Social aspects of drug abuse in headache

Medication abuse amongst headache patients is common, but the general population prevalence is difficult to estimate. Only patients who are symptomatic as a consequence, usually with chronic headache, are likely to come to medical attention. Review of these suggests strong female predominance, an age range older than for migraine, and no influence from social class. The responses to proposed therapeutic withdrawal of medication demonstrate a pattern, in part reflecting personality and social factors. It is highly probable that specific personality and social factors tend to give rise to this condition, and the social consequences of impaired interpersonal relationships and disrupted working ability may in part derive from these. Adverse consequences include, for some patients, severe financial penalties, and there is a potential for ligation against doctor. The economic cost to the community may be on the same scale as for migraine, although this affects possibly 20 times as many people.