Back Pain: Medication and Addiction

What Increases the Risk of Abuse? continued...

Miotto says she worries less about people who are simply taking too much of the painkiller than those who use the painkiller along with other drugs, such as sleeping pills or muscle relaxants. "It's the people who are mixing drugs that I find are often at highest risk of problematic use and side effects," she tells KB120.

There's also a widely held belief that people who are in pain are less likely to experience euphoric effects from a drug. The idea is that the medication is targeted -- it "goes to the pain" only and doesn't cause other euphoric effects, meaning that people with real pain are less likely to become addicted than people who don't.

"That's lore, sad to say," Zacny says. "It may very well be true, but it hasn't been really established. There's just a lot we don't know."

Although certain opioid drugs are often viewed as more addictive than others, there's very little evidence one way or another, Zacny says. Still, many think that the narcotics that don't last very long -- such as quick-release oxycodone or Vicodin -- may pose a somewhat higher risk of causing addiction. For opiods that last only a few hours, the pain will return. Over time, repeated medication can lead to a tolerance to these drugs. When tolerance develops, higher doses will be needed to get the same effective pain relief.

The risks of prescription drug addiction also depend on how you react to the drug. People who become addicted to prescription painkillers clearly experience a high, but most people find that the drug makes them feel unwell or nauseated. Other frequent side effects include mild dizziness, sedation, and confusion. According to some of Zacny's research, the majority of people who try the drug don't like the effects and would rather not take it again. So the risks of addiction may be higher in those who, for physiological reasons not understood, have a more positive reaction to the drug's effects.

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