06 Mar Emotional Issues, Prior Use Risk Factors for Painkiller Addiction
Opioid painkillers are narcotic substances that can potentially lead to physical dependence in both medication abusers and people who follow their doctors’ dosing instructions. In turn, dependence on one of these substances can lead to an opioid addiction. In a study published in January 2014 in the journal Pain Medicine, researchers from Great Britain’s University of Derby examined the factors that place an opioid user at risk for developing dependence-related issues. These researchers identified three major high-risk groups.
Opioid painkillers are also known as opioid pain relievers or prescription opioids. Doctors can prescribe specific types of these medications for people affected by any serious, impairing form of short-term or long-term pain. Some opioid painkillers also have additional usefulness as treatments for extreme diarrhea symptoms or severe coughs. The best-known prescription opioid pain relievers are morphine, codeine, oxycodone (OxyContin, Percodan) and hydrocodone (Lortab, Vicodin). Other medications in this class include fentanyl (Fentora, Duragesic), meperidine (Demerol) and hydromorphone (Dilaudid). Doctors also sometimes prescribe the opioid methadone, commonly associated with the treatment of heroin addiction, to combat the effects of seriously disruptive pain.
Dependence and Addiction
Physical dependence occurs when repeated exposure to a medication or drug leads to an alteration in brain chemistry and the subsequent acceptance of the substance in question as a necessity for everyday function. Although this sounds like an inherently harmful situation, that is actually not the case. People affected by long-term pain may need to regularly take a certain amount of opioid medication to get through the day; in turn, this ongoing need can easily turn into opioid dependence, even when an affected individual takes his or her prescribed doses properly.
However, a prescription user with an opioid dependence typically remains well adjusted and free from the critical problems that separate drug dependence from drug addiction. Classic examples of these problems include strong and recurring urges to take more of the substance in question, loss of control over the amount of the substance used, the establishment of a daily existence centered on drug-related matters and a declining ability to maintain personal relationships or personal and social obligations. Even though most prescription users never transition from opioid dependence to opioid addiction, doctors who prescribe opioids to their patients must remain alert to this possibility and address any symptoms of addiction that arise.
Risk Factors for Dependence
As part of their efforts to avoid the possibility of addiction in their patients, doctors who prescribe opioid medications typically monitor the development of opioid dependence. In the study published in Pain Medicine, the University of Derby researchers used an examination of 112 adults to identify the factors that are most likely to contribute to the onset of dependence in any given individual. All of these adults were affected by significant pain in the 30-day period prior to the beginning of the study and used some sort of pain-relieving medication to address that pain. Not all of the medications in use were prescription opioids.
The researchers gathered information from the study participants through an online questionnaire that was administered anonymously. Pertinent facts probed with this questionnaire included how often the participants felt pain serious enough to require treatment, how severe pain symptoms got before the participants resorted to medication use, how the participants were emotionally impacted by their pain experiences, how much pain-relieving medication the participants used in the previous 30 days, whether or not the participants had current symptoms of painkiller dependence and whether or not the participants had previous histories of any form of substance abuse.
After reviewing the participants’ responses, the researchers concluded that three potentially overlapping groups of people have the highest chances of developing a physical dependence on pain-relieving medications. These groups are people who use above-average amounts of painkillers, people with prior histories of abusing opioid medications or any other substance and people who don’t handle the emotional strain of pain well and have difficulty clearly understanding or expressing their emotional states.
Significance and Considerations
The authors of the study published in Pain Medicine conducted their work partly because of the relative lack of prior research on the mental/emotional factors that can help lead to a dependence on painkilling medications. They believe that improved understanding of these factors, as well as the other factors identified during the study, can potentially contribute to an improvement in the pain-related treatments received by the public, a reduction in the amount of money spent on pain relief and a reduction in the time that doctors must dedicate to addressing pain medication complications in their patients.
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