Prescription drugs and pain seem to go together like baseball and hot dogs, but unlike the latter, the former is anything but healthy – when used indiscriminately or for too long. The fact is that overuse of prescription drugs can put you into a self-defeating loop.

Here’s what can happen. You have pain, so you take prescription drugs to relieve it. This works for a while, but you figure, what the heck, I’ll just continue to take the meds so I don’t feel the pain. Over time, however (and how much time is different for everyone), the drugs don’t seem to work as well as they once did. You begin taking them more frequently, maybe even doubling up the dose.

Now you’re in a routine: take the meds, the effect wears off and you feel pain again, take more meds, pain comes back quicker, take more meds…until you can’t get the pain relief any longer. You may search out new medications or combine what you have with other drugs, legal and illegal. What you don’t take into consideration is the cumulative effect of too much medication, too frequently. Another danger is side effects. Taking prescription drugs in combination with alcohol is a really dangerous mix. Talk about adding fuel to the fire. Not only have you put yourself into a bad situation by taking pain medications pretty much non-stop, but you may become addicted to them as well.

What Happens When You Try to Cut Down or Quit

Once you’ve become accustomed to using the prescription drugs to wipe out your pain, you’ve settled into a routine that’s one definitely not recommended by your doctor. You’ve likely found that out when you tried to renew your pain medication prescription and your doctor says it’s only supposed to be used for a limited amount of time. What do you do? You find another doctor, one who knows nothing about your past use of the drugs – and you give him your tale of woe about pain and how you can’t stand it. And viola, your new doctor writes you a script for painkillers.

What have you really accomplished? You already know that continuing to take the pain pills is proving counter-productive. And you may even tell yourself that you’re going to cut down the amount or quit entirely – after this prescription is filled.
Little glimmers of what you feel when you don’t get your dose when you feel you need it is enough to send shivers up your spine just thinking about quitting cold turkey. How will you be able to stand the pain? You never stop to think that you’ve singled out painkillers as a crutch that’s easy for you to use. It doesn’t take any effort on your part to manage your pain in healthier ways. You just pop a pill and go about your business.

Except that it doesn’t work that way any longer. Now you are dependent upon the pain pills just to get through the day. Repeated use of the prescription drugs causes the body to adapt. This may result in the body developing a tolerance to the drug. That means that the individual using the drug requires more of it more often in order to achieve the desired effect (the effect achieved when the person first started taking the drugs).

Repeated exposure can also result in withdrawal symptoms when you abruptly stop taking the drug. Withdrawal symptoms can be mild, moderate, or severe and include:

• Restlessness
• Muscle and bone pain
• Insomnia
• Diarrhea
• Cold flashes with goose bumps (commonly called “cold turkey”)
• Involuntary leg movements

While the decision to stop taking prescription drugs for pain is well-intentioned, it shouldn’t be attempted without medical supervision. You should never just stop taking your meds – whether you’ve been going from doctor to doctor to get them or not. It’s just too dangerous. Going through withdrawal for opioid dependence and addiction may be so uncomfortable that you give up the effort and immediately go back to using the drugs. But taking too much at once of opioids, for example, which already produces drowsiness, causes constipation, and can depress breathing, may result in severe respiratory depression or death. So this is definitely not something you want to tackle on your own.

Still, you need to wean yourself off the prescription drugs for pain. How should you do so in a safe manner? The solution is to go for treatment.

First Step: See the Doctor

Let’s take the example of an elderly person with severe arthritis pain who’s been taking opioids to relieve it. Along with the arthritis, the individual has other age-related conditions or medical problems that require daily doses of other medications. Unable to sleep through the night, the person may take sedatives. Early-onset Alzheimer’s disease may also be present, causing the individual to forget when he or she took certain meds or mixing them up, doubling the dose, or taking them all at once.

Family members notice the change in their loved one. Grandpa or Mom seems to be out of it all the time. They have trouble with motor functions and they seem to have trouble with their cognitive skills. Upon examination of all the prescription bottles on the counter, in the medicine cabinet, or around the house, the family members try talking with the loved one to find out what’s being taken for what condition. If Grandpa of Mom is in a diminished capacity, the family members may – with good reason – urge a visit to the doctor.

