17 Mar How to Stop Abusing Painkillers
While it may have started innocently enough, once you’re hooked on painkillers the road back to normal can be rough – and lengthy. In many cases, a person doesn’t even realize they’ve become dependent on the substances until they run out of the source – pills, access to prescriptions, no street hook-up or friends willing to share. Painkiller abuse can be overcome, but, just like any other drug of choice, it isn’t easy.
Prescription Painkiller Abuse on the Rise
Recent data shows that prescription painkiller abuse is on the rise in the United States. The Treatment Episode Set (TEDS) collects data on the primary substance of abuse and up to two additional abused substances at the time of admission to treatment for substance abuse.
Using data from the 1998 and 2008 TEDS, a report issued in July 2010 shows that:
- The proportion of all substance abuse treatment admissions aged 12 and older reporting any pain reliever abuse increased fourfold from 1998 to 2008 – from 2.2 to 9.8 percent
- The increases in admissions reporting painkiller abuse cut across age, race/ethnicity, gender, employment, education, and region
- Among those admissions for which medication-assisted opioid therapy was planned, reports of pain reliever abuse more than tripled from 1998 to 2008 – from 6.8 to 26.5 percent
A more recent statistic comes from the National Insitute in Drug Abuse (NIDA) report which shows that about 7 million people aged 12 and older in 2009 reported past-month usage of psychotherapeutic drugs (2.8 percent of the U.S. population). Prescription pain reliever users accounted for 5.3 million – the largest number – in that report.
Examples of Painkillers
Painkillers, also known as opioids, are drugs that either contain opium or are derived from and imitate opium. Prescribed for pain relief, they are only available legitimately by prescription and most are non-renewable. Morphine derivatives, or narcotics, come from opioids and are used to treat pain, induce anesthesia, help alleviate diarrhea, and suppress coughing. These drugs induce a sense of euphoria or well-being by reducing tension, aggression and anxiety.
Here are some examples of painkillers, some of which are well-known brand names. They are listed alphabetically.
- Codeine – Used especially as a painkiller, codeine is found in opium, just as morphine is. Codeine is weaker than morphine.
- Fentanyl (also fentanyl analogs) – Similar to morphine and administered orally or via skin patch, fentanyl is a man-made opioid painkiller. Brand names include Actiq, Duragesic, and Sublimaze.
- Hydrocodone – This painkiller is often used in combination with acetaminophen to reduce pain. Its best-known brand name is Vicodin.
- Morphine – This drug’s powerful active ingredient is opium. Morphine is used as a sedative and painkiller.
- Opium – Comes from the opium poppy. Previously, opium was used in medicine to soothe pain. Now, opium is often replaced by drugs such as morphine and codeine (derivative alkaloids) or man-made substitutes (opioids).
- Ocycodone – This is a narcotic painkiller. Examples of brand names include OxyContin, Percodan, and Percocet.
About the Problem
There’s no question that when used appropriately and under medical supervision, hydrocodone (Vicodin, for example), oxycodone (e.g. OxyContin), morphine, and similar prescription painkillers provide an indispensible medical benefit by reducing pain and suffering.
But these same medications also have the potential to produce dependence or abuse in the individuals taking them. This can occur even under a doctor’s supervision, but especially when such substances are taken without medical supervision and oversight.
It’s become a major area of concern among health officials in the United States. In 2008, among the population of the U.S. aged 12 and older, nonmedical use of prescription pain relievers was the second most prevalent type of illicit drug use, right after marijuana.
Where do people obtain the prescription painkillers? It’s not always from their doctor’s prescription. In fact, the majority of nonmedical users of prescription painkillers in the past year (55.9 percent) got them from a friend or relative for free. Another 8.9 percent purchased them from a relative or friend.
The demands on the health care system from increases in prescription painkiller abuse are expected to rise as well. Adverse reactions from overdose is one such demand. In addition, more resources will likely be needed in order to treat dependence and abuse involving these medications.
