Pain medication and stress – a pathway to dependence

Angus has been living with chronic migraines for a few years. They challenge his ability to do his work as a midwife without pain management.  

He’s been prescribed opioid-based pain medication pro re nata, but only takes it when the migraines affect his ability to function. There’s been a lot of stress in Angus’s life, and he’s noticed his use increase. He thinks the migraines are getting more acute and seeks further advice from his GP.  

Detecting dependence

As his prescriber, Angus’ GP is concerned about the increase in medication use and notes that Angus’ migraines have not become more prevalent or intense. They see that Angus has been using the medication to relieve stressors beyond their prescribed use. Angus wasn’t aware of this at first, but it’s now clear that he is physically and psychologically dependent.  

Getting the right support

Angus is fearful that this will impact his career. His GP refers him to a nurse and midwife-led health and wellbeing service. The service connects Angus with other midwives who had similar challenges with pain management medication, and he doesn’t feel so alone. To support this, Angus works with a clinician and his doctor to slowly reduce his use of the medication and move to another pain management option that is less likely to create any dependence.