This is a wise course of action. The doctor needs to know exactly what the patient has been taking. The family member should accompany Grandpa or Mom to the doctor and bring along a complete list of all medications – or, better yet, bring all the containers.

Some drugs may no longer be needed, or the doctor could determine that certain drugs are working at cross-purposes with others. He or she could prescribe some that won’t produce negative interactions. If the doctor determines that Grandpa or Mom are dependent upon or addicted to prescription drugs for pain, a referral to a treatment facility may be in order.

Be prepared for the reaction from Grandpa or Mom when and if the doctor recommends treatment to wean them off drugs. Insist that the doctor tell your loved one in no uncertain terms what can happen if he or she continues to take these prescription drugs in a manner not prescribed. Call it scare tactics or just common sense, but someone needs to set your loved one straight.

If you are the person who is dependent or addicted, that’s all the more reason why you need the cold, hard facts about the self-defeating loop of taking prescription drugs for pain.

Look at the Big Picture

No one wants to live in a fog. No one wants interminable, unbearable pain either. Getting past the immediate circumstance takes action and outside professional assistance. It’s not an easy decision to make for many. There are many considerations often cited why a person can’t or won’t go in for treatment.

• It’s too expensive
• Insurance doesn’t cover it or there’s no insurance
• Can’t take off from work
• Don’t need treatment – I’m not addicted
• Embarrassment or shame
• Stigma associated (or perceived as such) with drug dependence or addiction
• I can do it on my own
• No one tells me how to run my life
• I’m not going to a place with a bunch of drug addicts
• I don’t want to give up drugs

Countering these objections may take some time. While you can’t force someone into treatment – unless it’s court-ordered or the family delivers an ultimatum (which may or may not be agreed to) – it may feel like you’re forcing it on your loved one. You actually are, and for his or her best interest.

Anyone entering treatment to overcome dependence, abuse, or addiction to prescription drugs for pain should take the long view. Look at the big picture. Life the way it currently is will only deteriorate further. The downward spiral of constant misuse of or addiction to prescription drugs will rob the user of vitality, physical and mental health, quality of life – even life itself. You or your loved one who’s been relying on these meds for pain need to look at what your life can be like without being dependent on drugs. First, you need to get them out of your system. Then you need to learn how to manage your life without the meds. Learning healthier ways to manage pain is part of the treatment process.

It’s certainly worth considering. And, in the long run, it’s a lot less expensive. Complicating conditions caused by drug interactions or overdose can easily run up hospital and doctor bills and further speed up the downward spiral.
Who wants that? Taking the big picture into consideration, a little time spent now in treatment doesn’t seem like too much to go through to come out on the other side in a healthier state, does it?

Figuring Out the Basics

How you go about getting yourself or your loved one into treatment is not particularly difficult. Ask your doctor for a referral or involve your family members in your search. A good place to start your research, if you want to check it out on your own, is the Treatment Facility Locator (http://dasis3.samhsa.gov/) website maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA). You can search by state or do a more advanced search to find drug and alcohol treatment programs at facilities across the United States. You can also call their toll-free treatment referral helpline at 1-800-662-HELP.

If money is tight, use the Detailed Search or List Search options on the treatment facility locator and check the boxes for “sliding fee scale” and “payment assistance.” Then call the facilities to inquire about their programs for more detail.
The locator also has listings for state substance abuse agencies (http://findtreatment.samhsa.gov/ufds/abusedirectors) that include name and address, phone and fax numbers, email and links to websites (if applicable).

You – or your family members – can research facilities and check with your doctor to see if he or she recommends one over the other or has referred patient there in the past, or research ones that the doctor has already recommended.
Once you find a particular treatment facility or facilities that appear to meet your needs, get more information directly from the facility either online, by telephone, or requesting that it be mailed to you. Definitely ask all the questions you need answers to. There’s no sense committing to a treatment program if it’s not going to fit your requirements. It’s also a good idea to visit the facility to see it firsthand – before you decide to go there for treatment.

