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Pain Management Health Center

Prescription Painkiller Addiction: 7 Myths

Experts Debunk Myths About Prescription Pain Medication Addiction
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WebMD Feature
Reviewed by Louise Chang, MD

Prescription pain medicine addiction grabs headlines when it sends celebrities spinning out of control. It also plagues many people out of the spotlight who grapple with painkiller addiction behind closed doors.

But although widespread, addiction to prescription painkillers is also widely misunderstood -- and those misunderstandings can be dangerous and frightening for patients dealing with pain.

Where is the line between appropriate use and addiction to prescription pain medicines? And how can patients stay on the right side of that line, without suffering needlessly?

For answers, WebMD spoke with two pain medicine doctors, an expert from the National Institute on Drug Abuse, and a psychiatrist who treats addictions.

Here are seven myths they identified about addiction to prescription pain medication.

1. Myth: If I need higher doses or have withdrawal symptoms when I quit, I'm addicted.

Reality: That might sound like addiction to you, but it's not how doctors and addiction specialists define addiction.

"Everybody can become tolerant and dependent to a medication, and that does not mean that they are addicted," says Christopher Gharibo, MD, director of pain medicine at the NYU Langone Medical School and NYU Hospital for Joint Diseases.

Tolerance and dependence don't just happen with prescription pain drugs, notes Scott Fishman, MD, professor of anesthesiology and chief of the division of pain medicine at the University of California, Davis School of Medicine.

"They occur in drugs that aren't addictive at all, and they occur in drugs that are addictive. So it's independent of addiction," says Fishman, who is the president and chairman of the American Pain Foundation and a past president of the American Academy of Pain Medication.

Many people mistakenly use the term "addiction" to refer to physical dependence. That includes doctors. "Probably not a week goes by that I don't hear from a doctor who wants me to see their patient because they think they're addicted, but really they're just physically dependent," Fishman says.

Fishman defines addiction as a "chronic disease ... that's typically defined by causing the compulsive use of a drug that produces harm or dysfunction, and the continued use despite that dysfunction."

For instance, someone who's addicted might have symptoms such as "having drugs interfere with your ability to function in your role [or] spending most of your time trying to procure a drug and take the drug," says Susan Weiss, PhD, chief of the science policy branch at the National Institute on Drug Abuse.

"Physical dependence, which can include tolerance and withdrawal, is different," says Weiss. "It's a part of addiction but it can happen without someone being addicted."

She adds that if people have withdrawal symptoms when they stop taking their painkiller, "it means that they need to be under a doctor's care to stop taking the drugs, but not necessarily that they're addicted."

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