Recognizing the Physical Signs of Painkiller Abuse
Maybe you already know if you are abusing painkillers, but, then again, maybe not. It’s important to recognize the physical signs of painkiller abuse first. Then you can decide what to do about overcoming the problem.
Short-term effects – Painkillers can cause the following symptoms in users: apathy, drowsiness, constipation, flushing of the face and neck, lack of energy, inability to concentrate, nausea, pupil constriction, respiratory depression, and vomiting.
Long-term effects – After using painkillers for a period of time, a person can become addicted to the drug. When trying to go off the drug, or when the supply runs out, the individual can experience withdrawal symptoms. Long-term painkiller use also leads to tolerance, which means the user requires more of the drug and more frequent use in order to produce the same euphoria or high. This could lead to overdose.
Potential drug interactions – Painkillers are powerful drugs in and of themselves, and should never be mixed with other medications or certain substances. Anyone already taking a prescribed medication should not take a prescription painkiller unless their doctor so advises – and then, it should only be taken exactly as the physician directs. Painkillers should never be taken with alcohol, antihistamines, barbiturates, or benzodiazepines – all of which slow breathing. The combination of any of those drugs and prescription painkillers could lead to respiratory depression, a potential life-threatening condition.
Overdose – Painkiller overdose has specific signs. These include cold and clammy skin, confusion, convulsions, pinpoint pupils, severe drowsiness (inability to stay awake), and troubled or slow breathing. NIDA reports that the number of fatal overdoses or poisonings involving prescription pain relievers has more than tripled since 1999.
Risks of Painkiller Abuse
Beyond these symptoms, risks associated with painkiller abuse include addiction, overdose, and HIV/AIDS. Prescription opioids act on the same receptors as heroin, and therefore can be highly addictive. In addition, people who abuse painkillers often alter the route of administration to intensify the effect. These include snorting or injecting instead of taking painkillers orally. Some painkiller abusers report moving from opioids to heroin.
Injecting opioids increases the risks of the diseases of HIV/AIDS through the use of unsterile or shared needles.
How to Stop Abusing Painkillers
It’s not as simple to get off your dependence or addiction to painkillers. You can’t just flush them down the toilet – well, you can, but you won’t be helping your situation any. Once you abruptly stop taking the painkillers you’ve been abusing for some time, you’ll begin having withdrawal symptoms. These range from mild to moderately severe. In some cases, they can be more severe, depending on your overall physical condition, any co-occurring disorders, other drugs you’re currently taking and other factors.
That’s why it’s never recommended that you try to come off painkillers on your own. Detoxification (getting the drugs out of your system) should only be done under medical supervision and monitoring.
Common painkiller withdrawal symptoms include cold flashes, diarrhea, involuntary leg movements, muscle and bone pain, restlessness, and vomiting.
Ask Yourself these Questions
If it sounds like an intimidating prospect to come off painkiller abuse, it doesn’t have to be. Still unsure if you fall into the category of abusing painkillers, or maybe are addicted? Ask yourself the following questions, and be honest.
- Do you take more of the drug and more often than originally prescribed (if it was prescribed for you) by your doctor?
- Do you feel compelled to take the drug and often experience anxiety about getting another prescription refilled (or getting another supply of the drug by other means) before it runs out?
- Are you unable to quit taking the drug, despite a sincere desire to do so?
- Is your life more and more disrupted as a result of your drug-taking overshadowing all other activities such as professional and social?
- Have you committed any illegal acts in order to get the painkillers, such as going to more than one doctor for prescriptions, stealing drugs or money to buy drugs from friends or relatives?
If you answered yes to any of these questions, you may be addicted to the painkillers either physically or emotionally.
But you don’t have to despair. There is help for you to get off painkiller abuse.
Treatment for Painkiller Abuse
As previously mentioned, you shouldn’t try to wean yourself off painkillers alone. Treatment to overcome painkiller abuse should be carried out by professionals and include both physical and psychological help.
Treatment settings for painkiller abuse include residential treatment or rehab facilities, hospital inpatient and outpatient centers. Counseling, medication-assisted opioid therapy, group sessions, and other components may be part of the overall treatment program.
