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Proper use of pain medications reduces likelihood of addictionFrom MayoClinic.com
Special to CNN.com
After your car accident the pain in your back was almost unbearable, but you followed your doctor's recommendations about stretching and gradually increasing your activities. Months later, the pain is still there, and over-the-counter medications don't help much. You'd like to try something else, but you're concerned about taking anything stronger for fear that you'll become addicted.
The possibility of addiction is one of the biggest fears of people who have chronic pain. And there's good reason. The National Institute on Drug Abuse estimates that in 1999, 2.6 million people age 12 and older took prescription pain medications for nonmedical reasons. It's unlikely they all were addicted, but developing an addiction is indeed possible.
Opioids: One way to relieve pain
Opioids, a family of drugs that have effects similar to those of opium, are among those prescribed for pain. The ingredient in opium and the active component of opioids that relieves pain is morphine. Morphine and other similar-acting compounds work by mimicking the actions of chemicals your body produces to relieve pain.
Medications containing hydrocodone (Vicodin, others), propoxyphene (Darvon, others), meperidine (Demerol, others) and oxycodone (OxyContin, others) are commonly prescribed opioids. Your doctor may prescribe other opioids, too, depending on your condition.
When you think about problems that pain medications can cause, you may think of addiction. But your body reacts to opioids in several ways:
Tolerance is the decreasing effect of a drug after regular use at a constant dose. Over time, you may need higher doses of the drug to achieve the same effect.
Physical dependence is a physiological state that occurs as your body adapts to certain medications taken regularly. Without the drug, you may experience withdrawal.
Psychological dependence is an emotional state that may occur as you become accustomed to taking a drug to experience its positive effects. Your body may or may not become physically dependent on the drug, but you believe that you need it.
Withdrawal is a set of symptoms you may experience after abruptly stopping or reducing the dose of certain drugs you've been taking regularly.
Addiction is a chronic, potentially relapsing disorder in which you compulsively seek and use drugs. Changes in the neurochemicals in your brain occur in addiction. Even though you know there may be serious consequences if you continue seeking and using drugs, you feel compelled to do so anyway.
Pseudoaddiction is behavior that suggests the presence of addiction but is really an attempt to relieve pain more effectively. A person with pseudoaddiction might occasionally take a higher dose of a prescribed drug or hoard pain medications for times when the pain is worse.
Tolerance, physical dependence, and withdrawal are your body's natural reactions to opioids. These reactions occur with addictive and some nonaddictive drugs, and with those available over-the-counter as well as by prescription. Developing these conditions doesn't mean that you're addicted to a prescription pain medication. The presence of tolerance and withdrawal without the compulsion to take medications is not addiction.
People who take their pain medications as recommended aren't likely to become addicted. Physical dependency and tolerance often develop in people who take opioids regularly, but they don't always become addicted to opioids. Even people who have a family or personal history of drug or alcohol addiction can sometimes use opioids for pain control if they get proper monitoring from a doctor.
Some people wonder whether they'll experience problems in their daily life — in thinking, driving or other activities — if they need to increase their dose over time to maintain pain control. Side effects of opioids — nausea, constipation, sedation and unclear thinking — are less evident in people who take them regularly compared with those who take them intermittently. Those who take opioids regularly develop a tolerance for many of the side effects of the drugs and function normally as long as they take the medications as prescribed.
Causes of addiction
If just taking opioid medications for pain over a long period doesn't cause addiction, what does? Researchers believe many things are involved in the development of addiction.
Genetic factors. A family history of misuse or addiction to prescription pain medications, recreational drugs or alcohol is a good indicator that you might be predisposed to become addicted to opioids.
Gender. In the general population, men appear to be more likely to develop an addiction than women. However, women are more likely to receive a prescription for an opioid drug that can be addictive.
Uninformed about proper use of medication. If you don't learn to take your medications correctly, you're more likely to take them in ways that promote addiction. Be sure to ask your doctor for specific instructions about proper use.
No one intervenes. When friends and family don't point out that you're taking larger doses or more frequent doses, it's easier to convince yourself that changing the dose without consulting your doctor is OK.
Use of multiple medications. Tell your doctor about the medications that you take so that he or she can avoid prescribing combinations of medications that cause problems.
Differences in medications' potential for addiction. In general, opioids are less addictive than cocaine but more addictive than alcohol.
Differences in medication delivery forms. Intravenous infusions have the greatest potential for leading to addiction, and oral medications have the least potential for developing an addiction.
Differences in drugs' chemical formulations. Rapid-onset and short-acting drugs tend to be more addictive than medications that have a slow onset or are long acting, for example, 12-hour formulations.
