How do you know if it's real or addiction (or both!)? I'm not really sure, but here are some things to consider.

1) Most medications prescribed for TN are not addicting. Narcotics are only used to supplement drugs like Tegretol and Neurontin, and then only in conjunction with such drugs. AND only after all such medications have been deemed ineffective, or not effective enough. They are never tried first or alone by a responsible doctor who is aware of the diagnosis.

2) Most people with TN and other cranial neuralgias have had to suffer fools who can't get it through their heads that even if we "look fine" we're still in excruciating pain. For some reason, explaining neuralgia to most people is difficult, and it's not necessarily we want to explain to everyone we have to interact with. Additionally, neuralgia is something that can go in and out of remission. I myself just had four good *years* with relatively little pain. I'm now on a higher dose of medication than ever. To some people, the fact that the pain comes and goes seems "fakey" and they'll give their opinion. Having such pain belittled can get old, and hurtful, and make us even less inclined to discuss the subject with others at all.

3) It is not unusual for surgeries to fail to fix TN. It seems often, in fact, to do nothing at all or even make it worse.

4) Back surgery does take a long time to heal from. The pain from her back may be outstripping her facial pain for now, if her TN isn't too bad.

5) As a college student, I often had to weigh the benefit of having my pain alleviated against the cost of being completely wiped out all the time. It's a fine balance. Un-medicated, I got a D on a test in a class I got A's on every other test in, because the pain was distracting me so much. Other classes, I had to ask for extra time just to *complete* the tests, because the medication was slowing me down so much. She may be having trouble striking the same balance at work.

You could always sincerely ask her what she's taking. We're each walking experts on what we're taking now, what we have taken, what worked, what didn't, and what god-awful side effects they had. Look up the medications- are they addicting? That should give you a lot of info right there. If all she's on is narcotics, then it might be suspect.