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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.

    Who Is at Risk? continued...

    While some treatments and physical therapy work for most people, Khoo says there are some problems that don't respond to this approach. Despite a good treatment plan, the pain remains. Khoo says patients who develop chronic back pain often have multiple problems with the spine, due perhaps to arthritis or a history of heavy labor, that can't be corrected surgically. He also says people who don't respond to one or two surgeries are more likely to develop difficult-to-treat chronic pain.

    It's this small population of people who have chronic pain and hard-to-treat problems that usually need long-term medication, Khoo says.

    What Increases the Risk of Abuse?

    According to rough estimates, between 3%-16% of people who suffer from chronic pain and are treated with long-term opioid narcotics have a prescription drug addiction, says Miotto. But what increases the risk?

    According to Zacny, we still don't have a perfect way of knowing. "The studies just haven't been done," he says. However, most people agree that a recent history of any substance abuse may increase the danger.

    Other possible risk factors for prescription drug addiction include any personal or family history of substance abuse, as well as recent emotional or psychiatric problems. "If you're in a high-risk group, if you or a family member has had a past history of addiction, or you're coping with a great deal of stress, you and your doctor may need to be especially vigilant," says Miotto.

    Although certain opioid drugs are often viewed as more addictive than others, there's very little evidence one way or another, Zacny says. Still, many think that the narcotics that don't last very long -- such as quick-release oxycodone or Vicodin -- may pose a somewhat higher risk of causing addiction. For opiods that last only a few hours, the pain will return. Over time, repeated medication can lead to a tolerance to these drugs. When tolerance develops, higher doses will be needed to get the same effective pain relief.

    The risks of prescription drug addiction also depend on how you react to the drug. People who become addicted to prescription painkillers clearly experience a high, but most people find that the drug makes them feel unwell or nauseated. Other frequent side effects include mild dizziness, sedation, and confusion. According to some of Zacny's research, the majority of people who try the drug don't like the effects and would rather not take it again. So the risks of addiction may be higher in those who, for physiological reasons not understood, have a more positive reaction to the drug's effects.

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