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Opiate Painkillers – Addiction’s Pathway

 

Prescription painkillers, also known as “opioid analgesics” and opiates are extremely effective at addressing pain but they are also highly addictive. Anyone taking these drugs should be closely monitored by their physician regarding dosage and negative long-term negative effects.

What Are Opioid Painkillers?

Prescription PainkillersMost opioids are semi-synthetic derivatives of opiates and are used to treat moderate to severe pain. Today the terms opioids and opiates are commonly used interchangeably; however technically opioids refer to the majority of this drug family and opiates are used to describe non-synthetics. Both opioids & opiates reduce the intensity of pain signals to the brain and affect the areas of the brain that control emotions reducing painful stimuli.

The most common types of these painkillers are:

  • Hydrocodone (Vicodin or Lortab)
  • Oxycodone (Oxycontin, Roxicodone, Percodan, Percocet)
  • Hydromorphone (Dilaudid)
  • Morphine
  • Codeine
  • Fentanyl (Duragesic, Actiq, Sublimaze)
  • Methadone (Dolophine)
  • Buprenorphine (Buprenex, Suboxone)

Are Opioid And Opiate Painkillers Safe?

Many patients have become conditioned to an instant gratification approach to medicine in general. Along with that conditioning is the common belief that if a doctor prescribes a particular medication, then it must be safe for all uses.

Another common misconception among medical doctors is around the highly addictive nature of these drugs. Many doctors, unfortunately, overestimate the effectiveness of prescription painkillers (opioids) while underestimating their risks, particularly concerning addiction.

Yet another driving force is the sheer demand for prescription painkillers over the last 20 years - as displayed on the graph on the right. Between 1991 and 2010, prescriptions for pain medications have more than quadrupled while cumulative pain levels among Americans remained constant. In 1991, there were 75.5 million prescriptions for painkillers. By 2010, the number had jumped to 209.5 million.

Opioid Prescriptions From 1991 To 2010

Chronic Pain And The Role Of Prescription Painkillers

A more compelling reason for increased opioid & opiate use is the effort to manage chronic pain. According to the Pharmaceutical Journal, chronic pain affects 1 in 5 adults worldwide. In the U.S. alone, chronic pain results have a wide range of causes:

Condition Number of Sufferers Source
Chronic Pain 100 million Americans Institute of Medicine of The National Academies
Diabetes 25.8 million Americans (diagnosed and estimated undiagnosed) American Diabetes Association
Coronary Heart Disease & Stroke 23.3 million Americans American Heart Association
Cancer 11.9 million Americans American Cancer Society

Source:The American Academy of Pain Medicine

What Is Chronic Pain?

By definition, chronic pain lasts longer than the injury that may have initially caused pain in the body. Most chronic pain lasts for several weeks, months or even years. Pain is caused by a signal sent from the nervous system to the brain to alert the body as a warning.

Normally, once the threat of pain has been removed, the nerve signals to the brain stop. However, with chronic pain, the nerves continue to send these warning signals and the pain continues.

How Chronic Pain Leads To Chronic Use

Overdose death rates in Amercia
Source: Business Insider / CDC

Pain is the most common reason people seek medical attention. Management of chronic pain with prescription pain relievers is a common strategy utilized by most physicians when presented with a diagnosis of chronic pain. However, even with aggressive treatment using opioid therapy, chronic pain can persist or worsen.

More importantly, there are other consequences associated with long term opioid therapy. Opioid-Induced Hyperalgesia is defined as an abnormal pain sensitivity that is associated with long term use of opioids. While opioids clearly have short-term benefits regarding addressing pain, there are other serious considerations to factor into a patient’s treatment plan regarding their use.

Of the 9.4 million Americans who take opioids for long term pain, 2.1 million are estimated by the National Institute of Health to be addicted to them. Additionally, 4 out of 5 heroin addicts say they began using it as a result of an addiction to prescription painkillers.

An average of 46 Americans dies every day from prescription drug overdoses while heroin deaths in the U.S. have more than doubled to 8,000 per year since 2010.

The graph details the growth in overdose deaths by drug type from 1999 – 2013, with opioid overdoses outpacing other illegal drugs by a wide margin according to the CDC:

In our quest to be pain free, we are creating a nation of painkiller addicts. According to the National Institute on Drug Abuse, the U.S. accounts for only 5% of the world’s population, but consumes 75% of the world’s supply of prescription drugs.