Look for a treatment facility that’s certified and whose practitioners carry the appropriate licenses and credentials. Other things to pay attention to include:

• Types of treatment offered
• Drug detox services (whether available on-site or off-site)
• Cost of treatment
• Insurance coverage or payment plans accepted
• Facility’s treatment success rate
• Availability of aftercare or continuing care
• Special groups treated (including age, gender, other demographics)
• Typical length of stay

Looking Forward to Recovery

After completing treatment for abuse, dependence, or addiction to prescription drugs for pain, what can you expect? While you will have learned a great deal about how to manage your life without abusing drugs, you will still need the support and encouragement of others as you begin your early days, weeks, and months of recovery. As part of your recovery plan, the one you created with your therapist during treatment, you will likely be attending 12-step group meetings on a regular basis. These groups can provide a lifeline for newcomers to recovery, especially when situations occur that may otherwise precipitate a return to using.

You will also more than likely have some follow-up care as part of your treatment program. This may include ongoing counseling or referrals to other agencies or sources for help. Be sure to take advantage of all such services made available to you.

Family is another critical factor in your recovery. They want you to be healthy and happy and drug-free. They, along with your 12-step sponsor and fellow group members, will serve as your support network.

No one recovers alone. A successful recovery requires a caring and continuous support network. The ability to develop resilience, to learn how to bounce back from daily stresses and challenges, is necessary for long-term effective recovery. Having others to talk with who’ve been through the same types of challenges after overcoming a problem with prescription drugs for pain can help you as well. What strategies and techniques worked for them in times of crisis or stress may also work for you, or you could perhaps adapt them to fit your situation and circumstances.

If you’re thinking about doing something to overcome your dependence on prescription drugs for pain, now is the best time to get started. The journey to recovery begins with the first step. Take that step now. Make the decision to get help. Learn how to manage your pain in ways that don’t involve overuse or misuse of prescription drugs. This will involve a change in lifestyle that may be much more pleasant than you imagine. Meditation, yoga, learning new hobbies, acupuncture, and therapeutic massage are just a few of the things that others have found helps them better manage their pain.

Help is available. Are you ready to accept it?

Prescription Drugs and Pain: the Self-Defeating Loop is a post from: Drug Addiction Treatment

Almost 30% of those individuals between the ages of 57 and 85 use a minimum of five prescription drugs. This group of individuals has the lowest compliance rate when it comes to following instructions for their prescription drug us. This makes them especially vulnerable. Considering the large number of seniors in the U.S. today, these facts indicate a high potential for complications related to prescription drug abuse in the elderly. In fact, nearly 13 percent of the population in the United States is 65 years old or older.

Differences in Senior Drug Abuse

When most of us picture drug abuse in our minds, we think of young people using street drugs recreationally in a foolish attempt to get high. The idea of prescription drug abuse in the elderly is usually the furthest thing from our minds. When seniors abuse prescription drugs or – even worse – become addicted to them, it’s not usually because they set out to abuse their medication.

Instead, prescription drug abuse in the elderly is often due to the fact that they don’t understand the potential risks of the medications they are taking. They don’t always realize that many drugs have the potential to interact with other medications as well as non-prescription treatments. As a result, there has been a phenomenal increase in the number of elderly patients who need intervention and treatment for drug abuse. They’ve accidentally become addicted to their prescription medications – and many don’t even realize it’s happened.

Where the Problem Begins

It’s no secret that we have a lot more health problems as we get older. Many seniors will develop health conditions that require long-term medication such as hypertension, diabetes, high cholesterol, and numerous other conditions. At the same time, they may develop other health conditions that require additional short-term treatment. In many cases, these additional medications are prescribed by a different doctor who is not their primary care physician.

Another problem experienced by the elderly is their high use of over-the-counter medications. They are often completely unaware that what seems like a harmless medication they bought at the store can be dangerous when taken along with their other prescriptions.

