Significant Portion Of ESRD Patients Suffer Severe Pain: How To Control Without Fear Of Addiction

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Pain remains a significant problem in patients with End-Stage Renal Disease (ESRD). There is growing evidence that more than 50% of dialysis patients believe that pain negatively impacts the quality of their lives in a significant way. The potential sources of that pain are numerous and varied, including such things as diabetic neuropathy, vascular access and other surgeries, and degenerative joint disease. There are solutions to the pain problem and your Nephrologist may prescribe pain medication for you.  

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Doctors are typically very careful when prescribing painkillers, but still 7% of patients who are given this type prescription will become addicted. A study on "how dialysis patients cope with pain" found that 36%  reported that they had taken more pain medication than their Physician had instructed them to use. Two further questions investigated the possible abuse of these medications. When asked if their family or friends ever told them that they used too much pain medication, 15% stated "Yes" and 33% reported that they had used their medication for other purposes such as to aid them in sleeping.

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For this reason some people do not want to use pain medicines at all because they are afraid of becoming addicted. However, poorly controlled pain can lead to a different set of problems including a diminished quality of life, mood changes, depression and even suicide. The best thing to do is to be strict and always follow prescribed medication instructions carefully. Before leaving your clinic or hospital, make sure you understand everything written in the prescription and follow exactly what the doctor tells you to do.

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Overuse of painkillers can become a physical disease because the medicine can cause nerve cells in the brain to stop producing endorphins (the body's natural painkillers). Your nerve cell degeneration causes a physical dependency on pain relievers and by reducing or not taking the pain killers you can experience painful physical withdrawals. Thus, if you have been prescribed pain relief medicine or anticipate having to take painkillers in the future, it is best to take all necessary precautions to avoid getting hooked.

  • Do not increase the dosage of the drug without consulting your doctor. If you feel that your painkiller is not as effective as it should be, always ask your doctor first to increase dosage.
  • Taking it too short of a time might not be enough to ease away all the pain caused by your injury. Follow what the doctor prescribes and do not stop taking the medication on your own.
  • Prescription drugs are usually designed to get released gradually so do not crush or break your pills unless otherwise directed by your Nephrologist. Breaking them into smaller pieces can lead to an incorrect release of chemicals, having a toxic effect.
  • Know the drug's potential interactions to other prescription medicines or over the counter ones that you are taking. Many pain killers can cause detrimental effects when taken in combination with other drugs. Always ask your Nephrologist BEFORE you begin your new regimen.
  • Inform your Nephrologist if you have any past history of substance abuse. Individuals with past experience of drug abuse are relatively more likely to get addicted again, so informing your Nephrologist would guard you against the pending risk of addiction.

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For personal protection make sure that you know the effects of the drugs you are using especially on driving and other important daily tasks. Most pain killers have significant effect on how you carry on your daily tasks. In some cases there are alternative approaches to pain relief such as physical therapy, acupuncture or meditation. Pain killer addiction can be a great burden to anyone, and everyone who uses pain medication is susceptible to it. encourages you to talk about this matter with your Social Worker and Nephrologist to determine your risk of addiction and the best options of pain relief for your personal circumstances.


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"Pain Killer Addiction Treatment." Spine-health.

"Pain Medications: Addiction and Fear of Becoming Addicted." WebMD.

"How to Avoid Pain Killer Addiction." Ezine Articles.

Lacono, Steven A. "Coping with Pain: The Dialysis Patient’s Perspective." Journal of Nephrology Social Work