Preventing Prescription Addiction

Press the “on” button on your television remote these days, and chances are you’ll see at least one ad or news segment related to prescription drug misuse and addiction.

Partly spurred by media attention to a real problem, many people who live with chronic pain harbor an unspoken fear – that they will become addicted to the very drugs that allow them to function in their daily lives.

According to the National Academy of Sciences, part of the National Institutes of Health, more than 100 hundred million Americans experience chronic pain from the effects of injuries and diseases including heart disease, diabetes and cancer. To manage the pain and function normally, they are routinely prescribed opiate pain medications, such as morphine and oxycodone, by a physician.  Oxycontin and Percoset are brand names of two of a number of opiates often linked to prescription drug misuse and addiction.

How likely is it that you or someone you care about could develop such an addiction, and how can you prevent addiction to prescription pain killers?

Moises Lustgarten, M.D., medical director of the Baptist Health Neuroscience Center’s Pain Management Program, is an anesthesiologist who has treated hundreds of patients for severe chronic pain.

“There’s inconclusive research on just how many patients, who use opiates for pain management, become addicted,” said Dr. Lustgarten, a Board-certified pain management specialist. But, self-monitoring and regular monitoring by a pain management specialist can help minimize that risk.”

What does a pain management specialist do?

According to the American Society of Regional Anesthesia and Pain Medicine, a pain management specialist is a physician trained specifically to evaluate, diagnose and treat all the different types of pain. Pain management is a complex area, partly because pain is a spectrum of disorders, including chronic pain, acute pain and cancer pain, but can be a combination. Surgery, injury, diabetes and nerve damage can also cause pain.

A doctor who makes an educated guess to assist a patient may not understand the risks of over- or under-medicating a patient, Dr. Lustgarten warned.

“They give patients what they believe is appropriate to manage their pain. It may not be appropriate. When the patient needs more, or asks for a stronger medication, they are sometimes thought to be addicted.”

Dependence vs. Addiction

True addiction, he said, is defined as a chronic brain disease that causes an intense craving, and an inability to abstain consistently, among other symptoms.

According to National Institutes of Health, drug dependence means that a person needs a drug to function normally. If the drug is stopped abruptly, the person will experience withdrawal symptoms. This can happen, even with blood pressure medications, Dr. Lustgarten said. Therefore, a person can have a physical dependence on a substance without being addicted to it. The reverse is also true. Some drugs, including cocaine, can cause addiction without leading to physical dependence.

How can you know whether you are experiencing addiction?

If you see that you are regularly taking more medication than prescribed, see your doctor. Your pain management physician can help you determine whether you need the medication for pain, or if you are experiencing addiction. The goal, said Dr. Lustgarten, is to manage the pain and live life as normally as possible.

“I have many patients who must take pain medications,” he said, “and they lead very functional lives.”