Chronic pain is a growing public health issue with economic, social and medical costs. As the percentage of the U.S. population utilizing opioid analgesics for pain control grows, so does the rate of abuse, misuse and overdose of these drugs. Examples of opiates include morphine, codeine, hydrocodone, heroin, oxycodone and heroin.
The Substance Abuse and Mental Health Services Administration’s 2013 National Survey on Drug Use and Health found that, among persons aged 12 years or older who were abusing analgesics, 53% reported receiving them for free from a friend or relative. According to the Centers for Disease Control and Prevention, about 17,000 overdose deaths involving opioids occurred in 2011. From 2000 to 2010, the number of hospitalizations for addiction to prescription opioids increased more than 4-fold to over 160,000 per year. In 2010, one out of every eight deaths among persons aged 25 to 34 years was opioid-related. In a 3-year period (2003 to 2006), more than 9000 children were exposed to opioids.
Salonpas spoke with leading addiction specialists to learn about the signs of this addiction and what people can do to find help:
Is it only “addictive personalities” that get hooked on opioids? “The concept of ‘addictive personality’ is erroneous,” says Dr. Hy Gia Park, a board-certified psychiatrist at Arahant Health Services. “There is no clinical definition of an ‘addictive personality.’ Addiction is a genetic and biological phenomenon; most studies estimate that 40-60% (depending on the drug discussed) is genetically determined based on twin-twin studies. What this means is that they track genetically identical twins who have been adopted into different families. Regardless of the family they were adopted into, 40-60% of these patients developed an addictive disorder regardless of family circumstance or environment.”
What is the ‘high’ that people get from opioid drugs? “Opioids create a sense of ‘euphoria,’ says Dr. Debbie Frankowski, Medical Director at the Center for Addiction Treatment. “Opioids are energizing to opioid addicts, but at higher doses are relaxing, sedating and create a sense of well-being.”
“Recreational experimentation with opioid analgesics is a common occurrence among teens and young adults,” says Dr. Frankowski. “As addiction progresses and tolerance grows, the pills become too expense and the addict may progress on to heroin which is cheaper and more plentiful.”
What are the symptoms that someone has become addicted to opioids? “Some common symptoms that you will see are mood swings, depression, anger – you know the kind where anything will set a person off,” said Joanne Sprecher, a certified alcohol and substance abuse counselor and the outreach manager at The Discovery House Treatment Center, a full service addiction treatment center that helps individuals who are struggling with drug and alcohol addiction.
“Addicts can’t maintain healthy relationships so they start losing friendships and partners,” adds Sprecher. “They will start hanging out with people more like who are they are now. There is also edginess, the kind you see when people have too much caffeine. These addicts are on the precipice of volatility, like they are waiting to explode. You have to remember that not only are they in physical pain but they also have a driving need for the drug. They will do anything to find it. This is when they discover ‘doctor-shopping,’ and go to several doctors to get a prescription for the drugs and when the pharmacy starts questioning them, they will find other pharmacists to fill prescriptions.”
If someone suspects their friend or family member is addicted to opioids, what should they do? “Talk to that person and see if they acknowledge the addiction, if they have been trying to do something about it, and see if they want help or if they have been getting help,” says Sprecher. “If they deny they have a problem and you feel there is one, seek professional help, find someone or someplace who can advise you based on your personal situation. Sometimes it might be therapy and attending meetings or more intense like a treatment center.”
There are many online resources to turn to which include: The National Institute on Drug Abuse, the National Council on Alcoholism and Drug Dependence, Partnership for Drug Free Kids, Substance Abuse and Mental Health Services Administration and the Veteran’s Administration.
Can opioid addicts safely go through drug withdrawal alone? “The physical symptoms of opioid drug withdrawal can include anxiety, restlessness, tremors, nausea, vomiting, diarrhea, runny nose, teary eyes, sneezing, and severe muscle aches, primarily in the legs and backs,” said Dr. Frankowski.
“Opioid withdrawal is extremely uncomfortable but not life threatening In contrast, withdrawal from alcohol or benzodiazepines can be life threatening.”
“Withdrawal can be a very painful experience and I would never recommend for a person to detox alone,” says Sprecher. “Without proper medical attention, there is a possibility to suffer from seizures or strokes and there have been extreme cases where people have died if not properly supervised.”
Aftercare for a recovering opioid addict includes getting involved in sober support activities such as Narcotics Anonymous. Keeping sober is a lifetime commitment. “If the recovering addict is following all the directives of a sober lifestyle, there should be no reason for a relapse,” says Sprecher. “But there could be any reason that could trigger a relapse from a memory or major life change which is why it is very important to have a strong support system in place There will be times when a relapse is possible but it doesn’t have to be probable.”
Non-prescription pain relief alternatives are available to treat pain and should be the first line of defense for recovering opioid addicts. “There are many terrific over-the-counter alternatives that work great for dealing with physical pain,” said Spreacher. “I would also recommend trying holistic approaches such as yoga, deep stretching and acupuncture.”