My doctor prescribed pain medication for my osteoarthritis but I am afraid to take it--aren’t a lot of pain medications addictive?

Martha Twaddle, MD, responds:

Pain can and should always be treated. When pain and symptoms are managed, the condition causing the pain can be coped with more effectively. Patients experiencing acute pain after surgery, for example, heal faster when their pain is controlled. It is difficult for the mind or the body to concentrate on healing itself if pain interferes with sleeping, eating or overall comfort levels. Living with prolonged chronic pain can have an enormous impact on quality of life, ranging from feelings of irritability to affecting relationships with the people who matter most.

Yet the fear of addiction, fueled by media reports of drug abuse on the streets, prevents many patients from getting the pain control they need. Patients suffering from both acute and chronic pain often don’t seek help for their symptoms or fail to take prescribed pain medication because they fear addiction. World Health Organization statistics show that patients who are in pain and take pain medication appropriately rarely become addicts.

While it is unfortunate that some of the most ground-breaking and effective pain medications also have been misused by addicts, it is important to differentiate between the use of prescription medications to control pain and drug abuse. Drug addicts take pain medication because they are addicts, not because they are in pain or suffering from chronic health conditions. Someone dealing with cancer pain is taking pain medication as a treatment for pain—medication that is prescribed and overseen by a physician. Drug addicts abuse drugs, taking them in ways that they are not designed for, with the sole purpose of getting high. A patient suffering from pain associated with severe osteoarthritis is taking pain medication, as directed and at the proper dosage, for the sole purpose of controlling pain and increasing daily activities and quality of life.

Talking to your doctor about your fears can help to allay your fears and expose many of the myths of addiction that surround prescription pain medications and prevent people from seeking the pain control they need. A palliative care specialist might also be able to help with establishing a pain and symptom management program with which you can be comfortable—talk to your doctor to see if a palliative care consultation is right for you.

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