Original article: doi.org/10.1016/j.bja.2024.09.015
This research looked at how adverse childhood experiences (ACEs) can affect how adults use and respond to pain medicines.
ACEs are difficult or stressful things that occur during childhood. They include abuse, neglect, problems in the household (such as domestic violence), or problems in the community (such as bullying). ACEs are common: almost half of adults in the UK report having at least one such
experience.
Chronic pain is any pain lasting longer than 3 months. Past research shows that people with ACEs are more likely to develop chronic pain as adults. However, it is not clear whether ACEs affect how well people respond to treatments for chronic pain, such as pain relieving medication.
To explore this, the researchers reviewed all the published papers relating to this topic. They found 66 studies from around the world, involving more than 137,000 adults. The researchers focused on how ACEs relate to the use, benefits, and harms of pain relieving medications.
The review found clear patterns. Adults who had more ACEs were more likely to use higher numbers of pain relieving medications. They were also more likely to experience harms related to pain relieving medications. This included side-effects, substance use disorder, drug overdose, and suicide attempts.
However, no studies looked at whether ACEs might influence the benefits of pain relieving medications (such as whether they actually provide pain relief). This is a clear gap in the research. Knowing about both the benefits and harms of a treatment is important. This would enable patients and healthcare professionals to make informed decisions about their care.
Additionally, most of the research focused on opioid medications (such as morphine). Some classes of medications (such as gabapentinoid drugs) were not covered by existing studies. This is another gap in the research.
Patients and healthcare professionals should be aware that ACEs can increase the harms of pain relieving medications. This is especially true for opioid medications. More research is required for other types of pain relieving medications. More research is also required to see if ACEs affect the benefits of pain relieving medications.