Back Pain and Drug Addiction

Back pain is a common condition affecting a majority of Americans. According to the University of Maryland Medical Center, around 60 – 80% of American adults suffer from lower back pain, and the condition is the second most common reason for visiting the doctor. It is also the leading cause of disability in people under the age of 45.

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american adults and back pain statistic
When you’re suffering from chronic back pain, it can severely affect your quality of life. It’s likely you will have tried everything imaginable to keep your back pain at bay, but you may have found that painkilling gels, pain patches and over-the-counter medications can only do so much to relieve your pain.

Taking prescription painkillers for back pain is perhaps the one thing you have found that provides relief. However, prescription-strength painkillers can and do cause addiction. Of course, no one wants to rely on drugs like opioid painkillers to alleviate their pain, as they come with this risk of addiction. On the other hand, when you’re suffering from debilitating and severe back pain, you need to get help.

So what can you do if you’re one of the many people who suffer from excruciating back pain on a daily basis? Are the benefits of taking prescribed painkillers enough to outweigh the risks?

What Causes Back Pain?

There are numerous causes of back pain. As your lower back is subject to a great deal of mechanical strain and stress, pain in this area is common. Similarly, overuse, poor posture and injury are some of the culprits of upper back pain.

Some causes of longer-term back pain include:

  • Disc tear
  • Herniated/degenerative discs
  • Vertebral fractures resulting from osteoporosis
  • Spondylolisthesis — where a vertebra moves more than it should and slides on top of another, resulting in pressure on the spinal nerves
  • Scoliosis — abnormal curvature of the spine
  • Spinal stenosis — a narrowing of the spine space around the spinal cord. It is typically caused by bone spurs related to osteoarthritis and creates pressure on the nerves.

Extent of the Prescription Drug Problem

Prescription drug addiction is a huge problem in the United States today, and the issues of addiction, overdose and even deaths associated with using and abusing painkillers are commonplace. Opioid narcotics are used in the treatment of pain, including back pain, and with more and more people receiving prescriptions for these, the number of people abusing the drugs has grown.

opioid related ER visits

According to NYC Health and Hospitals, between the years of 2004 and 2010, opioid painkiller-related ER visits almost tripled in New York. This alarming statistic echoes what is happening all over America today.

Published in the Annals of Internal Medicine in 2007, the authors of a study of the use of opioid medications for treating chronic back pain found that although these painkillers may only be effective for up to four months, current or lifetime abuse of the drugs can be more than 50 percent.

Types of Prescription Drugs for Back Pain Relief

With back pain being such a huge health issue for people living in the United States today, it is no wonder that so many people are being prescribed pain medications for the issue.

If you’re suffering from chronic back pain and just can’t get any relief, there are various medications your doctor may prescribe for you depending on the severity of your symptoms, how long you’ve been suffering and the exact location of your pain. These include anti-inflammatory medications, muscle relaxants, corticosteroids and yes, opioids.


When you initially begin to suffer from back pain, it’s likely you’ll buy an over-the counter nonsteroidal anti-inflammatory drug (NSAID), for example, naproxen or ibuprofen. As these are considered to be mild painkillers, they are often your initial go-to painkilling option. Tylenol is another common over-the-counter painkiller that is often used to treat back pain, although it isn’t an NSAID.

You may also be prescribed an NSAID, the most common prescription-only drugs in this category are:

  • Diclofenac (Voltaren)
  • Celecoxib (Celebrex)
  • Nabumetone (Relafen)
  • Meloxicam (Mobic)

nsaids organ damage

Although these medications are mild pain relievers, they still have side effects you have to watch out for. Taken at high doses and over a prolonged period, NSAIDs can give you ulcers, gastrointestinal bleeding and even kidney damage. Acetaminophen can also adversely affect your liver, particularly when exceeding the recommended dosage.

Anti-inflammatory topical creams are available as well, and they can be applied directly to your back. Although these also have the potential for side effects, they don’t affect your entire body. You can also use creams that contain natural painkilling ingredients, such as menthol or eucalyptus oil.

Muscle Relaxants

If NSAIDs and over-the-counter drugs aren’t providing you with back pain relief, your doctor may prescribe a muscle relaxant to relieve the spasms that are causing your pain. These muscle relaxants include:

  • Carisoprodol (Soma)
  • Cyclobenzaprine (Flexeril)
  • Tizanidine (Zanaflex)
  • Baclofen (Lioresal)

Muscle relaxants are useful for acute injuries in particular, but many of these drugs have sedative side effects.


Similar to anti-inflammatories, corticosteroids alleviate both back pain and inflammation and are either taken orally or via an injection directly into your back. If taken early enough, corticosteroids can calm inflammation in the back before it has the chance to become chronic.

Anti-Seizure and Antidepressant Medications

If your back pain is caused by nerve problems, your physician may prescribe anti-seizure or antidepressant medications that can alleviate your pain.

