Dear Doctor,

I think I’ve become addicted to painkillers and I don’t know how to stop it. It started when I got constant migraines but even when I do not have any pain; I take one of those pills that dissolve in water every morning just in case. The migraines are coming back. What should I do? Edgar

Dear Edgar,

You have not specified your age, how frequently you get migraine attacks and which pain killers you take. Pain killers like those of opiod group, for example morphine, oxycodein, among others, do carry risk of habituation and addiction, if taken regularly. Similarly barbiturates (phenobarbitone) also carry risk of habituation. NSAIDS (non-steroidal anti-inflammatory drugs) do cause many serious side effects like peptic ulcer disease, gastrointestinal bleeding, kidney problems, precipitation and aggravation of asthma, non-fatal heart attacks, and etcetera. But they do not cause habituation. However, a pill containing combination of NSAID and opiod can cause habituation.

Migraine is said to be precipitated and aggravated by mental stress. Prevention consists of adequate relaxation. Drugs like paracetamol, ergotamine, sumatriptan, NSAIDS are used to treat migraines. Drugs like beta blockers, calcium channel blockers, anticonvulsants, antidepressants, are used to abort an attack of migraine. It is better to avoid taking pain killers in excess. Keep yourself busy, when you have an urge to take a pain killer and avoid taking it. Moreover, any drug will abort or treat an attack. But if there is no chronic pain, there is no need to take any pain killer regularly.