Misuse of painkillers on the rise, but why?

Recent research has found the misuse of pharmaceutical drugs in Australia such as painkillers continues to rise. The latest National Drug Strategy Household Survey (NDSHS) reveals the non-medical use of pharmaceuticals continues to increase, from 3.7% of those surveyed in 2007, to 4.7% in 2013.

For many Australians, painkillers are the drug of choice, with about three quarters taking over-the-counter painkillers and half misusing prescription painkillers.

While it's easy to say that a small percentage of people take these drugs simply to "get high" or to feed an addiction, it is important to consider how cultural understandings of pain may contribute to this growing trend.

The word 'pain' is commonly used as an all-encompassing metaphor, dominating the coverage of several of the latest news stories. In an interview with Michael Parkinson, Ian Thorpe recently revealed how the 'pain' he experienced when subjected to homophobic slurs contributed to a fear of revealing his sexuality to the Australian public.

The word pain was frequently used in media coverage of the recent 2014 Federal Budget, with much focus on the way some measures will 'hurt' lower income earners the most.

What is it that makes 'pain' such a resonant description for emotional suffer or unfair social policy? And might our increasing use of the word 'pain' have a bearing on the way we now use analgesics?

Pain medicine

The medical profession has long been interested in a way to measure pain. Since the early twentieth century doctors have developed a series of language, image and number-based systems asking patients to rate their pain in the hope of providing the best medical intervention.

Contributions from neuroscience have been important in the development and success of pain medicine, and new neurological research has demonstrated that the brain's response to forms of social exclusion and emotion suffering actually share similar neural pathways to those involved in physical injury. This prompted scientific debate about how closely comparable emotional suffering and physical injury can be.

Advancements in pain medicine mirrors the medical profession's long history of intervening in social and emotional problems. The expansion and increased medicalisation of the 'psy' disciplines (psychiatry and psychology) in 1950s and '60's has seen an ever-increasing number of everyday emotions and social circumstances given a medical label with a pharmaceutical solution.

The introduction of tranquilizers in the 1950s saw the medical profession make its first discrete interventions into anxiety, panic and social phobia. Colloquially termed 'happy pills' and 'emotional aspirin', tranquilisers have contributed to a growing cultural promise that medicine can control the body's emotional responses to stress and anxiety.

A new wave of 'mood medicine' came in the 1980s with the introduction of anti-depressants, most notably with fluoxetine (Prozac, or Lovan in Australia). American society's eager embrace of Prozac in the years following its release was soon superseded by concern about the way it altered people's sense of self in socially undesirable ways.

These rapid advances in medicine have fostered a cultural expectation that we have the 'right to be pain-free' and that this right is extended to medicine's ability to cure and control our response to social and emotional problems.

Emotional suffering

In my own research I have spoken to a broad range of people, from a diverse set of backgrounds about what they consider to be painful.

A young woman from Sydney's Eastern Suburbs said that the physical and emotional elements of pain can be "hard to separate" because when you're in pain "you're focused on the pain, and you're centred on it. Like mentally your thinking about it and wishing you weren't in it".

The feelings associated with a breakup are commonly evoked, for example by a 30-year-old man backpacking across Australia, who remarked after a recent break-up "I could definitely feel my heart hurting".

A young mother of two boys under the age of ten described using painkillers for headaches that she directly associated with stress from the demands of her busy life: "about ten years ago I had my first kid, and I started to get a lot of headaches, I suffered from migraines and I would take at least eight Nurofen® a day throughout the day just to get through".

Pain is clearly no longer simply a physical problem caused by torn or damaged tissue; it also has a powerful cultural significance when applied to social and emotional problems.

People are no longer simply consuming painkillers to deal with physical pain, they are taking advantage of modern medicine to control their responses to social and emotional problems. So the next time you hear research about the increases in the non-medical use of painkillers, bear in mind the way society now talks about "pain". The reasons why people reach for pills may include anything from the loss of a loved one to the emotional impact of homophobia or financial stress.