April 15, 2016 / Chronic Pain
Separate fact from fiction
When it comes to prescription pain medications, there’s a lot of
misinformation out there. Whether you’re searching for information about how
they can help you relieve pain or reading the latest tabloid story
about a celebrity addict, separating fact from fiction can be tough.
Below, Richard Rosenquist, MD, Chairman of Pain
Management at Cleveland Clinic, debunks six common myths about
prescription painkillers, such as oxycodone and hydrocodone.
Myth 1: The more you
take, the better they work
More does not equal better. It’s true that in the short term —
after a severe injury, for example — two pills may be more effective than one
at relieving pain.
But over time, taking too much backfires. Research suggests that
chronic use of pain medications sensitizes a portion of the nervous system and
modifies the way your brain and spinal cord interpret pain signals, Dr.
Rosenquist says.
“You develop a tolerance to the medication over time,” he says.
“Sometimes if you take chronic pain medications for a long time, your pain may
actually get worse.”
Myth 2: If you take them
for a valid reason, you can’t get addicted
It can’t happen to me. I’m a good citizen. I’m a normal person. I
couldn’t possibly get addicted.
Thinking this way is dangerous. Even if you start taking a
prescription pain medication for a legitimate reason, you run the risk of
addiction. It has nothing to do with moral character and everything to do with
the highly addictive nature of these drugs.
Myth 3: Everyone who
takes them gets addicted
On the flipside, just because you take a prescription painkiller
does not mean you will become addicted.
It depends largely on your own personal risk of addiction. That’s why Dr. Rosenquist and others
in pain management screen for risk factors: a family history of addiction, a
personal history of alcohol and drug abuse, or certain psychiatric disorders.
“If I’m considering prescribing opioids, I’m going to do drug
screening and make sure you’re not taking recreational drugs,” Dr. Rosenquist
notes “If somebody uses recreational drugs, the likelihood they’re going to use
pain medications inappropriately is really high.”
Not everyone gets addicted, but everyone who takes painkillers
for an extended time period will experience symptoms of withdrawal if they
suddenly stop. It’s a natural reaction.
Myth 4: There are no
long-term consequences
Addiction is not the only risk that comes with prescription pain
medications. When you take them for extended periods of time, they also can
harm your body’s endocrine system and throw your hormones out of whack,
affecting everything from your libido to your risk of osteoporosis.
“There are a lot of bad things that can happen, but people don’t
always hear you when you describe them,” Dr. Rosenquist says.
Myth 5: You should avoid
painkillers altogether
As you can tell, there is plenty of scary information about
painkillers. However, there are certainly legitimate uses.
In addition to treating the pain from acute injuries, a very
small fraction of chronic pain patients see improvements in both pain levels
and function from taking pain medications — especially when other pain
management techniques fail for them.
For the majority of people, though, prescription pain
medications should be a short-term treatment at most.
Myth 6: Pain medication
can fix your pain
This may be the biggest myth of all. Pain medications simply
mask your symptoms; they don’t treat the root cause of your pain. That’s why
Dr. Rosenquist focuses on making a diagnosis and addressing the cause of the
pain whenever possible to help improve your function rather than just how you
feel.
Are you moving better? Are you able to get back to work? These
are important questions about function. So is the question of whether you’ve
been making efforts to get better. For example, have you been following
doctor’s orders and doing physical therapy to recover from an injury? Have you
been losing weight if you’re suffering from weight-related joint pain or back pain?
“If you’re not doing the other things you need to do to get
better, I’m not going to keep prescribing those drugs,” Dr. Rosenquist says.
“On their own, they’re not therapeutic.”
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