Can I Ask My Doctor for Stronger Painkillers?

How to Get the Right Painkillers From Your Doctor

A bottle of painkiller medication.
A bottle of painkiller medication.. Andrew Brookes/Getty Images

Can you ask your doctor for stronger painkillers if you need them? Absolutely.

Chronic pain, most simply defined, is pain that continues when it should not. One of the key components of managing chronic pain is finding the right painkiller. When you have acute pain, medications can be adjusted based on the type of pain you have. However, in chronic pain this is often a challenge.

According to the American Chronic Pain Association (ACPA), partial relief of symptoms - not full relief - is the most realistic goal.

Even opioids can't kill all your pain. They reduce pain by about 30 percent, on average. Knowing this can help you manage your expectations for your medications, and help guide you in seeking (or not seeking) stronger drugs for your pain.

Do you need stronger painkillers? You might, if you can answer “yes” to any of the following:

  • Do you frequently have breakthrough pain?
  • Is your current medication becoming less effective at controlling your pain?
  • Is your daily routine getting harder?
  • Is your quality of life decreasing?

Know Your Painkilling Options

Before you ask for stronger meds, you might want to learn about the options. Four classes of medications are used to treat chronic pain:

Non-opioids. These include aspirin, NSAIDs and acetaminophen.

Opioids. Also referred to as narcotics, these include morphine, codeine, hydrocodone, oxycodone and methadone. The medication Tramadol works on the opioid receptors, although it is not an opioid.

Adjuvant analgesics. These drugs were originally used to treat other conditions, but they're now sometimes also used in pain relief. Examples include certain antidepressants and anticonvulsants.

Other: Other meds that don't directly relieve pain, such as drugs to ease insomnia, anxiety, depression and muscle spasms, may be part of your pain management regiment.

Will I Look Like an Addict If I Ask My Doctor for Stronger Painkillers?

While it's true that opioid painkillers are one of the most commonly abused prescription drugs, asking for them does not necessarily target you as an addict.

Many people with chronic pain conditions simply cannot manage their pain with other types of medications. The attitudes toward the role of opioids in pain management are also changing. Studies show that with careful monitoring, addiction and abuse are not usually issues for people with legitimate chronic pain conditions.

Most physicians will consider the benefits of a stronger painkiller versus the potential risks. Stronger painkillers like opioids carry a higher risk of tolerance and abuse, but if they could possibly increase your quality of life they may be worth a try.

According to the ACPA: "...there are risks associated with almost any treatment for chronic pain. The best approach is for people with pain to ask questions about the benefits and risks or side effects when they are about to embark on any particular treatment approach or new medication. Does the risk justify the possible benefit?"

For the best outcomes, your doctor should follow up with your treatment regularly.

Remember: You can also do a trial of stronger painkillers to determine if they are right for you. If you're not happy with them, simply talk to your doctor about tapering them off and trying something else. (Depending on the dose, how long you've been taking them and your health status, going off your meds "cold turkey" could cause withdrawal symptoms, and could even be dangerous.)

If you still have concerns about asking for stronger painkillers, have a look at some of the following articles.

Sources:

APCA Consumer Guide to Pain Medication and Treatment. 2014 Edition. American Chronic Pain Association.

Blake, S., Ruel, B., Seamark, C., et al. Experiences of Patients Requiring Strong Opioid Drugs for Chronic Non-Cancer Pain: a Patient-Initiated Study. British Journal of General Practice. 2007 February 1; 57(535): 101–108.

Chou, R., Fanciullo G.J., Fine, P.G., et al. Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain. The Journal of Pain. February 2009. Volume 10, Issue 2. Pages 113-130.e22.

Hariharan, J., Lamb, G.C, and Neuner, J.M. Long-Term Opioid Contract Use for Chronic Pain Management in Primary Care Practice. A Five Year Experience. Journal of General Internal Medicine. 2007 April; 22(4): 485–490.

National Institute on Drug Abuse. Trends in Prescription Drug Abuse.

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