1. Slideshow: Surprising Reasons You're in Pain
2. Take the Pain Quiz!
3. Slideshow: Good and Bad Exercises for Low Back Pain

Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Author:

Standiford Helm Ii, MD

Standiford Helm Ii, MD

Dr. Helm has been practicing interventional pain management since 1982. Dr. Helm is a diplomate of the American Board of Anesthesiology with subspecialty certification in Pain Medicine and of the American Board of Pain Medicine. Dr. Helm is a Fellow of Interventional Pain Practice (FIPP), the only certifying agency which tests the ability to perform interventional pain procedures. Dr. Helm is also an examiner for FIPP.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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A major concern with the prescribing of opioids is to ensure that they are used to treat pain and not abused for the euphoric effect that some people get when they take them. The Federal government demands that physicians who prescribe opioids do so for a legitimate medical purpose and they do not prescribe for either abuse or diversion. Every State Medical Board expands upon these prescribing requirements. For example, physicians should do a physical exam on every patient for whom medication is prescribed, making the Internet prescribing of medications illegal. These issues are of particular concern in that the largest area of growth in drug abuse is the use of prescription medications rather than street drugs.

Many patients are concerned about addiction. Addiction is a confusing word, in that it has two meanings: physical addiction and psychological addiction.

Physical addition means that the body is used to having the narcotics on board. Abruptly stopping the medication can lead to withdrawal symptoms such as:

• flu-like symptoms,
• nausea,
• vomiting,
• diarrhea,
• bone aches,
• feeling like you are "crawling out of your skin,"
• goose bumps,
• chills,
• tremor, and
• difficulty sleeping.

These symptoms are all medical concerns and should be treated medically. Do not stop taking opioids unless under the direction of a physician.

Psychological addiction refers to craving for the narcotics, where the focal point of one's life is getting the opioids. Some people's brains are hardwired to crave narcotics. This drive is difficult to control and requires specific medical treatment. Patients suffering from psychological addiction are not good candidates for narcotic therapy to treat pain.

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