Studies don’t agree on how many people become addicted when using certain prescription drugs for chronic pain. But they do agree that opioid addiction has reached crisis proportions and that prescribing certain drugs for long-term conditions should be done with great caution to avoid risk of dependency and addiction.

As a result, when opioids are called for, physicians usually prescribe them for limited periods of time to avoid having patients become drug tolerant (requiring more and more medication for the same degree of relief) dependent or addicted. It isn’t just opioids that can lead to dependence and addiction. 

Muscle relaxants such as cyclobenzaprine (Flexeril, Amrix), diazepam (Vicotin) and carisoprodol (Soma), among others, are often prescribed to alleviate the muscle spasm and inflammation that arise from or contribute to pain. Gabapentin is primarily prescribed to relieve neuropathic pain and, while not classified as a controlled substance, long-term use of the drug can cause serious dependence. When used in combination with anti-seizure medications, drug packaging must now warn people of the increased risk of suicidal behavior and ideation. In combination with opioids, there is an increased risk of respiratory failure.

Corticosteroids are widely used to treat chronic muscle pain, sciatica and arthritis. Unfortunately, because they are also powerful immunosuppressants, prolonged use can lead to serious side effects including osteoporosis, higher risk of bacterial and viral infection, and even risk of depression, anxiety and insomnia. 

The healthcare and medical community distinguish between “dependence” and addiction. Dependence is considered a physical state that develops when the body adapts to and becomes accustomed to the presence of a drug. Perhaps the most common example of this is caffeine, where heavy users can develop withdrawal headaches and exhibit restless or anxious behavior. Addiction, on the other hand, is what’s considered a mental state, characterized by compulsive behavior despite negative consequences.

While some of the drugs used for chronic pain are not considered addictive themselves, they can create a negative cycle similar to withdrawal because of the very relief they provide. During “off cycles,” when physicians reduce or cease prescribing medications for a period of time, people in severe pain may use alcohol or dangerous combinations of over-the-counter medications to try to dull the pain. This form of self medication can be costly and dangerous.

What’s more alarming is that rates of addiction from opioid use across all indications is pretty low – around 3.3% overall.  However, among chronic pain users of opioids, a large study of 4.3 million non-cancer chronic pain patients found that nearly 30% show signs of psychologically aberrant, compulsive behaviors indicating misuse or abuse.

This landmark study examined how many people may be impacted, but it did not address exactly why chronic pain patients are more vulnerable. The cause of addiction is widely studied but remains elusive for individuals. People in chronic pain may have rewired brain risk/reward circuits which make them more vulnerable. They may also be at higher risk simply because they tend to be on higher doses of opioids for longer periods of time. In the meantime, pain professionals must be exceedingly careful to avoid doing more harm than good.

Due to these factors, the Veterans Administration healthcare system has moved increasingly toward multi-modal therapies for treating the many Veterans who sustain service-related injuries resulting in chronic pain. Included in the modern pain arsenal are numerous dietary supplements that help with a wide range of pain symptoms.

Nápreva is a dietary supplement made from terpenes that aims to become a part of the pain management regime for people with chronic pain. Studies of beta caryophyllene, one of the key, active ingredients in Nápreva, suggest that it may not only help significantly with chronic pain, but it may have direct impacts on reducing drug dependence and addiction. We aim to find out.

We now have hundreds of customers who have tried Nápreva and, while nothing works for everyone, many have found that it helps with conditions ranging from fibromyalgia to neuropathic pain.

Learn More:

Prevalence of problematic pharmaceutical opioid use in patients with chronic non-cancer pain
https://onlinelibrary.wiley.com/doi/10.1111/add.16616

US Veteran's Administration Whole Health Library: Supplements for Pain
https://www.va.gov/WHOLEHEALTHLIBRARY/tools/supplements-for-pain.asp

About Prescription Opioids
https://www.cdc.gov/overdose-prevention/about/prescription-opioids.html

Our National Crisis
https://time.com/opioid-addiction-epidemic-in-america/