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Prescription painkillers:
A double-edged sword

Ever break a leg? Have surgery? Hurt your back?

Easing the pain that follows helps you heal better and feel happier all-around. Keep in mind, though, that as choices for strong prescription pain relief have expanded in recent years, unexpected dangers have multiplied, too.

That’s because the potent painkillers called opioids can be unintentionally addictive, particularly if used improperly. A few examples of these prescription drugs are the short-acting Vicodin (hydrocodone), Percoset (oxycodone), Tylenol with Codeine and the long-acting OxyContin (oxycodone) and fentynal.

In the 2010 National Survey of Drug Use and Health, a startling one in twenty Americans 12 and older reported having misused such painkillers. The steadily rising tide of prescription drug abuse has many serious consequences, warn experts at the Centers for Disease Control and Prevention (CDC). Accidental overdoses of prescription pain relievers have more than tripled in the past decade, killing more Americans than heroin and cocaine combined. And for every deadly overdose, nine people enter treatment for substance abuse, 35 wind up in the emergency room and 161 report drug abuse or dependence.

Healthy strategies for easing pain

“Our goal as physicians is to strike the right balance of pain relief. We want to prescribe wisely without undertreating or overtreating pain,” said Dr. Jan Cook, medical director of Blue Cross Blue Shield of Massachusetts. “Often, a mix of healthy strategies is the best way to ease pain.”

To find the right mix, your doctor should work with you to:

  • Assess addiction risk. An honest risk assessment for addiction helps you and your doctor make the safest, most effective choices for medication. Your doctor will ask about family history and personal experiences with drugs, alcohol, sexual abuse and mental health issues that may influence addiction.

  • Prescribe the right level of pain relief. Long-acting drugs like OxyContin aren’t the right choice for pain that will be short-lived (after surgery, for example). And even a short-acting, strong painkiller like Tylenol with Codeine isn’t needed if Tylenol alone will suffice. No matter what medication is prescribed, your doctor will recommend the lowest dose that eases your pain. That lessens risk for unpleasant side effects.

  • Explain the emotional side. Fear of pain worsens your perception of it. Stress and loneliness may also make pain feel worse. Stay ahead of pain by taking medications on a schedule before it escalates. Try coping skills that help you relax and stay connected (see below).

  • Make sure you understand the plan. Ask your doctor these questions: How long is the pain likely to last? If medication is prescribed, when should I take it? For how many days? What can I do if the pain isn’t well controlled? When should I step down to a lower level of pain relief? When should I stop taking pain medication?

  • Look beyond medications. Drugs are not the only way to manage pain. Ask your doctor what else might help for your situation. Icing injuries offers good temporary relief. Lower back pain often responds to regular, gentle exercise. Warm showers, water aerobics or limbering up with tai chi, yoga or stretches may be part of a plan to ease arthritis pain. Acupuncture and biofeedback may alleviate pain from various sources. Awareness helps, too. Ask yourself when your pain is worse — in the morning? In the middle of the night? When you’re alone? After certain activities? — And when it’s better. This can help you and your doctor devise ways to handle it.

Build up coping skills

How do you cope with pain? Many people try to numb it with alcohol or drugs. Some overeat. Unfortunately, strategies like these create additional problems. Set a safer course for yourself and be a better role model for children by trying healthier coping skills, such as these:

Ask for help. Unhealthy behaviors like substance abuse or overeating are hard to stop on your own. Gain support through groups like Alcoholics Anonymous, Narcotics Anonymous or Overeaters Anonymous. Group or individual psychotherapy can provide much-needed emotional and psychological support and strategies to help you handle chronic pain. Ask your doctor about these options.

Support your body. Try to get enough sleep and eat a healthy diet.

Reach out. Family, friends and support groups (online or in-person) can help you feel cared for and connected. Let people know how to help you.

Stay engaged. Try not to let pain block out the world around you. New interests provide a healthy distraction and may expand your circle of friends, too.

Be active. Gentle exercise eases stress, back pain and arthritis pain. Walking, swimming and tai chi are good examples.

Relax. Breathe slowly and deeply through your nose, counting up to four as you inhale, and then down from four as you exhale. Do for three to five minutes or longer. Or try tensing and releasing muscles of your body, starting at your toes and moving section by section toward your face. Yoga, tai chi, visualization and meditation are excellent for relaxation, too.