Rush Limbaugh, radio personality, made headlines when he admitted that he was addicted to prescription painkillers. His announcement may have discouraged some people who have chronic pain from getting appropriate treatment, but Limbaugh is not typical.

Addiction is rare when prescription painkillers are used properly. The most powerful class of painkillers-opioids, such as codeine, morphine and oxycodone (Oxycontin)-are potentially addictive, but less than 1% of pain patients ever become addicted.

People who take these drugs can develop a drug tolerance and then require higher doses. If they stop taking the drug, they may experience withdrawal symptoms, such as heightened anxiety and pain, but they rarely exhibit the hallmark signs of addiction.

Warning signs of addiction...

Diminished ability to concentrate.

Diminished ability to concentrate.

Watching the clock until the next dose.

Hiding drug use from your friends and family members.

To prevent addiction, first try to achieve pain relief through nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. If these aren't effective or if they cause stomach bleeding or other side effects...

Ask your doctor about other non-opioid drugs that help pain. Many antidepressants, including amitriptyline (Elavil), are effective at very low doses. The anticonvulsant gabapentin (Neurontin) works for nerve pain. These drugs are not addictive.

Try some pain-relief therapies, such as acupuncture and biofeedback. Nondrug approaches often allow patients to take lower doses of painkillers or even discontinue them.

Helpful: Get treatment at a multidisciplinary center. Specialists at these centers are familiar with a wide variety of therapies. For information, contact the American Pain Foundation at 888-615 -7 246 or online at

If these approaches don't work, a pain specialist may recommend opioid drugs. If you take an opioid...

Limit use. The risk of addiction tends to rise when a patient takes a prescription painkiller for one year of more.

Take a long-lasting drug. Sustained-release opioids such as MS Contin can stay in the bloodstream for 12 hours and are less likely to cause addiction than shorter-acting drugs such as Percocet. Methadone is also long-lasting and a good choice for chronic pain.

Talk to your doctor immediately if you notice any addiction warning signs-especially if you have a personal or family history of alcoholism or addiction

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