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Back Pain: Medication and Addiction

There are risks involved with prescription drug addiction, specifically narcotic painkillers. In most cases, the benefits of these medications outweigh the risks.
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WebMD Feature

In the last few years, everyone's heard about the apparent epidemic of prescription drug addiction, especially to narcotic painkillers. We see human-interest stories on the news about regular folks getting hooked on OxyContin or Vicodin. Every few months, it seems, we get another news release from a new celebrity confessing to an addiction. The reports may give you the impression that the lure of these drugs is irresistible, that we're all just a few pills away from addiction.

This leaves many people with chronic back pain -- and often their doctors -- stuck in the middle. On the one hand, they're afraid of the risks of addiction that come with powerful painkillers. On the other, they're suffering from severe and debilitating pain and need some kind of help.

But are the risks of prescription drug addiction really as great as we think?

"There's this buzz that these painkillers are demon drugs being marketed to unsuspecting grandmas," says Karen Miotto, MD, an addiction psychiatrist at the UCLA Neuropsychiatric Institute. "But that's not the case."

There's no doubt that prescription drug addiction can be devastating and destroy lives. But for many experts, the more widespread public health issue is that people in desperate and debilitating pain aren't getting the painkillers they need because of inflated fears of addiction. While opioid painkillers -- like OxyContin, Percocet, and Vicodin -- have risks, they're often outweighed by the benefits, experts say.

How Big Is the Addiction Problem?

Prescription drug addiction is a growing problem. According to the Office of National Drug Policy, emergency room visits resulting from the abuse of painkillers alone has gone up 163% since 1995. There are three main classes of prescriptions drugs that are abused: opioid narcotics used to treat pain, depressants used to treat anxiety, and stimulants used to treat conditions like ADHD and obesity.

But those numbers may not be as meaningful they appear, says Jim Zacny, PhD, a professor in the department of anesthesia and critical care at the University of Chicago. More people are abusing the drugs because more people are receiving prescriptions for them. So while there has been a growth in the number of abusers, there has been a much greater rise in the number of people who are using these medications safely and benefiting from them.

Zacny also cites recent data showing that of all the people in the U.S. who checked into substance abuse centers in 2002, only 2.4% were there because of an addiction to opioid narcotics. "In other words," he tells WebMD, "the majority of people who use prescription opioids are using them responsibly."

Miotto stresses that addiction is a more complex process than people tend to think. "It's not the pills alone that make an addiction," she says. She points out that addiction develops from a number of physiological, psychological, and social factors.

Zacny agrees. "There's this myth out there that if you take an opiate, you automatically become enslaved to it," he says. "That's not the truth at all."

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