How someone could go from prescription painkillers to drug addiction is easy to understand. The pain bone’s connected to the doctor bone. The doctor bone’s connected to the opioid bone. The opioid bone’s connected to the addiction bone. Once the addiction bone takes over, the word “pain” takes on a whole new meaning.
The pain bone
Americans aren’t having more pain lately, but they are being prescribed a whole lot more pain medicine, according to the Centers for Disease Control and Prevention (CDC). In fact, prescribers wrote 82.5 opioid prescriptions per 100 persons in the United States in 2012 alone, according to a database analysis by the CDC.
The United States is the world’s largest consumer of prescription opioids, but Americans aren’t having less pain, either. They are having an epidemic of substance use disorders, though.
The doctor bone
Visits to the doctor can be put off indefinitely, except when it comes to pain. Pain demands immediate attention.Opium has been used and abused throughout the millennia. Opium derivatives, natural or synthetic, all have the same basic mechanisms of action. They are effective painkillers and safe when used appropriately, and a blessing when the pain is bad.
Some commonly prescribed opioids include:
Hydrocodone (combined with acetaminophen in brand name Vicodin)
Oxycodone (brand name OxyContin)
Oxymorphone (brand name Opana)
Methadone (when prescribed for pain)
Opioids are potent narcotic medications meant to relieve severe, acute pain from surgery/trauma or terminal pain from end-stage disease.Their side effects and risks are well-known facts. Yet about 30 years ago, the use of opioids for the treatment of chronic, nonmalignant pain became acceptable and encouraged. So began the current prescription drug abuse epidemic.
The opioid bone
Opioids bind with receptors in the brain’s reward center, causing neurochemical derangements and physical changes in neuropathways. Over time, tolerance develops, requiring higher and more frequent dosing to achieve pain relief. Soon, higher dosing is required just to prevent withdrawal symptoms, and the person has become physically dependent on the drug.
Overdose is another risk of opioid use. According to the CDC, prescription opioid overdose is now a leading cause of accidental deaths, which have quadrupled since 1999. For every death, about 30 people are treated in the emergency room for nonfatal opioid misuse. Shockingly, almost all people who overdosed on opioids and survived continued to obtain prescriptions for opioids, often from the same providers, according to a newly published study.
The addiction bone
Due to the nature of opioids and the circuitry of the human brain, addiction can develop rather quickly. Genetic factors affect how different people metabolize opioids and how the drugs make them feel. Many other factors determine the rate at which people become addicted, but all humans are susceptible.
Heroin addiction has also reached epidemic proportions in the United States and it often begins with prescription opioid use. When prescriptions can no longer be obtained, addicted individuals turn to illicit ways to obtain the same medications. On the streets, the prices for opioid painkillers are reportedly very high, so many turn to heroin for relief of the extremely unpleasant withdrawal effects.Alcohol and other drugs also act on opioid receptors, so the addiction can lead to taking whatever drink or drug is available. And so it goes.
Preventing addiction before it starts is obviously ideal. Patients who do not want to take opioid painkillers for chronic pain should feel comfortable talking with their health care provider about the medication and possible alternatives. The purpose and therapeutic goal for the medication should be clear when it is first prescribed. Some considerations when being prescribed an opioid painkiller:
Use nonpharmacological pain treatment, such as exercise
Try non-narcotic pain medications
Understand how to taper down the dosage over time
Avoid regular, daily use
Numerous refills should not be needed
Cost of prescriptions should not cause financial strain
Just because it is prescribed does not mean it must be taken
What to do about opioid addiction
Most people suffering from opioid addiction cannot believe it happened to them. They do not know at what point they lost control. They describe a period of time during which they tried to deny the problem, cover it up or try to quit on their own. Without help, too many people die from opioid addiction or end up in jail, or worse.
Treatment for opioid withdrawal has improved greatly over the past few decades. Medications like methadone or buprenorphine can be given to ease symptoms during detoxification.Withdrawal in a treatment setting is much easier because symptoms can be treated with other medications and supportive care is available.
At Sovereign Health, we offer safe and comfortable opioiddetoxification in a confidential, private setting. Our team of experts specializes in addiction treatment and other behavioral disorders. We use state-of-the-art medical, technological and complimentary therapeutic approaches to treatment, such asnatural assisted detox. For more information about our programs, please visit our website or call our 24/7 helpline.
Written by Dana Connolly, Ph.D., Sovereign Health Group medical writer