Approved Research

Adverse childhood experiences and analgesic outcomes in adults living with chronic pain and multimorbidity.

Lay summary

Why we are doing this research: Adverse childhood experiences (ACEs) are stressful events that happen to people before the age of 18. They include things like abuse, neglect and parental separation. Previous research has shown that experiencing more ACEs as a child leads to poorer health as an adult. This might be because specific conditions (like chronic pain) are more severe. Or it might be because people who have experienced ACEs develop multiple long-term health conditions that are hard to deal with at the same time. We want to test the theory that people who have had ACEs may respond differently to pain medications (such as morphine), compared with those who have not had an ACE.

Our approach: People with lived experience of ACEs, chronic pain and multiple long-term health conditions helped us to decide on our research questions. This helps us ensure our work can explore topics that are meaningful to the relevant people.

Some example questions:

Compared with people who have not experienced ACEs, are people who have experienced ACEs more likely to...

1) ... be prescribed pain medications?

2) ... be prescribed higher doses of pain medications?

3) ... experience harms relating to pain medications (such as addiction, overdose or death)?

4) ... find pain medications unhelpful?

5) ... have side-effects from pain medications?

We will see if the answers to these questions are different for people with multiple long-term health conditions. We will use the UK Biobank database to answer these questions. We think that the large size of this database (over half a million people) will make our results relevant to patients and clinicians.

Project duration: 36 months.

Public health impact: Knowing how ACEs affect our responses to pain medications is important. It may help some people understand how their childhood affects their current health. For many people, knowing "why" can help them come to terms with their condition. This research will highlight the importance of trauma-informed care, and may guide patients and healthcare professionals when discussing treatment plans. It may be that for some people pain medications don't help, and that other options (such as psychological therapy) might be better.