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.
Doctor vs. Patient
In part because of the stigma of prescription drug addiction, chronic back pain can sour even the best doctor-patient relationships. Over time, the patient becomes increasingly frustrated by the doctor's inability to cure his or her pain. Meanwhile, the doctor may become suspicious of someone who always refills of powerful narcotics.
"Doctors can get afraid when dealing with patients with chronic pain, because they don't want to be the ones handing out hardcore painkillers all the time," says Khoo. "But that leads to a lot of undertreated patients with real back problems. These are people who are in so much pain that they're just not functional human beings."
Khoo also says doctors may be too focused on trying to figure out the underlying source of pain while in the meantime ignoring the debilitating symptom.
"The patient came to see the doctor because of pain," says Khoo, "and he doesn't really care about the underlying cause. He doesn't care whether it's a disc problem or a deformity. He just wants the pain to go away. So doctors need to concentrate on treating the symptom, too."
While this situation can be difficult for anyone with chronic back pain, people with a past history of addiction face the most skepticism from their doctors.
"I hate to say it, but when people walk in to the doctor and mention an addiction history, they may not be able to get these painkillers," says Miotto. "The doctor may just not trust them."
Working With Your Doctor
In order to get the treatment you need, you need to keep a good relationship with your doctor. This may require that you seek out a doctor with expertise in pain management. For a lot of understandable reasons, your regular doctor may not be comfortable handing out long-term prescriptions for narcotics.
For people who have a past history of substance abuse or are at higher risk of developing a prescription drug addiction for any reason, seeking out an expert -- or specialty center -- is especially important.
"Too often, addiction programs are completely divorced from pain management programs and vice versa," says Miotto. Khoo agrees and recommends programs that combine not only pain management and prescription drug addiction treatment, but also exercise, physical therapy, weight loss, and if necessary, therapy for depression.