Depending on how serious your painkiller abuse is, your doctor may recommend various types of treatment programs. First, you’ll need to go through detoxification (detox, for short) to clear the substances from your body. Detox can be long or short, and accomplished as an inpatient (where you stay at the hospital or facility) or outpatient (where you return to your own home each night). Research studies show, however, that inpatient detox tends to be more effective for most patients, especially those who have been addicted or dependent upon painkillers for a long time.
Certain medications may be prescribed to help eliminate or reduce the severity of withdrawal symptoms from painkiller abuse or addiction. These are synthetic opioids that were originally developed to help heroine addicts overcome their addiction. They also work with opioids or painkillers.
There are four major medications that have been and are used to help patients with withdrawal symptoms from painkiller abuse and addiction.
- Methadone – This synthetic opioid medication has been used successfully for more than 30 years to help people overcome their addiction to heroine and other opioids. It blocks the effects of heroin and other opioid painkillers, eliminates cravings and withdrawal symptoms.
- Naltrexone – An opioid blocker, naltrexone can be used with people who are motivated to overcome painkiller abuse and addiction. It has been proven to help with relapse prevention.
- Naloxone – This medication is used to treat opioid overdose. It can also counter the effects of painkillers.
- Buprenorphine – This synthetic opioid medication, approved in 2002 to treat heroin addiction, is also very effective for other opioids.
According to the NIDA, promising new approaches to the treatment of painkiller abuse include depot or long-acting formulations of medications with effects that last for weeks – instead of hours or days. An example is the already FDA-approved depot formulation of the opoid receptor blocker naltrexone (Vivitrol). NIDA reports that clinical trials in heroin abusers in Russia showed “extraordinary outcomes regarding drug abstinence, treatment retention and decreased craving.”
Following detox, the so-called active phase of treatment begins. It’s not enough just to get the drugs out of your system. Without counseling to learn how to cope with the triggers – the people, places, and things that cause you to use – and strategies to help you deal with recurring cravings and urges, you’re at greater risk of relapse.
In other words, you need professional guidance to help you in your desire to remain drug-free. If you originally started taking painkillers in order to manage chronic pain, there are doctors, counselors, and physical therapists who can help you learn how to safely manage pain as a recovering painkiller abuser or addict.
Start with your doctor and ask for a referral to treatment to overcome painkiller abuse. Another source is the Treatment Facility Locator maintained by the Substance Abuse and Mental Health Services Administration (SAMHSA). This is an online searchable database of more than 11,000 addiction treatment programs around the United States that treat drug abuse, alcoholism, alcohol abuse problems. For help navigating the site, click on the link at the top of the page for “Learn how to use all the locator search features.”
You can also call the toll-free, confidential Treatment Referral Helpline at 1-800-662-HELP (1-800-662-4357).
Support is Key
Let’s say you go in for detox and then stick around for the full treatment program. Whether that is 30 days or 60 days or longer (in the case of co-occurring substance abuse and mental health disorder, chronic alcoholism and painkiller abuse, multiple-drug abuse), once you complete treatment, that isn’t the end of the line for your recovery from painkiller abuse.
The most important part of overcoming painkiller abuse or addiction is the sincere desire to live a life of sobriety. That means no more prescription drug abuse – period.
But you need more than just the desire to stay clean. You also need to develop an effective support network that includes family members and participation in a 12-step group. Your family, friends, and your doctors can help you to stay away from painkillers. By joining a support group, such as Narcotics Anonymous, you can receive ongoing, non-judgmental encouragement and support that can help prevent your relapse following completion of treatment for painkiller abuse.
In the end, while others may urge you to seek help for a problem with painkiller abuse, it’s up to you to make the decision to quit and to go through the detox and treatment process. Remember that you didn’t become dependent or addicted to painkillers overnight and it will take some time for your body and brain to wean off such dependence.
You can get off painkiller abuse. Millions already have. You can be one of them. The best thing to do is to look into getting treatment today. The sooner you start, the sooner you will be on the road to recovery and a life free of painkiller abuse.
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