Addiction, Tolerance and Other Nasty Wives Tales

July 11, 2002

Many people that live with chronic pain are afraid to take narcotic pain

medicine because they don't want to become addicted to it. They have also

been told that they will develop tolerance to narcotic medicines and need

more and more and more of it to achieve pain control. These beliefs are

wives tales that can actually cost the pain sufferer a great deal in terms

of quality of life and controlling pain in the body.

Less than 1% of the people that take narcotic pain relievers become addicted

to the medicine. This is due in part to the fact that people with legitimate

pain do not get that " high " feeling when they take these drugs. The medicine

is metabolized differently and goes directly to the pain. The person may get

tired but they do not get high. Therefore there is no " reward " for taking

the medicine for any reason other than keeping the pain at bay.

Opiates are not highly dangerous or destructive drugs. In general they are

safer than many over the counter medications that we use every day.

Anti-inflammatory medications such as Aspirin, Naproxin, even Vioxx can be

hard on the stomach.

Another important consideration when evaluating pain medications is to

remember the longer the pain is untreated or under-treated the more likely

the pain will cause destructive and permanent changes in the nervous system

of the person experiencing the pain. Taking the heroic position is not only

not necessary, it is also dangerous to your body.

Tolerance is another misunderstood myth. Taking narcotic medicine can

produce a type of tolerance but the truth is most often what looks like

tolerance is actually an increase in the pain rather than a decrease in the

effectivenes of the medication. Morphine has no dose " ceiling. " It can be

increased in small increments to relieve pain with no fear of overdose or

loss of effectiveness. Another approach is to switch to another opiate for a

short time to give the body a " holiday. " Once the body has time to rest from

the medication then switched back it will be effective once again.

Opiates have been used for pain relief for centuries. They are the most

effective medications doctors have in treating pain and when handled

properly they are safe. Perhaps some day science will come up with something

better, but today narcotics can be our best friend.

Pat Oreilly, 2001

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