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Pain Management

6 Myths About Painkillers

By Richard W. Rosenquist, MD , Chairman of Pain Management at Cleveland Clinic

When it comes to prescription pain medications, there’s a lot of misinformation out there. Whether you’re searching for information about how they can help you relieve pain or reading the latest tabloid story about a celebrity addict, separating fact from fiction can be tough.

Below, I debunk six common myths about prescription painkillers such as oxycodone and hydrocodone.

MYTH 1: THE MORE YOU TAKE, THE BETTER THEY WORK

More does not equal better. It’s true that in the short term — after a severe injury, for example — two pills may be more effective than one at relieving pain.

But over time, taking too much backfires. Research suggests that pain medications may do something to desensitize the way your brain and spinal cord interpret pain signals.
You develop a tolerance to the medication over time. Sometimes if you take chronic pain medications for a long time, your pain may actually get worse.”

MYTH 2: IF YOU TAKE THEM FOR A VALID REASON, YOU CAN’T GET ADDICTED

It can’t happen to me. I’m a good citizen. I’m a normal person. I couldn’t possibly get addicted.

Thinking this way is dangerous. Even if you start taking a prescription pain medication for a legitimate reason, you run the risk of addiction. It has nothing to do with moral character and everything to do with the highly addictive nature of these drugs.

MYTH 3: EVERYONE WHO TAKES THEM GETS ADDICTED

On the flipside, just because you take a prescription painkiller does not mean you will become addicted.

It depends largely on your own personal risk of addiction. That’s why I, along with others in pain management, screen for risk factors: a family history of addiction, a personal history of alcohol and drug abuse, or certain psychiatric disorders.

If I’m considering prescribing opioids, I’m going to do drug screening and make sure you’re not taking recreational drugs. If somebody uses recreational drugs, the likelihood they’re going to use pain medications inappropriately is really high.

Not everyone gets addicted, but everyone who takes painkillers for an extended time period will experience symptoms of withdrawal when they stop. It’s a natural reaction.

MYTH 4: THERE ARE NO LONG TERM CONSEQUENCES

Addiction is not the only risk that comes with prescription pain medications. When taken for extended periods of time, they also can harm your body’s endocrine system and throw your hormones out of whack, affecting everything from your libido to your risk of osteoporosis.

There are a lot of bad things that can happen, but people don’t always hear you when you describe them.

MYTH 5: YOU SHOULD AVOICE PAINKILLERS ALTOGETHER

As you can tell, there is plenty of scary information about painkillers. However, there are certainly legitimate uses.

In addition to treating the pain from acute injuries, a very small fraction of chronic pain patients see improvements in both pain levels and function from taking pain medications — especially when other pain management techniques fail for them.

For the majority of people, though, prescription pain medications should be a short-term treatment at most.

MYTH 6: PAIN MEDICATION CAN FIX YOUR PAIN

This may be the biggest myth of all. Pain medications simply mask your symptoms. They don’t treat the root cause of your pain. That’s why I focus on how you function rather than just how you feel.

Are you moving better? Are you able to get back to work? These are important questions about function. So is the question of whether you’ve been making efforts to get better. For example, have you been following doctor’s orders and doing physical therapy to recover from an injury? Have you been losing weight if you’re suffering from weight-related back pain?

If you’re not doing the other things you need to do, I’m not going to keep prescribing those drugs. On their own, they’re not therapeutic.

Richard W. Rosenquist, MD, was appointed Chairman of the Department of Pain Management in the Anesthesiology Institute in July 2011. Dr. Rosenquist comes to Cleveland Clinic from the University of Iowa Hospitals and Clinics, where he served as Professor of Anesthesiology and Director of the Pain Medicine Division. This article originally appeared on the HealthHub from Cleveland Clinic.