Elderly individuals also have a greater risk for problems due to changes in their metabolism. These changes make them more susceptible to adverse medication reactions than individuals who are younger. Also, if they consume any alcohol it can intensify the effects of some types of drugs. It can also affect how they react to various medications. With regards to prescription drug abuse in the elderly, the majority who become addicted to their medications don’t do so intentionally. Whether abuse or addiction occurs also depends on other factors, including their overall physical and emotional health as well as the types of medications prescribed for them.

In addition to the normal aches and pains associated with aging, many elderly also have more issues with pain. This may be due to more frequent falls, arthritis, chronic back pain, and so on. Potent pain medications are often prescribed to give them much needed relief. Vicodin and other prescription painkillers provide fast relief which is one of the reasons so many people become dependent on them.

Another problem that frequently occurs in the elderly is insomnia. Benzodiazepines, which are often prescribed for anxiety disorders, can be sedating. The sedating effect, along with the sense of calm they quickly provide, makes them effective for sleep problems. Unfortunately, medications in this category, such as Ativan and Xanax, are highly addictive. They are supposed to be used for only a short period of time.

It’s no surprise that prescription drug abuse in the elderly often involves pain medications and benzodiazepines.

Timing is Everything

If every elderly person who took prescription medications did so according to their doctor’s instructions, there would be little incidence of abuse or addiction. However, seniors are much less likely to do this than younger individuals. This may be due to forgetfulness, confusion, disliking the medication due to side effects, or a variety of other issues that are much more common with seniors. Certain types of medication can cause confusion when they are taken in excess, which leads to more problems with inaccurate dosing.

When elderly individuals take pain medication, they may rely too heavily on their pain symptoms as a guide to when their next dose is due rather than keeping track of when it was last administered. Since many types of pain medication are highly addictive, this can quickly become a problem. Once they develop a tolerance, they need more of the drug to alleviate their pain. Some may also ascribe to the philosophy that "if some is good, more is better", which also contributes to prescription drug abuse in the elderly population.

Seniors make up only about 13% of the population, but they take nearly one-third of all the medication that is prescribed by health care professionals. Not only that, many of the drugs prescribed to this age group have a high potential for addiction.

Overlooking the Warning Signs

Many people aren’t aware of the growing problem of prescription drug abuse in the elderly. They may also ignore the warning signs in their loved ones. Since many elderly individuals have problems with forgetfulness and agitation – symptoms that are often caused by drug abuse – they may be dismissed as normal. The effects of prescription drugs may also cause unsteadiness, leading to falls and other accidents – problems that, again, may be disregarded as normal due to age. Sadly, serious injuries may result which could have been prevented had the warning signs been heeded.

The effects of prescription drug abuse in the elderly are often experienced more easily and more intensely than in those who are younger. This is because the metabolism of elderly individuals is slower and their organs function less efficiently. This may result in more serious side effects with much lower concentrations of various medications than needed for the same response in younger people.

The Most Commonly Abused Prescription Drugs

Prescription drug abuse in the elderly can occur with many different medications. However, not all are addictive. The drugs that cause the greatest risk for elderly individuals fall into two categories:

• Opioids – These are the most frequently abused prescription drugs by elderly individuals as well as the younger population. They are prescribed to relieve pain. OxyContin, Percocet, and Vicodin fit in this category. Their ability to boost dopamine levels and cause a feeling of euphoria makes them highly addictive. Their ability to slow down respiration is one of the characteristics that makes them so dangerous.
• Benzodiazepines – These are drugs prescribed for anxiety and insomnia. They include Klonopin, Xanax, Valium, and Ativan. They produce a sense of calm quite quickly. Some people also experience euphoria as well.

Perhaps the greatest reason that prescription drug abuse in the elderly is a growing problem is because there is no single solution that works in every case. Those seniors who are left on their own can’t be monitored, making it especially difficult to notice a problem. However, all elderly individuals are vulnerable. Family members, friends, nursing home and assisted living staff, and health care professionals all need to be educated about the problem of prescription drug abuse in the elderly population.

Prescription Drug Abuse in the Elderly is a post from: Drug Addiction Treatment

It’s no surprise to doctors, addiction specialists and researchers that abuse of prescription drugs is climbing. Ohio, for example, has experienced a 10 percent jump in people looking for help for addictions to opiate-based drugs since 2010, according to research from the Ohio Department of Alcohol and Drug Addiction Services.

