Medical Edge Newspaper Column

Pain Medication and the Risk of Addiction

Oct. 28, 2007
Dear Mayo Clinic:
Can I get addicted to pain medication? What's my risk?

Answer:
Some estimates say that 10 percent to 40 percent of people with chronic pain misuse opioids — narcotic pain medications such as hydrocodone (Vicodin, Lortab); morphine; oxycodone (OxyContin, Percocet); hydromorphone (Dilaudid); meperidine (Demerol); and methadone.

However, there is a difference between medication misuse and addiction. Misuse is taking a pain medication for a purpose other than pain relief — such as to aid sleep or ease anxiety. In addiction, people use a drug for its mood-altering or euphoric effects, even when the result creates problems with relationships and obligations at home, work or school.

The tendency to develop an addiction seems to be inherited. If you have family members who abuse drugs or alcohol, you have a higher risk of the same problem. Anxiety, depression and loneliness also increase the risk. Past problems with substance abuse play a role as well. For example, a history of alcoholism increases the risk of problems with prescription pain medications — even if you're in recovery.

When you take pain medication as prescribed, the risk of abuse will more than likely be minimal. But it's helpful to know the warning signs of misuse or addiction:

• You take more pain medication than your doctor has prescribed.
• You request prescriptions from multiple doctors.
• You use alcohol or other medications to increase the effects of the pain medication.
• You take pain medication to deal with other problems, such as anxiety or stress.
• Your doctor, friends or loved ones express concern about your use of pain medication.

Over time people may require increased dosages to achieve the same level of pain control and some do become dependent on opioids. If this occurs, patients should talk with their doctors about dosage changes or other treatment options.

— W. Michael Hooten, M.D., Anesthesiology, Mayo Clinic, Rochester, Minn.