I asked my doctor about using a stronger pain killer for my chronic low back pain. She is concerned I might become addicted and wants to stick with my current drug. But it's not really working. I can't help but wonder if narcotic drugs used for pain control are so addictive, how do so many other people seem to get them?

It is an irony in this country that people are buying and selling prescription drugs on the streets. At the same time, patients with real medical problems can't get the same drug for a legitimate purpose.

There are actually many methods used to obtain prescription medications illicitly. Some people steal prescription pads while in the doctor's office and forge their own. Others change the way the drug is administered. For example, instead of swallowing the pill, they crush it up and snort, smoke, or inject it.

Stealing or borrowing from others, such as family and friends is not uncommon. Pretending to lose a prescription or demanding more drug works for some patients.

People with a long history of drug and other alcohol use and abuse are really the ones at greatest risk for addiction. Casual users of narcotic medications without a medical need can also lead to addiction.

Doctors are rightly concerned about avoiding drug addiction for their patients. But with careful management and close follow-up, chronic pain patients can benefit from narcotics without concern about misuse and abuse.

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