Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

Are Painkillers Safe to Take Long Term?

Monday, 24 Feb 2014 04:19 PM

By Peter Hibberd, M.D.

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Question: I suffer pain all over my body from rheumatoid arthritis, and I only get relief from pain medication (hydrocodone). But I’m worried about becoming addicted and the potential risk to my liver. What else can I do to relieve the pain?

Dr. Hibberd's answer:
 
Hydrocodone is actually a reasonable choice of pain reliever for arthritis and for bone pain, but by itself is not a very good pain reliever. It also is a poor choice by itself for long-term pain management. Bone pain almost always needs a NSAID medication with the narcotic as a supplement to get reasonable pain relief.

The potential for addiction is present, and the overuse of Tylenol used in combination with hydrocodone products that already contain hydrocodone does increase your risk of liver injury and toxicity. Arthritic pain responds well to anti-inflammatories and other agents are now usual to induce remission of rheumatoid arthritis.
 
Unfortunately you have a very destructive form of arthritis, and pain relief often does require a narcotic supplementation with hydrocodone and similar drugs just to keep you comfortable. So, discuss this with your doctor. You might benefit from specialty consultation with a rheumatologist if you have not done so already, and a pain management consolation may be in order if you are narcotic dependent for pain control.
 
Rest assured that addiction is not the same as tolerance. You may become tolerant to narcotics when used in the long term, but addiction only occurs when a patient starts taking ever-higher doses without a doctor's supervision.

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