What is a Medication Overuse Headache?

Headache pain medication ads are everywhere, from glossy magazine spreads to flashy television commercials. It has been reported that 45 million Americans suffer from headaches, many on a daily basis. Though some just put up with the pain, others become totally disabled during the headache. Most people initially turn to an over the counter drug such as a non-steroidal anti-inflammatory drug (NSAID).  The ad’s you see on a constant basis relay the message …your headache deserves a strong painkiller, which will instantly cure the problem. Pain should not slow you down, since there’s an easy, swift solution.But is there really?

 What is a medication overuse headache?

This is a relatively new term for a long-standing, “unnamed” and largely unrecognized condition caused by the daily or regular basis use of painkillers for migraines or other headaches. Sadly, this condition is common. About 1 in 50 people develops this problem at some point during the course of their medication regiment. It also affects five times more women than men.

How does a medication overuse headache happen?

Headaches flare up in response to physical, chemical or emotional stress. As a “solution,” many people take painkillers frequently. Initially, the first doses may provide relief, which reinforces the idea that painkiller consumption is helpful. On a psychological level, what’s known as “positive conditioning” spurs the sufferer to continue reaching for painkillers for relief. What’s going on may have more to do with chemical changes in the brain than psychological conditioning. Painkillers with caffeine, barbiturates, codeine and other opioids are the most likely to have this effect. For example, caffeine increases alertness, relieves fatigue and improves performance and mood. Caffeine-withdrawal symptoms, such as irritability, nervousness, restlessness and headaches all encourage patients to continue their use and abuse.

Addictive Pathway:

Abused drugs, from painkillers to alcohol, activate a “pleasure pathway” in the brain and reinforce the behavior. The pleasure pathway, which is called the “dopamine reward circuit,” is connected to areas of the brain controlling memory, emotion and motivation.

The pleasure pathway undergoes actual chemical and anatomical changes that create and prolong addiction, affecting a physiological hold on a person’s ability to function. This is why addiction is often referred to as a brain disorder and isn’t as easy to kick as simply mind over matter. Like drugs such as cocaine or heroin some painkillers trigger the release of the brain’s natural “feel-good” pain fighting chemicals called endogenous opioids or endorphins. As with any addictive drug, the more often they are used, the less sensitive the brain becomes to them. These drugs literally alter the brain.

Withdrawal Woes:

            After a period of regular painkiller doses the body becomes used to the pain medication. When the sufferer doesn’t take a painkiller within a day or so of the last dose, then “rebound” or “withdrawal” headaches develop. What the sufferer thinks is just an especially persistent headache is actually a symptom of medication withdrawal. Not recognizing that the medication is the culprit, the patient may take another dose. When the effect of each dose wears off, a further withdrawal headache develops. In time, sufferers will develop regular headaches that may appear on a daily basis. Some people resort to taking painkillers “routinely” to try to prevent headaches, which only makes the situation worse.

Which painkillers cause medication overuse headaches?

If you think that only prescription medication can cause medication overuse headaches, you’re wrong! Almost any pain medication that provides “rapid” headache relief can cause a medication overuse headache. Culprits include simple pain relievers like aspirin, acetaminophen (Tylenol) and ibuprofen (such as Advil, Motrin, Aleve, and Midol). Mixed analgesics, which include over-the-counter and prescription drugs containing caffeine, aspirin and acetaminophen, are especially known as medication overuse headache instigators. Other offenders included migraine-specific medications, such as Ergomar, Migranal, Imitrex, Zomig, and opiates, such as Tylenol 3, Vicodin and Percocet. According to the researchers, “Medication overuse headaches patients have a greater risk of suffering from anxiety and depression, and these disorders may be a risk factor for the evolution of migraine into a medication overuse headache.”

Medication overuse headaches may be a precursor to other disorders:

Although research into this area is still preliminary, scientists speculate that medication overuse headaches may be a precursor for more serious conditions. Researchers hypothesize that the same brain changes and chain of events that lead to medication overuse headaches may trigger other disorders, if medication overuse continues. Besides emotional problems, these disorders may include other forms of chronic pain, fibromyalgia and chronic fatigue syndrome.

Wellness Lifestyle Solution:

As a wellness doctor I teach all my patients that the solution to headaches isn’t found in a pill.  The solution should include an in-depth consultation that begins with evaluating the entire body and lifestyle choices. A convincing study reported that chiropractic was 57% more effective than drug therapy in reducing headache and migraine pain!  They concluded – chiropractic first, drugs second and surgery last. Treatment for headaches is often a multidisciplinary approach which involves stress reduction techniques such as regular chiropractic adjustments, biofeedback, acupuncture, prescribing a healthy diet, and regular exercise. All the components of a full wellness lifestyle are proven to eliminate headache pain and free you, the patient, from the side effects of medications.

Call our office today (916) 973-1661 to start your true wellness journey to health and vitality!