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Pain Relief & Addiction: A Catch 22

Published October 2, 2017
| Written By SpineNation Editorial Staff  

You are in chronic back pain. Day after day, you struggle to do normal activities and sometimes the only way to relieve that pain is to take a painkiller. It seems simple; you have a problem and the solution. You consume the solution in hopes it removes the problem, but is that always the case?

You get prescribed an opioid for your back pain. At first, it's like magic. The pain suddenly becomes bearable. After a few weeks of taking the medication as prescribed by your doctor, the dose you were once taking, may not work as well as it originally did. So you take more. A few more weeks go by and not only have you increased your tolerance to the drug, you now need it to wake up and get out of bed. You need it to carry on with your day that's already filled with more than enough pain already.

You may experience:

  • Cold sweats
  • Constipation
  • Nausea
  • Shallow breathing
  • Restlessness

Or even severe drug cravings when you go without the medication after taking it for an extended period of time. These cravings can consume you. Picture, the worst flu on steroids.

So there you are, in so much back pain and now adding withdrawal to your list of symptoms that you may think it's just not fair. After all, you were originally prescribed these from your doctor to help you and now you are hurting like never before.

In 2015, of the 20.5 million Americans ages 12 or older that had a substance abuse disorder, 2 million had a substance abuse disorder involving prescription pain relievers. More people than ever are using them recreationally over street drugs such as heroin, cocaine, ecstasy, hallucinogens, and inhalants combined, but here's where the stigma lies.

Chronic back pain sufferers need some sort of medication to ease that pain, but there's a thin line between taking them as prescribed and abuse. Enter, the accidental addict.

According to the Institute of Medicine of The National Academies, approximately 100 million Americans suffer from chronic pain including back and spine pain, leading the charge over American's suffering from diabetes, heart disease, and cancer. That's a lot of fellow back pain sufferers. 

“I don’t think we’ve ever seen anything like this. Certainly not in modern times,” said Robert Anderson, overseer of death statistics at the Centers for Disease Control and Prevention (CDC).

The CDC also reported that 259 million prescriptions for opioids were written in 2012 — “Enough for every American adult to have a bottle of pills,” according to the site — leaving chronic back pain suffers in a catch 22.

If you consume pain meds the way they were prescribed, you may experience withdrawal symptoms after only two weeks. The longer you take them, the worse the withdrawal may be.

Director of Addiction Medicine at Melbourne's Western Hospital in Melbourne, Australia, Dr. Michael McDonough said, “While some people can function well on opioids for a long time, the painkillers are turning some ordinary people with no history of substance abuse into addicts.”

In some specialist pain clinics, McDonough explained, “These people are sharing tips in waiting rooms about how to crush their tablets and inject them because their doctors are not giving them enough to satisfy their need. These are people who would have never imagined themselves injecting drugs.”

So what now?

Dr. McDonough added, “Many general physicians (GPs) are already in a difficult position with patients potentially both addicted and relying on the drugs to manage pain.”

“Long waiting lists of up to a year for specialist pain and addiction medicine mean many GPs are continuing to prescribe opioids to people who need to stop taking them and, if necessary, find alternatives for pain management and relief.”

Dr. Matthew Frei, Head of Clinical Services at Turning Point Alcohol and Drug Centre in Melbourne, Australia, said, “This shortage of services is exacerbating the problem because the longer patients stay on the drugs, the more risks there are to their health.”

The potential risks include:

  • Overdose resulting in possible death
  • Poor working immune systems
  • Increased risk of cancerous tumors
  • Hormone imbalance
  • Gastrointestinal problems

''These people still need care, so GPs can't shut their doors to them but they also need to know when they're doing more harm than good,” said Dr. Frei. “We need to give GPs the tools to manage these people because the numbers are only going to get more difficult.''

Finally, after campaigning for years, the U.S. government reported this past February that they would allocate $5 million dedicated to a live prescription-monitoring system, assisting physicians and patients alike to ultimately end 'doctor shopping'.

What Can I Do to Avoid Becoming an Accidental Addict?

Before you start your opioid regime, have your physician speak with you on the inherent risks for addiction.

Some things to discuss with your physician include:

  • Your detailed personal and family history of substance abuse, including psychiatric disorders and family background with addiction that could place you at a higher risk for abuse
  • Speak with your doctor about non-opioid pain treatments
  • When in doubt, ask for help.

We at BackerNation feel your pain. We want to help.  We not only want to educate you, but we truly care about your pain. After all, knowledge is power, Backers. 

Updated: February 19, 2020

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