Managing pain comes with addiction warning.

Byline: Straight Stuff by By Jerry Gjesvold For The Register-Guard

Everyone experiences physical pain from time to time.

Usually, it's temporary, but in some cases it's chronic. Some have a high tolerance for pain. Others don't. Either way, we definitely know it when it's there. And when we're in pain, we naturally want relief.

While many types of pain are relieved by over-the-counter medications, some call for stronger measures - everything from acupuncture to major surgery. Physicians often prescribe strong painkillers such as OxyContin, Vicodin or other opiates.

In most cases, these powerful drugs are very helpful. Still, it's important to be aware that for some, addiction is a risk.

Because the drugs provide needed relief, it's easy to simply keep taking them whenever any pain occurs.

Most people stop, but others develop a kind of "relationship" with the drug. It becomes associated with sleeping, functioning or carrying on in everyday life with less pain.

As the pain medication becomes embedded in the person's biochemistry, two things happen. The body develops a tolerance for the painkiller, so it takes more and more to provide the same relief. The patient might take a higher dose than prescribed, or start cutting the time between doses.

At the same time, the person may begin to experience irritability, restlessness - even headaches or sweating - between doses. When denied the chemical, the body, in effect, says "Hey! Where's the drug?"

At this point, the person has actually added a new pain - the pain of withdrawal.

As dependency begins to develop, it's surprisingly easy to lose the capacity to think clearly about what we're doing. We can easily persuade ourselves that we need more than we're getting. We might believe that just because the doctor prescribed it, it must be OK. Usually, this is true, but our physicians need to know what's going on with us in detail.

Of course, there are situations in which the risk of addiction is handled in special ways. One is the case of the terminal patient in great pain. There are now specialists in "palliative" care - the humane treatment of pain in someone who is dying. That's a whole different case, and needs to be handled in a different way.

The second is the pain management specialist who assists people in chronic and severe pain. Here, the risk of addiction is considered - and monitored - when creating a long-term, comprehensive treatment plan.

But if you're taking these medications, be aware of some warning signs.

If you are taking pain medications for longer than 60 to 90 days, talk it over with your doctor. The same is true if you run out early, if you become very anxious if you don't have the drug, or if you know exactly when you will run out.

It's also a concern if you get the painkiller from multiple sources - more than one doctor, for example, or your doctor and the emergency room.

To be sure, major painkillers do help - but they're not without risk. Over the years, I can't count the number of times I've heard this statement from people in detox at Serenity Lane: `I had no idea this stuff was as addictive as it is!'

If we don't pay attention, we can get in trouble. We'll miss what the drug is doing to us rather than what it's doing for us.

The opinions expressed in this column are those of the writer. As Serenity Lane's statewide coordinator of employer services, Jerry Gjesvold helps companies across Oregon create and manage their drug-free workplace policies and programs. More information is available on the Serenity Lane Web site at www.serenitylane.org.