Prevention: Your best defense
Special to CNN.com
After your car accident the pain in your back was almost unbearable, but you followed your doctor's recommendations about stretching and gradually increasing your activities. Months later, the pain is still there, and over-the-counter medications don't help much. You'd like to try something else, but you're concerned about taking anything stronger for fear that you'll become addicted.
The possibility of addiction is one of the biggest fears of people who have chronic pain. And there's good reason. The National Institute on Drug Abuse estimates that in 1999, 2.6 million people age 12 and older took prescription pain medications for nonmedical reasons. It's unlikely they all were addicted, but developing an addiction is indeed possible.
Opioids: One way to relieve pain
Opioids, a family of drugs that have effects similar to those of opium, are among those prescribed for pain. The ingredient in opium and the active component of opioids that relieves pain is morphine. Morphine and other similar-acting compounds work by mimicking the actions of chemicals your body produces to relieve pain.
Medications containing hydrocodone (Vicodin, others), propoxyphene (Darvon, others), meperidine (Demerol, others) and oxycodone (OxyContin, others) are commonly prescribed opioids. Your doctor may prescribe other opioids, too, depending on your condition.
When you think about problems that pain medications can cause, you may think of addiction. But your body reacts to opioids in several ways:
Tolerance is the decreasing effect of a drug after regular use at a constant dose. Over time, you may need higher doses of the drug to achieve the same effect.
Physical dependence is a physiological state that occurs as your body adapts to certain medications taken regularly. Without the drug, you may experience withdrawal.
Psychological dependence is an emotional state that may occur as you become accustomed to taking a drug to experience its positive effects. Your body may or may not become physically dependent on the drug, but you believe that you need it.
Withdrawal is a set of symptoms you may experience after abruptly stopping or reducing the dose of certain drugs you've been taking regularly.
Addiction is a chronic, potentially relapsing disorder in which you compulsively seek and use drugs. Changes in the neurochemicals in your brain occur in addiction. Even though you know there may be serious consequences if you continue seeking and using drugs, you feel compelled to do so anyway.
Pseudoaddiction is behavior that suggests the presence of addiction but is really an attempt to relieve pain more effectively. A person with pseudoaddiction might occasionally take a higher dose of a prescribed drug or hoard pain medications for times when the pain is worse.
Tolerance, physical dependence, and withdrawal are your body's natural reactions to opioids. These reactions occur with addictive and some nonaddictive drugs, and with those available over-the-counter as well as by prescription. Developing these conditions doesn't mean that you're addicted to a prescription pain medication. The presence of tolerance and withdrawal without the compulsion to take medications is not addiction.
People who take their pain medications as recommended aren't likely to become addicted. Physical dependency and tolerance often develop in people who take opioids regularly, but they don't always become addicted to opioids. Even people who have a family or personal history of drug or alcohol addiction can sometimes use opioids for pain control if they get proper monitoring from a doctor.
Some people wonder whether they'll experience problems in their daily life — in thinking, driving or other activities — if they need to increase their dose over time to maintain pain control. Side effects of opioids — nausea, constipation, sedation and unclear thinking — are less evident in people who take them regularly compared with those who take them intermittently. Those who take opioids regularly develop a tolerance for many of the side effects of the drugs and function normally as long as they take the medications as prescribed.
Causes of addiction
If just taking opioid medications for pain over a long period doesn't cause addiction, what does? Researchers believe many things are involved in the development of addiction.
Genetic factors. A family history of misuse or addiction to prescription pain medications, recreational drugs or alcohol is a good indicator that you might be predisposed to become addicted to opioids.
Gender. In the general population, men appear to be more likely to develop an addiction than women. However, women are more likely to receive a prescription for an opioid drug that can be addictive.
Uninformed about proper use of medication. If you don't learn to take your medications correctly, you're more likely to take them in ways that promote addiction. Be sure to ask your doctor for specific instructions about proper use.
No one intervenes. When friends and family don't point out that you're taking larger doses or more frequent doses, it's easier to convince yourself that changing the dose without consulting your doctor is OK.
Use of multiple medications. Tell your doctor about the medications that you take so that he or she can avoid prescribing combinations of medications that cause problems.
Differences in medications' potential for addiction. In general, opioids are less addictive than cocaine but more addictive than alcohol.
Differences in medication delivery forms. Intravenous infusions have the greatest potential for leading to addiction, and oral medications have the least potential for developing an addiction.
Differences in drugs' chemical formulations. Rapid-onset and short-acting drugs tend to be more addictive than medications that have a slow onset or are long acting, for example, 12-hour formulations.
Prevention: Your best defense
