Narcotics for Back Pain - Limited Use, Serious Problems

At some time in their lives many people will experience back pain. For some it's nothing more than a few twinges. For others it's a major strain that occurs every few months - or years - but then eases up and fades away. But some people live with this pain every day of their lives. It can be severe enough to be disabling.

Many physicians recommend some type of medication for the treatment of chronic back pain. When the pain is severe some doctors automatically prescribe narcotics like Vicodin, Oxycontin, Demerol, or morphine. Now, a new review of more than 2,000 studies has shown that these drugs may create more problems than they solve.

These narcotics, which are called opioids because of their resemblance to the drugs made from the opium poppy, work by changing the way pain messages are interpreted by the brain. The messages are still there; it's just that the person doesn't perceive pain the same way. It's similar to the joke that people make about being "too drunk to care" about something.

Opioids are strong medicine. They can be very effective, but those effects can depend on individual factors like the patient's emotional state and whether they're combined with other medications or alcohol.

Opioids can also have serious side effects. These include dizziness, drowsiness (these are the drugs whose prescriptions come with warnings not to drive while taking them), depressed breathing, and even seizures. But the most dangerous problem may be that people build up a tolerance to them, requiring larger and larger doses to get the same effect. Add to this the problem of withdrawal (restlessness, insomnia, mood swings, and worse) when the drug wears off, and there's a huge risk of addiction.

The most recent research, conducted at the Yale University School of Medicine, was a review of many previous studies of the use of opioids for chronic back pain. The review showed that these drugs may be good for a short time, when the pain is severe and the person can't function without medication. But none of the studies reviewed lasted longer than four months, which doesn't give any indication of how useful these drugs would be for people who have back pain all the time.

Also, almost a quarter of the cases identified behavior that could be a sign of addiction or abuse - trying to get a prescription refilled before it was due.

The researchers believe that longer study of the use of opioids for chronic back pain is necessary. In the meantime, they recommend that physicians trying to treat patients with chronic back pain consider less risky alternatives first. These alternatives might include the following:
- non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin) and naproxen (Aleve)
- acupuncture
- physical and other body therapies
- electrical stimulation
- tricyclic antidepressants for people whose pain is affecting their outlook on life

Back pain may be common, and it may be chronic, but it doesn't have to be disabling. If you experience this kind of pain on a regular basis talk to your doctor. There are things you can do to ease the pain you have now and avoid it in the future without compromising your mental status as well.