By Nick Triggle
The term "painkiller" should not be used, to help bust the myth they cure pain, a government adviser suggests.
Prof Jamie Coleman said the phrase raised unrealistic expectations - with "pain-reliever" a better option.
Research suggests just one in 10 patients seeking help for long-term pain, benefit from strong painkillers.
Prof Coleman also said he was in favour of ending the over-the-counter sale of low-dose codeine drugs in pharmacies, to combat prescription drug addiction.
He said even in low doses, the medication could become addictive, and users risked serious side-effects, such as vomiting and nausea.
Prof Coleman, who is part of a working group looking at the use of opioid medication for the government in England, said making such drugs prescription-only alongside a change in culture towards painkillers, was the key to tackling misuse.
A report published last year by Public Health England (PHE) warned that people were getting hooked on prescription drugs, such as opioids, anti-depressants and sleeping tablets.
Opioids, such as codeine and morphine, are given by doctors to control pain. They are widely used in hospitals for cancer patients, and patients who are dying.
GPs also prescribe them to patients in the community who suffer from long-term pain.
The PHE research found that every year more than 5 million people are given them - with 1.2 million on them for at least 12 months.
Prof Coleman, an expert in pharmacology at Birmingham University, said there needed to be a culture approach and attitude around the use of painkillers, much as there has been with antibiotics because of the rise of drug-resistant superbugs.
He highlighted the "painkillers don't exist" public awareness scheme which is running in Sunderland, calling it an "intelligent" approach which could be replicated elsewhere. It stresses that drugs like opioids just mask the symptoms.
"We need to educate people. For some, they will have very little impact."
He said he sympathised with GPs who were often under pressure to see patients quickly and did not always have other options to turn to, such as mental health care and support schemes to address loneliness.
"These can be important factors in tackling long-term pain. We are seeing more support being made available through social prescribing schemes, but there is a definite lack of alternatives for doctors."
Painkillers 'can be life-changing'
Dr Cathy Stannard, a consultant in pain medicine at NHS Gloucestershire, who has carried out the research suggesting only one in 10 patients seeking help for long-term pain will get benefit from painkillers, said she agreed there needed to be a re-think.
"We probably do over-prescribe. GPs don't have enough time to get to the bottom of what is wrong with patients.
"For some a painkiller will be life-changing, but for many it won't work. Pain can be related to grief, social isolation or mobility issues for example. Address those and you can make a difference to the pain."
But she added that the problems being seen in the UK were not on the scale of the US, where there has been a rise in drug-related deaths, partly linked to prescription painkillers.
She said the oversight and regulation of prescription drugs meant their use was much more closely controlled, so that while prescription rates had risen it was still not on the scale of that seen in the US.