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.
How Big Is the Addiction Problem? continued...
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."
Who Is at Risk?
Most people who have back pain are not at risk of prescription drug addiction for a number of reasons. First off, the majority of people with back pain never get prescribed potentially addictive painkillers in the first place.
"Most of the people with back pain will take drugs that don't pose a risk of addiction," says Larry Khoo, MD, co-director of the UCLA Comprehensive Spine Center. People with back pain often use non-addictive medications like Tylenol or nonsteroidal anti-inflammatory drugs (NSAIDs). Some NSAIDs are over-the-counter, like Motrin or Advil, and others are by prescription. In April 2004 the FDA asked that over-the-counter NSAIDs revise their labels to include information about potential heart and stomach ulcer bleeding risks.
Steroids can also be prescribed for pain due to swelling and inflammation. Steroids are not narcotics either, but these powerful drugs must be used carefully.
While opioid narcotics like OxyContin, Percocet, and Vicodin are options for patients with acute pain that's more severe, the risks of developing prescription drug addiction still aren't very high.
"Most of the people who need opioid drugs will only use them for a very short time, often a few weeks or a month," says Khoo. "Even the most powerful drugs are not very addictive when they're used that way."
Khoo says these drugs relieve pain immediately and allow people to get out of bed, start physical therapy, and change some of the behaviors that caused their back problem in the first place. "But it all hinges on being able to get out of bed," says Khoo, and without these drugs, that first step is sometimes just too painful.