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.
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
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.
One common way of using opioid narcotics safely is to use a
pain agreement, a formal understanding between a doctor and patient about how
the drugs will be used. The patient may promise to use the medication as
instructed and, in some cases, agree to regular drug testing by urine analysis.
In return, the doctor agrees to prescribe narcotic pain relievers as part of
the treatment plan.
"Pain agreements or contracts are a way for a doctor to say
to the patient, 'We're taking you seriously, so you need to take us
seriously,'" says Khoo.
But these agreements may not be enough for people at high risk
of addiction. "Some people decide that they just can't take pain
medications responsibly," says Miotto. If that's the case, you may be able
to get someone else to hold and dispense your medication for you. Another
possibility is to use a transdermal patch -- these contain the medicine but
deliver it slowly through the skin, preventing the high and reducing the risk
For anyone with chronic pain, having a knowledgeable doctor and
a trusting relationship is key. An expert won't have unfounded worries about
the relatively small risk of prescription drug addiction. But he or she will
also know how to help people at high risk of developing a problem.
"Doctors should not be afraid of treating pain," Miotto
tells WebMD. "There are addicts out there who don't have pain but shop
around and hustle for medication. But I think that there are very few compared
to the number of people who have terrible pain and need help."