Unfortunately, these drugs come with a list of potential side effects, that include:

  • Fatigue
  • Headaches
  • Constipation
  • Nausea
  • Diarrhea
  • Insomnia
  • Sexual side effects


If you’ve tried NSAIDs and muscle relaxants and are still in considerable pain, your physician may prescribe opioids as a treatment option. If you’re suffering from long-term chronic back pain, often as a result of surgery, you may be given narcotic or opioid medications.

opioids work on brains pain receptors

Opioids work on the brain’s pain receptors and nerve cells to alleviate pain, and most people begin with the milder types, such as Tylenol with codeine or Vicodin (hydrocodone and acetaminophen).

Common side effects of prescription opioids include:

  • Constipation
  • Drowsiness
  • Sedation
  • Itching
  • Hives
  • Risk of dependency and addiction

Who Is at Risk of Being Addicted to Opioids for Back Pain?

If you are taking opioid painkillers, it doesn’t necessarily mean you will consequently suffer from an addiction for medication to back pain.

If your back pain is chronic and severe and you have been prescribed an opioid medication, you will generally only take it for a limited amount of time — such as a few weeks to a month. This method of prescribing will limit your chances of becoming addicted.

opioid addiction risk

However, if you have been taking your opioid painkillers for a longer period of time, the addiction potential increases. Your risk for addiction to opioids also increases if you’re in a high risk group, such as having a past history of drug addiction or having a family member who has a past history of drug addiction.
If you’re worried about becoming addicted to your prescription drugs for back pain, there are a few factors that can increase your risk. These are:

  • A personal history of substance abuse.
  • A family history of substance abuse.
  • Emotional/psychiatric problems.
  • Coping with a high degree of stress.
  • Long-term use of the painkilling drugs.
  • Mixing drugs — such as taking opioid painkillers and sleeping pills together.
  • Your physical reaction to the drug itself — you’re less likely to become addicted to a drug if it makes you feel unwell or nauseous, than if it gives you a “high.”

If you are at all concerned about your relationship with prescription painkillers, seek help as soon as you can.

The Effects of Being Addicted to Prescription Drugs for Back Pain

The effects of being addicted to prescription drugs can be devastating for both you and your loved ones. What is particularly worrying is that an addiction can creep up on you, and before you know it, you’re in its grip.

If you have noticed that you or a loved one is exhibiting any of the following behaviors, then it could be time to seek help:

  • Calling for prescription refills early.
  • Taking medications that are not prescribed for you/them.
  • Taking medication when they aren’t actually in pain.

Addiction is a disease of denial. It can make you act completely out-of-character and take risks you wouldn’t normally dream of. In addition, it’s often difficult to ask for help, as there is a great deal of stigma attached to the subject of drug addiction.

Can Prescription Opioid Addiction Lead to Heroin Addiction?

It’s well-known that marijuana is often referred to as a “gateway drug.” That is, it can be the starting point to other types of drug abuse. What is less well-known, however, is that prescription opioid addiction can be a gateway to becoming addicted to heroin.

opioids and heroin correllation

Studies have shown that if you’re abusing prescription opioid painkillers, you can become addicted to heroin. Once you’ve been using your opioid painkillers for a while and are instructed by your doctor to discontinue their use, you may have developed such an addiction that you feel compelled to seek out illicit drugs.

Your prescription opioids work on the exact same areas of the brain as heroin. Because they are very addictive, there is a real risk that once your medication is taken away, you could begin using heroin in its place.

When you’re addicted, trying to withdraw from prescription opioids or heroin is very difficult, and you will experience symptoms such as:

  • Insomnia
  • Diarrhea
  • Restlessness
  • Bone and muscle pain
  • Vomiting
  • Cold flashes accompanied by goose bumps
  • Involuntary leg movements

For some people trying to quit by themselves, buying heroin could seem like the easier option.

Alternatives to Prescription Drugs for Dealing With Back Pain

If you’re struggling with back pain and worried about the effects of taking prescription drugs, or if you are addicted to opioids you’ve been using to manage your back pain, you might be concerned that if you quit taking opioids, you’ll be unable to get back pain relief.

Fortunately, there are alternatives to prescription drugs for dealing with back pain. Any one of these treatments may help you begin to lead an active and pain-free life again:

acupuncture to relieve back pain

  • Acupuncture. Through inserting thin needles into specific points of your body, acupuncture is intended to relieve pain, including back pain. When successful, its results can be realized as quickly as after your first session, and relief can last for a few hours to a few weeks.This method of treatment is particularly helpful if you are suffering from nerve-related pain or if you’re experiencing muscle spasms.To find a good qualified acupuncturist, ask friends or family members for recommendations or ask your doctor to refer you.
  • Massage. An excellent therapy for relieving muscle-tightness, massage can soothe your back pain, work out muscle spasms in your back, and enable you to function better. It may even allow you to cut down on any medication you might need.To reap the full benefits of massage, it’s important to have regular, targeted sessions.

