Childhood trauma and use of analgesics in adolescence and young adulthood

Abstract

Young individuals exposed to childhood trauma use more analgesics than their unexposed peers. Analgesics are commonly used among young people. While paracetamol and NSAIDs are considered safe to use within recommended doses for otherwise healthy young individuals, adolescents and young adults commonly report a frequency of use that is associated with medication overuse headache and chronification of pain. For opioids and gabapentinoids there is also high risk of misuse and dependence. Childhood trauma exposure is associated with an increased risk of persistent pain and psychological distress, and such symptoms are associated with frequent analgesics use. The aim of this thesis was to investigate the relationship between childhood trauma and use of analgesics in adolescence and young adulthood. Data from three waves of The Trøndelag Health Study linked to registry data from the Norwegian Prescription Database (NorPD) were used. We found that adolescents and young adults exposed to childhood trauma used more over-the-counter (OTC) and prescription analgesics than their unexposed peers. Exposure to more than one trauma type was found to be particularly strongly associated with using more analgesics in both adolescence and young adulthood. Symptoms present in adolescence, including weekly headaches and musculoskeletal pain, psychological distress, and posttraumatic stress symptoms, were found to be relevant for the associations between childhood trauma exposure and analgesics use. Our findings indicate that individuals exposed to childhood trauma are at increased risk of pursuing and receiving pain treatment that represents a risk for future adverse health outcomes. The increased risk of frequent analgesics use among trauma-exposed young individuals could be accounted for clinically by assessing childhood trauma exposure in young people seeking help with management of persistent pain. Contact with health care providers for help with pain management may represent an opportunity for trauma-exposed individuals to receive trauma-specific care.