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By Eve Glicksman, Staff Writer, myOptumHealth

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Your back is killing you. Over-the-counter pain relievers aren't helping. Your doctor wants to prescribe a stronger drug, but you're not sure. Aren't painkillers addictive?

It's true that addiction to prescription painkillers is on the rise. Yet, most problems occur when someone takes them for nonmedical reasons. Abuse of pain relievers like Vicodin and OxyContin is a growing problem among teens. When taken as directed, though, addiction is uncommon.

People with a history of substance abuse - or whose relatives have had substance abuse problems - need to be more careful. Their risk of addiction is higher, as is the risk for people who are depressed, anxious or lonely. If you are in one of these high-risk groups, ask your doctor for a painkiller that is less likely to be addictive. Your doctor can also monitor you more closely.

How do painkillers work?
Pain relief medicines (opiates) block receptors in your brain and spinal cord that cause you to feel pain. The most popular opioids and a few of their brand names are:

• Hydrocodone (Vicodin, Lortab)
• Oxycodone (OxyContin, Percocet, Percodan)

Other common opiates - also called narcotics - are Darvon, Demerol and Dilaudid. Medications with codeine and morphine are in the opioid family, too.

Besides relieving pain, opiates affect the part of the brain that perceives pleasure. That's why these drugs can be addictive. If you crush, snort, chew or inject OxyContin, for instance, you destroy the time-release feature. The intense rush of medicine can produce a "high" ... and also cause severe breathing problems and death.

Rejecting pain medication when you really need it can lead to other problems, though. Enduring extreme pain can cause fatigue and high blood pressure. It can lower immunity to disease, slow your recovery from illness and lead to disability and depression.

Related link: Controlling Cancer Pain 

Using prescription pain meds safely
Taken as directed by your doctor, even long-term use of painkillers is unlikely to cause addiction. Your body may become tolerant of a drug and you may need a higher dose to get the same relief. This is normal, though, and not the same as addiction.

Likewise, don't just stop taking painkillers when you feel better. Because your body is used to the drug, you may get unpleasant withdrawal symptoms. Your doctor can help you get off the medication slowly and safely.

In addition:

• Consult your doctor if your pain reliever stops working. Don't increase the dose - or take it more often - on your own.
• Follow usage instructions. Do not chew, break or crush tablets before swallowing.
• If you forget to take a dose and it is almost time for the next pill, skip the missed one. Never take a double dose.
• Don't use someone else's prescription.
• Always have your medicine prescribed by the same doctor.
• Don't take pain medicine to dull anxiety, stress or depression.
• Don't use opiates if drinking alcohol or taking other drugs that depress the nervous system (such as sleeping pills or antianxiety drugs). The mix is very dangerous.

Addiction means that you are unable to stop using a medication, even when you want to. Pay attention if family or friends express concern that you are becoming dependent on a drug. If you think you might have a problem, talk to your doctor at once. Addiction is much easier to treat at an early stage.

Related link: Managing Arthritis Pain