As Ohio and other states look to fight even harder against prescription drug abuse, they’re uncovering a new reality: Drug addicts may be going after veterans to acquire more prescription medications. For many people with a prescription drug addiction, the supply they might acquire from one physician isn’t large enough to feed their addiction, as addressed in recent news posts.

Veterans may be a likely target because they’re an older population and may be able to acquire larger amounts of prescription painkillers due to federal assistance with insurance and prescription co-pays. They may also receive larger prescription levels from their doctors.

The medications are typically stolen from veterans through methods like using false prescriptions. Others acquire veterans’ prescription medications by working in the healthcare industry or by tampering with mail delivery of medications.

Experts speculate that the problem may intensify as veterans return from combat zones with injuries that may be long-term and require pain medications for treatment.

Veterans: A Target for Prescription Medication Theft is a post from: Drug Addiction Treatment

Addiction can come quickly and users routinely will go back to their doctor and tell them their pain persists and then they continue to get more Vicodin or other painkillers. This perpetuates the vicious cycle that leads to addiction. A prescription painkiller addiction has dangerous consequences, and ultimately the outcome from the addiction can become death.

In the past decade, fatal overdoses from prescription painkillers have more than tripled, according to recent government reports. U.S. officials have called the problem an epidemic as painkillers like Methadone, OxyContin and Vicodin have led to nearly 15,000 deaths alone in 2008, which is over three times the amount as the year 1999.

Prescription painkiller addiction affects people of different races, gender, and age groups. Recently reports have highlighted the sweeping problem among teens. A recent survey highlighted the problem of painkillers among adolescents showing that 10 percent of all seniors in high school are using Vicodin now as the new recreational drug.

Why People Get Addicted to Prescription Painkillers is a post from: Drug Addiction Treatment

The government reports that the sales of prescription painkillers have increased greatly in recent years, and in many cases the drugs are being misused. The CDC reported that in 2010 nearly 12 million Americans had used prescription painkillers for non-medical purposes. Patients have put their trust in their health providers’ hands and don’t think that something prescribed to them could be so dangerously addictive. But these painkillers, which are often used over a long period of time, can cause the body to build a tolerance; leading the patient to crave more of the painkiller until they eventually develop an addiction. Meanwhile, other problems like hepatitis, severe liver damage, and HIV exposure may also occur.

Professionals are seeing more teens use prescription painkillers, which then start using heroin. An anonymous healthcare worker reported they have seen more young people abusing heroin than they did five years ago. They start using them after something like a sports injury, and then when the prescriptions become too expensive, they find heroin on the streets. A Deputy in Southern California reported that he talked with a heroin abuser whose story was the same. The abuser said that he started using the painkiller OxyContin in high school. Eventually, he had a difficult time paying for the prescription and then he started injecting heroin to fight his pain.

Even if people don’t turn to using heroin, the government reports that there are 5.3 million people over the age of twelve who admitted to abusing prescription drugs in the past year. This escalating addiction is leading to drug overdoses at an alarming rate. The CDC reported that over the past 10 years, deaths due to prescription narcotics have tripled. Averaged out, 40 people would die daily from prescription painkillers.

According to the New York Times, Purdue Pharma, the maker of OxyContin, has come under scrutiny for their role in claiming that OxyContin would be less addictive than other narcotics because it was an extended-release drug rather than a short-acting one. However, published reports confirmed that a growing number of people went from using OxyContin to using heroin after their addiction made them crave even more.

The FDA hopes to protect consumers and curb the number of people who fall into the cycle of addiction to prescription painkillers. They plan to better educate doctors on the safe prescription of painkillers and enact stricter policies on the distribution of these prescriptions. As the distribution of prescription painkillers decreases, less people are likely to start an addiction that may take them from a drug that eases pain to one that causes it.

Prescription Painkillers Are Leading Americans into Drug Addiction is a post from: Drug Addiction Treatment

The Department of Health is talking to doctors and drug agencies in order to monitor safety and keep careful watch of how drugs are prescribed. Experts are worried in Britain and the United States, as more and more deaths every year are linked to prescription drug addiction.

