Back Pain: Medication and Addiction

Working With Your Doctor

In order to get the treatment you need, you need to keep a good relationship with your doctor. This may require that you seek out a doctor with expertise in pain management. For a lot of understandable reasons, your regular doctor may not be comfortable handing out long-term prescriptions for narcotics.

For people who have a past history of substance abuse or are at higher risk of developing a prescription drug addiction for any reason, seeking out an expert -- or specialty center -- is especially important.

"Too often, addiction programs are completely divorced from pain management programs and vice versa," says Miotto. Khoo agrees and recommends programs that combine not only pain management and prescription drug addiction treatment, but also exercise, physical therapy, weight loss, and if necessary, therapy for depression.

One common way of using opioid narcotics safely is to use a pain agreement, a formal understanding between a doctor and patient about how the drugs will be used. The patient may promise to use the medication as instructed and, in some cases, agree to regular drug testing by urine analysis. In return, the doctor agrees to prescribe narcotic pain relievers as part of the treatment plan.

"Pain agreements or contracts are a way for a doctor to say to the patient, 'We're taking you seriously, so you need to take us seriously,'" says Khoo.

But these agreements may not be enough for people at high risk of addiction. "Some people decide that they just can't take pain medications responsibly," says Miotto. If that's the case, you may be able to get someone else to hold and dispense your medication for you. Another possibility is to use a transdermal patch -- these contain the medicine but deliver it slowly through the skin, preventing the high and reducing the risk of addiction.

For anyone with Chronic Pain, having a knowledgeable doctor and a trusting relationship is key. An expert won't have unfounded worries about the relatively small risk of prescription drug addiction. But he or she will also know how to help people at high risk of developing a problem.

"Doctors should not be afraid of treating pain," Miotto tells KB120. "There are addicts out there who don't have pain but shop around and hustle for medication. But I think that there are very few compared to the number of people who have terrible pain and need help."

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