basis” you will find that over time you should have better control and need less medication.

Are There Exceptions?

There are always exceptions to any rules. Sometimes, people who have taken pain medications, or even over-the-counter medications, will have more pain just because they are taking pain medications every day. They then have “rebound pain” that is caused by the body’s need to have the medication. The brain, and body, learns to become “dependent” on the medication. So some people are better off tapering off their medications and using the lower possible dose.

However, these are also the very people who many times tend to take regular medication, but on a “pain-related” basis rather than on a “time-related basis.” Since stress can influence the body, and increase pain issues, it is easy to “medicate ones moods” with pain medications rather than dealing with the real stressors in your life.

Addiction vs Dependency

There is also the fear that if one takes medication on a regular basis that they will become addicted to it. In fact, research has shown that this does not happen. Many times, patients are under-medicated and so are always in pain and feel that they “have to have something” making them, and others, feel that they are addicted. In fact, taking medications on a regular basis does not create addiction. It may create a “dependency” on the medication in order to function better in life and on a daily basis. The body may come to depend on it, but this does not mean that one is addicted to it.

For this reason, it is important to not just stop medications abruptly. You need to work with your physician about how you take your medications and the schedule you are taking it on. Dependency is okay if you are working with your physician in positive ways to achieve the best and most appropriate pain control.

At the same time, it is important to remember that you will “never” be without some pain. Even with regular pain medications you cannot “knock out all the pain.” The goal is overall “management of the pain problem over time.” The goal also focuses on your being an active participant in the process, learning active self-care techniques, and working with your pain management specialists–like us!

Hopefully this will answer many of your questions about the importance of taking pain medications on a “Time-Contingent Basis” for the best overall control and management of your pain.

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