Pain Medications and the Risk of Addiction
Most people who use strong pain medications will not become dependent on them, but you should be aware of the potential for addiction.
By Dennis Thompson Jr.
Medically Reviewed by Pat F. Bass III, MD, MPH
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Pain management often involves the use of potentially addictive pain medications. In fact, the most effective pain medications also come with the greatest risk for physical dependency and addiction.
However, people who must manage pain often need these pain medications, and experts say they should not avoid taking them for fear of addiction. Very few patients who take drugs as part of their pain management become addicted, although they may have to deal with issues of physical dependency and increased tolerance.
There are ways to determine if you are at risk for becoming addicted to your pain medications, as well as signs to look for if you feel you are addicted.
Pain Management: Addiction and Pain Medications
Opioids are the pain medications most often associated with addiction. Types of opioids include:
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin)
- Propoxyphene (Darvon)
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
People with chronic pain who take opioids for extended periods in pain management often develop a physical dependency on these drugs. Their bodies become habituated to the pain medications and, if they stop taking them abruptly, they will experience withdrawal symptoms. Patients also may develop tolerance to the drugs and need higher and higher dosages to achieve the same level of pain relief, although this is much less likely to occur.
Pain management specialists draw a clear distinction between addiction and dependency issues. They consider addiction a disorder that goes beyond mere physical dependency. Addictive behavior includes:
- Compulsive use of drugs
- Craving for drugs
- Inability to control drug use
- Continued drug use despite suffering mental, physical, financial, and social harm
This distinction is important for pain management specialists because their patients often need to take opioids in order to manage their pain, but are reluctant to do so for fear of addiction.
Risk Factors and Signs of Addiction
There are some risk factors for addiction among chronic pain patients who have been prescribed pain medications as part of their management plan. These risks include:
- Ignoring the directions given for the medication's use
- A history of drug abuse, either personal or in your family
- Age — people under 26 and over 65 are more likely to become addicted
- Gender — women are more likely than men to become addicted to prescription painkillers
Signs of addiction you should watch for include:
- Taking multiple doses of medication
- A rapid increase in the amount of medication you feel you need
- Going from doctor to doctor (“doctor shopping”) to get additional prescriptions
- Craving the pain medications
- Feeling unable to stop or slow your use of your pain medications
- Medication use that interferes with your ability to perform tasks or enjoy favorite activities
- Going to inordinate lengths to obtain more medication
- Feeling withdrawal symptoms when you slow your use of the medication
Pain Management: Preventing Addiction
There are steps you can take to reduce the chance you'll develop a prescription drug addiction:
- Read the directions for using your pain medication and carefully follow them.
- Talk to your pharmacist about any potential interactions the drug might have with other medications you're taking.
- Ask your doctor before you change your dosage or increase the frequency of your medication use.
- Never take any medications prescribed for another person.
Pain medications can provide you with help for your chronic pain. Work with your doctor to feel comfortable taking what you need and to manage your prescription use.
Video: Risk factors for addiction to pain medications: Palliative care
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