Deaths in the US have risen more than three-fold in the previous ten years, and Britain’s deaths have risen six-fold since 1991, to roughly 1.4 billion deaths. There are approximately 500 million prescriptions per year that are given for addictive drugs, such as sleeping pills, sedatives and tranquilizers, as well as benzodiazepines that are prescribed for anxiety.

Doctors in the United Kingdom are worried that the numbers of deaths are actually higher than what has been recorded. Unfortunately data has been lost and not collected over the years, so officials worry they have more of a problem than they are aware of. In order to fix this, the Department of Health has worked with addiction specialists, clinicians, drug agencies and NHS regulators to increase monitoring and make sure the addiction doesn’t go unrecorded.

According to a report from the Centers for Disease Control and Prevention, the abuse of painkillers and prescribed medication has risen to an epidemic level in the United States. This is believed to be true because the number of deaths is higher and more widespread than deaths of HIV and liver disease that can be caused by alcohol consumption and abuse.

The National Institute of Clinical Excellence (NICE) of the United Kingdom shared that the time period for prescriptions ought to be restricted to four weeks, but after a review of other prescriptions, it was found that a majority of prescribed medications are for eight weeks or more.

Prescription drug abuse may take unique forms and have different meanings. Some examples include taking in excess of the amount prescribed by a provider, taking the drug with certain narcotics or alcohol, using a friend or family member’s prescribed medication as a relief for pain, or using a medication that is not prescribed to you.

It is not unusual for people to develop an addiction to prescription drugs. These types of drugs focus on the reward center of the brain and make it extremely difficult to let go of the high and rewarding feelings that drugs can provide. Certain behaviors can act as caution signs that you or someone you know is abusing prescription drugs. Some of the signs include telling the doctor that the medication has been lost and usually numerous health providers are visited in order to get more medicine.

It is important to be aware of these symptoms and signs. If you are worried that someone you know might have an addiction to prescription drugs, it is important you talk with them and find help immediately.

The Fear of Addiction Leads to a Call for Tighter Monitoring of Prescriptions is a post from: Drug Addiction Treatment

Prescription drug abuse has grown into a public health problem nationwide. Over the past decade, abuse of pharmaceutical drugs, especially opiate medications, has skyrocketed across all demographics and regions of the U.S. Through its take-back initiative, the DEA and its partners are attempting to not only promote awareness of this growing epidemic among Americans, but also to educate the public on how to properly dispense their unused medications. Most Americans are unsure of how to dispense medications, and end up flushing them down the toilet or throwing them into the trash. Others forget about unused medications that end up lingering in their home medicine cabinet, where they can potentially be stolen by family members or friends without notice.

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 55.9% of prescription drug treatment admissions illicitly obtain prescription medications from a friend or family member. Pain relievers, tranquilizers, stimulants, and sedatives are all highly potent drugs that can be just as toxic as street drugs when misused. The nation’s increasing rate of prescription drug abuse has also led to an escalating rise in legal drug overdose and poisonings. Through the annual take-back event, prescription drugs can be properly returned to authorities for destruction, ensuring public safety and avoiding hazardous waste to the environment.

Some local law enforcement, health resources, or pharmacies have already practiced their own annual prescription drug ‘take-back’ events in an effort to decrease the rate of drug abuse in their communities. Yet for the first time, the Department of Justice has taken the safety initiative to a national level with this annual event, rallying community services across the U.S. to communally participate. Citizens of all ages and backgrounds are encouraged to take advantage of this proactive event by contributing their unwanted medications to authorities. Their efforts will help keep dangerous, potent drugs from falling into the wrong hands where they can be sold, misused, or responsible for more addiction and death.

Unlike illicit street drugs that must be confiscated by law enforcement, prescription drugs can be legally kept in every American home. Some controlled substances are purposely abused by users, stolen, or sold illicitly to vulnerable individuals who may be unaware of the drug’s unsafe potential. By participating in the annual Prescription Drug Take-Back Day, every citizen has the ability to play a significant role in the preservation of their local, state, and federal community health.

