The Effects of Addiction and Abuse continued...
The problem is that people who have a prescription drug addiction don't realize it. "Addiction is a disease of denial," Miotto says. "It can take years before people realize what's happening to them." It pushes people to horrible extremes. Miotto knows one patient who eventually admitted that she pushed for surgery solely because she wanted the opioid painkillers she knew she'd get afterward.
There's also another dimension to prescription drug abuse you should consider. Even if you don't abuse the opioid pills you've been prescribed, someone else could.
"A lot of the opioids that get used illicitly -- especially by adolescents -- come from the medicine cabinets of people who were prescribed the drug for legitimate pain," says Webster. "People need to understand the potential harm that they can do to communities if these medications aren't properly secured."
Doctor vs. Patient
In part because of the stigma of prescription drug addiction, chronic back pain can sour even the best doctor-patient relationships. The patient can become frustrated by the doctor's inability to cure his or her pain. Meanwhile, the doctor may become suspicious of someone who's always demanding refills of powerful opioids.
"Doctors are getting sued from both ends," says Miotto. Some have been sued for providing opioid painkillers that lead to addiction; others get sued for not prescribing them to relieve debilitating 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."
Alternatives to Opioids for Back Pain
Miotto says that some people with serious pain become too focused on opioids. They come to believe that opioids are the only thing that will help. But sometimes, you need to take a step back.
"If you keep increasing your dose of opioid pain medication but pain is still an 8 or 9 out of 10, it's time to shift gears and try something else," says Miotto. She points out that at high doses, opioid painkillers can actually make your pain worse -- a condition called opiate-induced hyperalgesia.