Pain Medications: Addiction and Fear of Becoming Addicted

What to know about becoming addicted to pain medications.

By Eric Metcalf, MPH
WebMD Feature

Many people taking medication to control chronic pain are afraid they'll become addicted to those drugs.

Some people do become addicted, and the results can be devastating. But there are ways to limit your risk.

Candy Pitcher of Cary, N.C., knows all about the fear of addiction. One summer day in 2003, a tree cutter working at Pitcher's home started to topple from his ladder. "If he hits the ground, he'll break his back. I have to catch him!" she thought.

Pitcher broke the man's fall, which crushed a vertebra in her upper back. Ever since then, she's had chronic pain. To manage it, she's had a prescription for a drug that's widely feared and often misunderstood: morphine.

"I've never been 'high' from morphine," she says, nor has she ever been tempted to take more than the prescribed amount. But she says she's wary of becoming addicted.

She's not the only one with that fear. "Addiction" is a widely used word. But many people don't use it accurately.

What Addiction Is ... and Isn't

Addiction is far more than a craving. It also means there are troubling consequences that can often disrupt someone's personal life or job.?

"Addiction means the individual has lost control over the use of the drug. They're using it compulsively, there are consequences to using the drug, and they continue to use it anyway," says Gary Reisfield, MD. He's a chronic pain and addiction specialist at the University of Florida.

Tolerance and dependence are not the same as addiction.

Tolerance is common in people using opioids (such as hydrocodone, oxycodone, and morphine) for chronic pain. It means the body has become used to the drug, and it has less effect at a given dose, Reisfield says.

Dependence means that there are unpleasant withdrawal symptoms if a person abruptly stops taking a drug.

People who aren't addicted can develop drug tolerance or dependence. And both can be absent in people who are addicted to certain drugs.

Potential for Addiction

Opioid pain medications are some of the most commonly abused prescription drugs. However, the risk that well-screened people will become addicted to opioid drugs when they're taking them for chronic pain is actually low, Reisfield says.

A 2008 study that compiled previous research found that about 3% of people with chronic non-cancer pain using opioid drugs abused them or became addicted. The risk was less than 1% in people who had never abused drugs or been addicted.

Other common drugs with the potential for addiction are benzodiazepines, especially when they're prescribed along with opioids, Reisfield tells WebMD. Some benzodiazepines include Ativan, Klonopin, Valium, and Xanax.?

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