exercise release back disk pressure

  • Exercise. Leading an active lifestyle and exercising releases pressure on the disks in your back. Try to begin gently by walking regularly or practicing Tai Chi.
  • Pilates and Yoga. As both these activities combine strength and stretching exercises, they can help to alleviate your back pain. Yoga can reduce tension and stress in your back muscles, and Pilates can help strengthen the back, side and front muscles that are associated with supporting your spine. Try to work a few 10 minute bursts of Pilates or yoga into your daily routine to feel the benefits.
  • Chiropractor. Among individuals who seek alternatives for back pain relief, the majority choose chiropractic care. A chiropractor can treat your back pain with a spinal manipulation or adjustment to properly align the musculoskeletal structure of your body.Many chiropractors add other therapies to spinal adjustments, including physical therapy and exercise. Often, people feel the effects of their sessions immediately, and they continue to reap the benefits for weeks or even months afterwards.
  • Herbal remedies. Many back pain sufferers swear by herbal remedies for their painkilling effects. Preparations such as capsaicin cream (a form of cayenne pepper) are thought to block pain signals from reaching your brain.Another popular herbal remedy is white willow extract, which has similar properties to aspirin. To find out more about how herbal remedies may improve your back pain symptoms, it’s worth visiting an herbalist for a consultation.
  • Biofeedback and Relaxation. You usually engage in biofeedback at a therapist or doctor’s office. Using specially-designed equipment that provides information on the physical reactions of your body, you are taught how to control and monitor both your pulse and your breathing to help you relax and ease your pain.

meditation reduces sensation of pain

Other treatments for back pain include meditation, which helps you utilize the power of your mind to reduce the sensation of pain, and progressive relaxation, where you tighten and relax various muscles.

How to Deal With Back Pain

In addition to your physical health, suffering from chronic back pain can significantly impact your mental health as well. It is common to feel anger, frustration, anxiety and even depression when you’re constantly in pain. You may also feel cut off from your family and friends as you can no longer manage to take part in the activities you used to enjoy before you started to experience back pain.

If your pain is beginning to get you down:

  • Speak with your doctor about what can be done to help support you.
  • Don’t be afraid to reach out to friends and family if you need a helping hand with daily tasks.
  • Speak with your manager at work about your condition. See what steps they can take to help you manage your work more effectively and reduce the stress on your back.

Ensure You Have Emotional Support to Cope With Pain

emotional support to cope with pain

No one likes to ask for help, but when you need it, your family and friends will step up to the plate. In fact, they can play a very important role in your recovery, so don’t be afraid to ask for assistance.

What they can do:

  • Friends. We all need to build strong bonds with others for our emotional well-being, and helping each other is a huge part of being a friend. Just knowing you have someone there to support you practically and emotionally can make a huge difference to how you feel inside.
  • Family. Your family can provide you with encouragement on your down days and with invaluable support when you need it. They can also attend appointments with you.
  • Support Groups. If you don’t have close friends or family, attending a pain support group is an excellent option. You’ll meet other people who are going through the same or similar pain you are.

Treatment for Back Pain and Drug Addiction

If you’re suffering from chronic pain alongside an addiction, you have two distinct clinical conditions, or a dual diagnosis, and both conditions must be treated to get you well again.

Here at 12 Keys Rehab, we take a multi-disciplinary approach to tackling your back pain and drug addiction, as chronic pain and addiction are both persistent conditions that require long-term treatment. We focus on real and holistic recovery, treating you with a combination of therapies to ensure every aspect of your body, mind and spirit is completely cared for.

Everyone is different, so we gather information via observation, self-disclosure and your family and friends. This enables us to formulate the best tailored treatment plan to help you beat your addiction.

Our 12 Keys Model of Treatment treats you holistically, and your recovery process is administered by our fully trained and qualified staff, many of whom have conquered addictions themselves.

We have a very low client to therapist ratio, so we have the time and manpower to fully devote to treating and helping every aspect of your mind, body and spirit concurrently. In addition to this, there will always be someone on hand to talk to you, whenever you need extra support — be it day or night. You will also meet many people who are going through the struggles you are facing currently.

It can be very difficult to stop using painkillers when you are suffering from back pain drug addiction. We will offer you a full evaluation, as well as comprehensive, holistic treatment to ensure you can detox in the gentlest way possible.

At 12 Keys Rehab, you’ll learn a number of ways to live your life drug-free. These include:

  • Participating in cognitive-behavioral therapy (CBT) and other therapies, to learn skills for recovering from substance abuse and for managing your pain.
  • Learning how to truly relax.
  • Participating in regular gentle exercise to help release those feel-good chemicals in the body.
  • Working with our fully-qualified staff to explore your substance use and to move forward in your recovery.
  • Identifying a sponsor to support you on your journey through recovery and beyond.
  • Engaging in pleasurable and fun activities that help you enjoy life and take your focus away from your pain.
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We understand that living with chronic back pain and addiction is difficult. As such, we provide you with all the necessary tools and strategies to get sober and enjoy living a clean and healthy life again. Contact 12 Keys Rehab if you or your loved one is struggling with drug addiction.

The Addiction Blog