The Truth About Painkillers

Celebrity magazines all too often feature stories about overdose deaths and rehab admissions, and the Office of National Drug Control Policy is running an advertising campaign about the dangers of prescription drug abuse.

But when taken as prescribed, just how risky are drugs like OxyContin and Vicodin?

The truth might surprise you. Myths and misinformation about opioid painkillers are widespread. Here are the facts.

Myth No. 1: Toughing it out is always better than relying on painkillers.

Although Americans pride themselves on their toughness, those who refuse medications despite severe pain may be putting their health— and their jobs and relationships— at risk.

“Uncontrolled pain is associated with adverse consequences in terms of daily functioning, mood, sleep, overall quality of life, energy level, the ability to work and marital relationships,” says Russell Portenoy, chair of Pain Medicine and Palliative Care at Beth Israel Medical Center in New York City.

Adds Dr. Richard Payne, professor of medicine and divinity at Duke University: “Newer studies actually show that persistent pain causes changes in the brain and spinal cord that begets more pain.” Some animal studies suggest that controlling pain could help prevent these problems.

“It’s clearly obvious that people whose pain is controlled effectively following surgery go home earlier, have fewer complications, get out of the hospital faster and recover better,” says Dr. Gavril Pasternak, a neurologist at Memorial Sloan-Kettering Cancer Center in New York City. “On the other hand, do I think every time a child scrapes his knee he needs an opioid? No.”

Myth No. 2: People on opioids are always impaired—and cannot drive safely or work in demanding jobs.

Studies of drivers on steady doses of opioids do not find impairment. In fact, says Portenoy, “At least one study by Finnish researchers showed that impairment on standard driving measures was more correlated with poorly controlled pain than with taking medication for it.”

“What people are concerned most about is judgment and somnolence,” says Pasternak.

“Would I recommend that someone just starting opioids drive? Of course not. But I would give the same advice to someone starting a sleeping pill. Once someone has been on the same dose for a while, they can.”

Adds Payne: “For people on a stable dose, they acclimate or develop tolerance to sedative and mental clouding effects.”