Those interested in taking part in the event should visit www.dea.gov to locate participating collection sites. The DEA also encourages visitors to their site to check back often before September 25, as new locations are continually being added. Any prescription and over-the-counter medications in capsule or tablet form are acceptable for collection. Injectable medications and paraphernalia, as well as illegal substances will not be accepted.

The DEA’s National Prescription Drug Take-Back Day is also sponsored by the White House Office of National Drug Control Policy; the Partnership for a Drug-Free America the National Association of Boards of Pharmacy; the Federal of State Medical Boards; the National Association of Attorneys General; and the National Districts Attorneys Association.

Source: Department of Justice, DEA Heads First-Ever Nationwide Prescription Drug Take-Back Day, August 19, 2010

DEA Announces National Prescription Drug Take-Back Day is a post from: Drug Addiction Treatment

This study – the National Youth Risk Behavior Survey, conducted by the Centers for Disease Control – found that just over one in five high school students in the United States admits to having taken a prescription drug without a prescription from a physician.

Within the survey, the CDC found that 20.2 percent of high school students report having taken a drug such as Ritalin, Xanax or OxyContin without a prescription. In addition, prescription abuse was most common among white students at 23 percent, followed by Hispanics at 17 percent and African-Americans at 12 percent.

Drug abuse proved to be the most common among high school seniors at 26 percent and least common among freshman at 15 percent. There appeared to be no difference in prescription drug abuse by gender as it was 20 percent for both male and female students.

“We are concerned to learn that so many high school students are taking prescription drugs that were not prescribed to them,” Howell Wechsler, EdD, MPH, director of the CDC’s Division of Adolescent and School Health, saidin a news release. “Some people may falsely believe that prescription drugs are safer than illegal drugs, yet their misuse can cause serious adverse health effects, including addiction and death.”

Teen Drug Abuse Increasingly Focused on Prescription Drugs is a post from: Drug Addiction Treatment

Medscape Today reports that The National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study found that those who tapered off the medication using buprenorphine during a 9-month period, whether initially or after a period of improvement, almost universally relapsed.

Roger D. Weiss, MD, professor of psychiatry at Harvard Medical School in Boston, and chief of the Division of Alcohol and Drug Abuse, McLean Hospital in Belmont, Massachusetts, said: "There has been virtually no research on the treatment of persons dependent on prescription opioids, in spite of the major increase in prescription opioid abuse and in the numbers of persons entering treatment for addiction to prescription opioids.”

"The trial was designed to help the physician manage patients who are dependent on opioids and want off the drugs but refuse treatment in a drug abuse treatment program," Dr. Weiss said.

The study enrolled 653 people with prescription opioid dependency and offered them standard medical management, which included buprenorphine, an initial one-hour visit, and weekly 20-minute sessions with a physician who counseled the patients and monitored for adverse drug effects. Half the group remained in this standard medical management group and half received enhanced medical management, which included twice-weekly 60-minute individualized drug counseling focusing on interpersonal issues, coping with triggers and high-risk situations, homework, and more.

Patients were evaluated after periods of individualized buprenorphine tapering and maintenance and were assessed for abstinence from opioids at various times.

Several patients reported current chronic pain (42%), and some were taking opioids for this condition. Many patients reported a lifetime history of heroin use (23%), alcohol abuse (60%) or dependence (27%), cannabis abuse (47%) or dependence (15%), and cocaine abuse (32%) or dependence (18%).

Opioids used within 30 days included sustained-release oxycodone (35%), hydrocodone (32%), immediate-release oxycodone (19%), methadone (6%), and others (8%).

Thirty percent of subjects had received some previous treatment for opioid dependency, primarily self-help (59%), inpatient/residential treatment (42%), outpatient counseling (40%), and methadone maintenance (31%). But Dr. Weiss noted that the trial was the first treatment for most subjects.

Treatment success was defined as four or fewer days of opioid use per month, no positive urine screens for opioids for two consecutive weeks, no other formal substance abuse treatment, and no injection of opioids.

