Pain Management: Drug Tolerance and Addiction
Some medications used to treat pain can be addictive. Addiction is different from physical dependence or tolerance, however. In cases of physical dependence, withdrawal symptoms occur when a substance suddenly is stopped. Tolerance occurs when the initial dose of a substance loses its effectiveness over time. Addiction is a psychological and behavioral response that develops in some people with the use of narcotic pain medicines.
People who take a class of drugs called opioids for a long period of time may develop tolerance and even physical dependence. This does not mean, however, that a person is addicted. In general, addiction occurs in only a small percentage of people when narcotics are used under proper medical supervision.
Addictive Pain Medications
Opioids, a family of drugs that have effects similar to those of opium or morphine, can be addictive. They include:
- Fetanyl (including brand name Duragesic)
- Oxycodone (including brand name OxyContin, Percocet, Percodan, Tylox, and Roxicet))
- Morphine (including brand name MS Contin)
- Meperidine (including brand name Demerol)
Hydrocodone (including brand name Vicodin and Lortab)
- Hydromorphone (including brand name Dilaudid)
Who Is at Risk for Addiction?
Most people who take their pain medicine as directed by their doctor do not become addicted, even if they take the medicine for a long time. However, some people may be at a higher risk of becoming addicted than others. People who have been addicted to substances in the past or those with a family member who is or has been addicted to drugs or alcohol may be at increased risk of becoming addicted to narcotics.
How to Prevent Addiction
The key to avoiding addiction is to take your medicine exactly as your doctor prescribes.
Share with your doctor any personal and/or family history of substance abuse or addiction. Your doctor needs this information to prescribe the medicines that will work best for you. Fears about addiction should not prevent you from using narcotics to effectively relieve your pain.
Remember, it is common for people to develop a tolerance to their pain medication and to need higher doses to achieve the same level of pain relief. Such a situation is normal and is not a sign of addiction. However, you should talk to your doctor if this effect becomes troubling.
Reviewed by the doctors at The Cleveland Clinic Pain Management Department.