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
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
"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
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.