In the standard medical management group, only 7% met the criteria for success, as did just 6% of the enhanced medical management group. "Nearly all patients relapsed after a four-week taper," Dr. Weiss said.

Patients who relapsed were asked to enter phase 2, at which time 360 patients were randomly assigned to standard medical management or enhanced medical management and received 3 months of buprenorphine stabilization, then had treatment tapered for one month, with a two-month follow-up.

At the end of the stabilization (at week 12), substantial improvement was noted for 52% of the enhanced medical management group and 47% of the standard medical management group, though there was no additional benefit to enhanced management.

Substantial improvement was defined as abstinence for three or more of the final four weeks of buprenorphine stabilization.

However, by the end of the stabilization period, many patients had relapsed again, Dr. Weiss reported.

"We went from an average success rate of 49% to 26% at week 16,"he said. At week 24, only 9% of patients remained successfully treated.

"At the end of the study, we were back into phase 1 territory," he said. "Seven of eight patients doing well on buprenorphine maintenance had relapsed."

The study also found that the presence of chronic pain did not influence outcomes. Patients with chronic pain were equally likely to enter phase 2 (indicating early treatment failure) and were equally likely to be substantially improved at week 12 of phase 2 (53% vs. 47% for those without chronic pain).

"Interestingly, we found that in many cases the patient’s pain got better," he added, explaining that one cannot assume that buprenorphine itself improved the pain, as there was no control group, but he noted that it is an interesting possibility.

Study Examines Treatment for Prescription Opioid Dependence is a post from: Drug Addiction Treatment

The finding comes from a study involving 662 chronic noncancer patients taking opioid drugs for pain relief, and the results are published in the April issue of The Journal of Pain.

Researchers say misuse by women seems to be closely related to psychological distress. Prescription pain drugs are more likely to be misused by men who have social and behavioral problems.

“Since little has been published about gender differences and misuse of prescription pain medication, it is valuable to document whether risk factors for abuse are gender specific to some degree,” says study researcher Robert N. Jamison, PhD, a clinical psychologist at Harvard’s Brigham and Women’s Hospital.

The study shows that men and women have similar frequencies of aberrant drug behavior but different risk factors for abuse of opioids.

Women who misuse pain drugs are more likely “to admit to being sexually or physically abused or have a history of psychiatric or psychological problems,” Jamison says.
Women who are being treated for pain not caused by cancer and who exhibit signs of significant stress should be treated for mood disorders and counseled on dangers of relying on pain pills to help them sleep or reduce stress, the researchers say.

Men taking pain pills should be closely monitored for suspected behavioral problems, Jamison says. In addition, their pills should be counted to check adherence, and frequent urine screens also should be done.

Jamison and colleagues write in the study that the use of opioids for chronic pain has been growing, and that between 3% and 16% of the population has a substance use disorder.

Indeed, some pain centers that dispense opioids “are overwhelmed with patients who are known or suspected to be abusing” their medications, the researchers write.

The study involved patients who had been prescribed opioids for chronic noncancer pain; about half the participants were men, half were women.

Five months into the study they were interviewed and had to submit a urine sample. Physicians also completed a substance misuse behavior checklist.

The researchers write that women in the study tended to display signs of emotional issues and affective distress, compared with men.

Men tended to show signs of worrisome behaviors, such as association with other people who abused drugs and alcohol and engaging in criminal behavior.

For women, a history of sexual abuse was an issue in later misuse of prescription drugs. “These results are in agreement with past research that highlighted the importance of sexual and physical abuse history in predicting opioid misuse,” the researchers write.

“These same studies also showed that women with a significant history of anxiety and depression tend to do less well in properly managing opioids prescribed for pain, possibly because of the tendency to self-medicate a mood disorder using opioids.”

The researchers also say that past research has suggested that women may be more open and truthful about behaviors and to seek psychological help than men.

“Given the prominence of sex differences in a variety of pain-related processes, we may eventually arrive at a method for tailoring risk assessment and risk-reducing interventions in part as a function of gender,” the researchers say, adding that more research is called for by their study.

Gender May Play Role in Prescription Drug Abuse is a post from: Drug Addiction Treatment