Scientists from Universidad Rey Juan Carlos investigated self-medication among people experiencing pain in the European Union
42.7% of respondents who reported pain stated that they had used self-medication in the previous two weeks. Women reported a higher prevalence (47.0%) than men (36.9%)
The study Self-medication and pain in the European Union: Gender differences and associated factors was conducted by Spencer Yeamans, Ángel Gil-De-Miguel, Valentín Hernández-Barrera, and Pilar Carrasco-Garrido, and was published in early May 2026. This study aimed to examine how common self-medication is among people experiencing pain in European Union countries, as well as the factors associated with this behaviour, with particular attention to differences between men and women.
The research was based on data from the European Health Interview Survey (EHIS), collected between 2018 and 2020. EHIS is a large, standardised survey carried out across EU Member States, covering individuals aged 15 and older. People living in institutional settings, such as hospitals or nursing homes, were excluded.
The final sample included 149,349 respondents from 26 EU countries. The data were anonymised and collected using a harmonised methodology to ensure cross-country comparability, although there were some differences in data collection methods (such as face-to-face interviews, telephone interviews, or questionnaires). “Twenty-six of the twenty-seven European Union member states are represented in this study, as French data were unavailable via Eurostat. Data from Malta for the nationality variable was also excluded due to anonymization practices. Results are comparable between countries due to the use of a common regulatory framework….We calculated the prevalence of self-medication in individuals experiencing varying levels of pain in the past four weeks by country and for each independent variable, selected based on relevancy in the literature, via answers to the dependent variable,” the scientists explained in the study.
The main outcome variable was self-medication, defined based on respondents’ answers to whether they had used medicines, herbal remedies, or vitamins without a prescription. Respondents were grouped into three categories: mild or very mild pain, moderate pain, and severe or very severe pain. The mild pain group was used as the reference category in the analyses. In addition, the study included a range of other variables that could influence self-medication. These included demographic factors (age, sex, nationality), socioeconomic factors (education level and employment status), lifestyle behaviours (smoking, alcohol consumption, and physical activity), health status (chronic conditions, self-perceived health, and depression), healthcare utilisation (visits to general practitioners and specialists), and unmet healthcare needs due to financial reasons.
A part of the analysis focused on the availability of over-the-counter medicines. Countries were grouped according to whether such medicines could be purchased only in pharmacies, in pharmacies without pharmacist consultation, or also outside pharmacies.
42.7% of respondents who reported pain stated that they had used self-medication
The analysis was conducted in several steps. Overall, 42.7% of respondents who reported pain stated that they had used self-medication in the previous two weeks. Women reported a higher prevalence (47.0%) than men (36.9%). Prevalence was highest among those with moderate pain, followed by severe pain, and lowest among those with mild pain. Large differences were also observed between countries, ranging from 19.0% to 85.1%.
“Spain also has low self-medication prevalence, with no sex or pain subgroup surpassing 25% prevalence…The prevalence of self-medication among patients with pain varies between countries, with lower frequencies in countries such as Spain and Italy and higher prevalence values in countries like Finland and Cyprus….Men and women with higher education were more than 2.5 times and four times as likely, respectively, to self-medicate compared to those without formal education…”
The results of the multivariate analysis showed that pain intensity was significantly associated with self-medication. Among women, the likelihood of self-medication increased with higher pain intensity, while among men the strongest effect was observed for moderate pain. Individuals with higher education were significantly more likely to engage in self-medication. Greater physical activity was also associated with higher likelihood of self-medication in both sexes. Depression was significantly associated with self-medication among men, but not among women. Greater availability of over-the-counter medicines outside pharmacies was linked to increased self-medication. Similarly, individuals reporting unmet healthcare needs due to financial reasons were more likely to self-medicate.
The large, standardised dataset strengthens the reliability of the findings
In the discussion, the authors note that their findings are consistent with previous research showing higher rates of self-medication among people in pain and among women. They also highlight substantial cross-country differences, which they attribute to cultural, economic, and healthcare system factors. Accessibility of medicines is emphasised as an important driver of self-medication, as easier access tends to increase usage. Pain intensity is also confirmed as an important factor, although with gender differences that may reflect variations in pain perception and coping strategies. Also, higher education may be associated with a greater tendency to self-manage symptoms without consulting healthcare professionals.
As for limitations, the authors point out that this is a cross-sectional study, meaning causality cannot be established. There is also a lack of detailed information on specific types of medicines and pain characteristics. Potential issues include self-report bias, differences in data collection methods across countries, and possible effects of the COVID-19 pandemic in some settings. Despite these limitations, the large, standardised dataset strengthens the reliability of the findings.
The study shows that self-medication among people experiencing pain in the EU is very common, more frequent among women, and varies considerably across countries. It is associated with pain intensity, education, access to medicines, and financial barriers to healthcare. “It is necessary to identify an appropriate context for self-medication in people with pain, incorporating training on the correct use of medications into general health education,” the authors concluded.
Image: Lessons from a chronic pain management program, Harvard.edu