This cycle has an even darker path as pain pills appear to be a new dominate “gateway drug” to cheaper, illegal drugs like heroin and other substances. According to the U.S. Substance Abuse and Mental Health Services Administration, a full 80% of all users arrive at heroin after abusing opioid painkillers such as OxyContin, Percocet and Vicodin. The National Institute of Drug Abuse states that one in 15 people who take nonmedical prescription painkillers will try heroin within the next 10 years. 

How Reliance On Painkillers Turns To Addiction

The general mindset of the patient experiencing chronic pain is, “I feel pain. I take pain medication”. Once the medication no longer helps in reducing the pain, the patient starts taking more or may opt to try other, stronger medications. The patient then begins to exhibit signs of anxiety or depression around the continued pain given that the prescribed medications no longer work.

Ironically, extensive usage of pain medications over long periods exaggerates or amplifies pain. Thus, this cycle typically ends with the patient becoming addicted to prescription painkillers. When a patient starts to exhibit certain behavioral changes in the form of compulsive or self-destructive tendencies – or there is a desire to continue taking opioids for reasons other than mere pain relief – these are indicators of addiction and should be addressed with an appropriate treatment program.

Is Dependence The Same As Addiction?

Only One in Ten Americans Struggling with Prescription Drug Abuse Will Receive Treatment

Source: Trust For America's Health

It’s important to note that one can be dependent on opioid or opiate painkillers and not be considered addicted to them. Someone who is taking opioids for pain relief for an extended period will require higher dosages due to the tolerance they have built up for the drug. If they were to stop taking it, they would experience withdrawal symptoms due to their dependence on the painkiller.

Dependence does not always result in addiction. Any patient taking opioid painkillers should be closely monitored by their doctor for adequate pain management while ensuring painkiller dependence does not become addiction. However, if addictive behaviors and symptoms are present the unfortunate reality is the majority of individuals never receive the treatment they need.

Successful Treatment For Opioid Painkiller Addiction

More Than 26% of Americans Age 20 and Over Have Reported Some Type Of Persistent Pain

Source: CDC

The occurrence and treatment of pain is so common that without a more holistic approach addictive behaviors are inevitable. The perception of pain can vary greatly from one individual to another and is influenced by some psychological factors (culture, previous life experiences and current mental status). 

Due to pain being such a subjective and personal condition, physicians need to move beyond the standard pain reduction techniques – prescription medications, physical therapy and surgery – and utilize a multifaceted approach to treatment. Such an approach would address the different psychological, social and spiritual factors that contribute to chronic pain. Additionally, patients should be taught physical, mental and other behavioral techniques to assist them in living life fully and achieving pain relief without reliance on addictive medications such as opioids.

Painkiller Abuse Treatments

Memorial Hermann Prevention and Recovery Center (PaRC) has been successfully using such a multidisciplinary treatment approach to substance abuse and dependency in patients suffering from alcoholism, addiction and chronic pain for the past 30 years. PaRC offers educational, therapeutic and medical programs necessary for successful long-term recovery. Pain Recovery Program patients receive a combination treatment for substance use disorders and chronic pain. Recovery always begins with taking the first step to get more information to see if this holistic treatment is the best option for you.

Painkiller Addiction Physical Therapy

Proper treatment usually begins with a medically supervised detoxification which helps minimize discomfort. Drug and alcohol withdrawal symptoms are monitored and medicated by our “comfort-trained” staff members. Nursing and counseling staff members utilize encouragement, warm blankets, ice packs, “self-practice” pain management practice and virtual reality mindfulness meditation to comfort patients on how control their pain.

Pain management physicians and physical therapy treatments are offered. A psychological evaluation is offered and designed to help in treatment planning for emotional issues. Fitness and wellness classes are also provided by a fitness staff.

Many evidence-based therapies are offered in our program schedule including: comprehensive substance use disorder treatment, yoga, acupuncture, meditation, mindfulness, biofeedback, dialectical behavioral, cognitive behavioral therapy, Eye Movement Desensitization & Reprocessing, and trauma resolution therapies. Early in treatment pain management skills are taught to help our patients develop a way of internally decreasing anxiety and pain.

Patients are encouraged to begin establishing an effective 12-step recovery support network and link with needed professional community providers for continued recovery.

The Best Treatment Option

Finding the right treatment is vital for a successful recovery which is why our medical staff provide an unbiased diagnosis. If there is even a possibility that you or a loved one is addicted to painkiller drugs contact us to discover your options.