Question: I suffer pain all over my body from rheumatoid arthritis, and I only get relief from pain medication (hydrocodone). But I’m worried about becoming addicted and the potential risk to my liver. What else can I do to relieve the pain?
Dr. Hibberd's answer:
Hydrocodone is actually a reasonable choice of pain reliever for arthritis and for bone pain, but by itself is not a very good pain reliever. It also is a poor choice by itself for long-term pain management. Bone pain almost always needs a NSAID medication with the narcotic as a supplement to get reasonable pain relief.
The potential for addiction is present, and the overuse of Tylenol used in combination with hydrocodone products that already contain hydrocodone does increase your risk of liver injury and toxicity. Arthritic pain responds well to anti-inflammatories and other agents are now usual to induce remission of rheumatoid arthritis.
Unfortunately you have a very destructive form of arthritis, and pain relief often does require a narcotic supplementation with hydrocodone and similar drugs just to keep you comfortable. So, discuss this with your doctor. You might benefit from specialty consultation with a rheumatologist if you have not done so already, and a pain management consolation may be in order if you are narcotic dependent for pain control.
Rest assured that addiction is not the same as tolerance. You may become tolerant to narcotics when used in the long term, but addiction only occurs when a patient starts taking ever-higher doses without a doctor's supervision.
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