In movies depicting life in the Wild West, cowboys are told to bite down on their belts while their legs and arms are operated upon by dirty, scowling surgeons. To modern viewers, these scenes are nothing less than barbaric. Most patients demand relief from pain, both during painful procedures and throughout the healing process. It’s considered part of providing good medical care, and patients might simply storm out of the room if they’re told that no medications of any sort would be provided. It’s just not done that way anymore. Painkillers are considered an acceptable part of modern life, and they truly have flooded all corners of society. In fact, according to the Centers for Disease Control and Prevention, in 2010, so many painkillers were prescribed, that they could medicate all American adults for a month.
While the medications can prevent pain, their use is far from benign. With this same increase in prescriptions comes an increase in addiction rates. The medications are easy to get, easy to abuse and easy to get hooked on. This is the perfect storm of addiction.
Routes of Addiction
Medical providers are quick to point out that many people take pain medications at the proper dosage, under the direction of their doctors, and they stop using the medications when the pain has abated. These people may, however, keep their pain medications accessible, just in case the pain returns. They may have a significant amount of medications in the bathroom cupboard, for example, just waiting to be abused by curious family members, friends and house guests. This sort of experimentation and diversion of a legitimate prescription is surprisingly common.
The Office of Applied Studies reports that of people who were dependent on painkillers, 37.5 percent obtained the drugs from a friend or relative at no cost and 19.9 percent bought the drugs from a friend or relative. In other words, a significant amount of people who are addicted to painkillers don’t have a prescription for the drugs, but they know someone else who does. There are some people, however, who begin taking pain medications for a legitimate purpose and then develop a severe addiction issue as a result.
Modern painkillers are often closely related to opium or heroin. The active ingredient in these drugs crosses into the brain and attaches to specific receptors. When the drug is attached in this manner, the brain is fooled into thinking that something wonderful is about to occur, and it sends out a series of chemicals in response to prepare the person for the great thing that is to occur. When the drugs are taken properly, this response may be muted, allowing the person to feel a mild sense of happiness or euphoria. But, when the drugs are crushed or dissolved in water, they are allowed to enter the body rapidly, and the sensation may be incredibly strong.
Over time, the body develops a form of resistance to the drug. It may release fewer chemicals when the drug hits the receptors, or it may weaken those receptors so the body can’t be overwhelmed by the drug. When a person using medication finds that he or she needs more of the medication in order to gain the same results, this is called tolerance, and it’s not considered abnormal. In fact, it’s a normal part of the human body’s response and it shouldn’t be confused with addiction.
True addiction, according to the Encyclopedia of Behavioral Neuroscience, is characterized by:
- Lack of control over the use of painkillers
- Compulsive use
- Inability to stop using, even when the user faces harm
- Craving for the drug
Someone addicted to painkillers no longer has control over the use of the drug. Instead, taking the drug has become the top priority in the person’s life, and he or she may be physically unable to quit using the drugs without help. It’s a physical issue, as well as a mental issue, and this addiction can have serious consequences.
Consequences of Addiction
Opioid ingredients in painkillers may be quite helpful in treating pain, but they can cause severe damage to other systems in the body. For example, according to the National Institute on Drug Abuse (NIDA), painkillers can slow down the functions of the brain and respiratory system. An addict who takes a high dose of the drugs, or who combines painkillers with another drug such as alcohol, faces a high risk of coma or even death. This risk of death is so high, in fact, that the NIDA reports that more people die of overdose to prescription painkillers than from cocaine and heroin combined.
Addictions don’t just impact the addict, however. Anyone who comes in contact with the addict can be impacted by the disease, and sometimes, family members suffer greatly as a result of the addict’s abuse of painkillers.
- Fight frequently
- Suffer economic losses, particularly if the addict loses his or her job
- Feel guilty about the addiction, wondering if they are to blame
- Worry over the addict’s health
Some addicts are incredibly adept at hiding their addictions from the ones they love, and as a result, their families may not even know that the addiction is in progress until the addict suffers some sort of severe consequence, such as an arrest or hospital visit. When this happens, the guilt the family feels may be enormous.
People who abuse prescription medications may take incredibly high doses of the drugs, each and every day, and as a result, they may need to go to great lengths to keep an adequate supply of the drugs within reach at all times. According to the March of Dimes, they may engage in deceitful tactics with medical professionals, claiming that they’ve lost medications. They may visit multiple doctors and ask for prescriptions. Or, they may steal medications or prescription tablets from providers in order to gain access to the drugs. In order to counter this problem, some doctors ask probing questions of their patients during their doctor visits. According to the American Pain Foundation, people who are taking pain medications begin to see an improvement in their quality of life scores. Where they might not have been able to leave the house before they received medication, for example, after they got medication, they feel healthier and able to do more. People who abuse medications, by contrast, might score more poorly when asked, in the hopes that the doctor will prescribe more medications.
Pain is real, and it’s often subjective, but families of people who take pain medications should watch their loved ones for signs of abuse.
Someone might be abusing the medications if he or she does the following things:
- Crushes or snorts the pills
- Takes pills too often
- Seems desperate to keep a stock of pills
- Takes the drugs when no pain is present
- Spend time with others who also seem slow or sedated (particularly if the addict is a teen)
People who are abusing the drugs without a prescription or an underlying pain problem may:
- Seem sedated
- Ask for pills or money to buy pills
- Withdraw or become defensive when asked about medication use
- Spend time with others who also seem slow or sedated (particularly if the addict is a teen)
What to Do
As the Substance Abuse and Mental Health Services Administration makes clear, the first priority should be to get an addicted person into treatment, and often, this means that families must speak up and speak out against prescription painkiller abuse. Families live with the addict, and they’re in the best position to both identify abuse and encourage the addict to make the needed changes.
Sometimes, the best way to start this conversation is to hold a structured intervention with the addict. Here, family members meet with the addict, outline the problem as they see it and provide treatment options. Some interventions are confrontational, where the family surprises the addict with a meeting and they use strong language to convince the addict that help is needed. Other interventions are more supportive and educational. Families often hire experts to conduct the meetings; these professionals allow the family to participate in all the planning stages as well as the intervention itself. Either method can be helpful.
This is not the only way to talk to an addict about painkillers, however. Sometimes, it can be difficult for families to truly know if the person is addicted to the painkillers, or if the person is using the painkillers appropriately for a medical purpose. For families in this tight spot, a conversation with the doctor might be quite beneficial. Here, the doctor, the patient and the family can discuss the medications the patient is using, and gain expert medical advice on whether or not help is needed.
To prepare for this appointment, the Mayo Clinic suggests that the family make a list of:
- All of the medications the person is using
- When the person uses the medication
- How much the person takes
- What symptoms the person feels before and after taking the drugs
It might be tempting to suggest that a person taking painkillers, whether they are prescribed or not, should stop taking them immediately. In general, this is not a good idea. The person’s body has become accustomed to having access to the drugs, and when those drugs are gone, the body might revolt with a series of unpleasant symptoms including vomiting, sweating and shaking. While these symptoms might not be life-threatening, they’re certainly uncomfortable, and in some cases, they can make the addiction stronger. An addict who feels uncomfortable when he or she stops taking drugs might be more inclined to simply never stop usage. Instead, it’s best to taper off the drugs slowly with the help of a doctor. And, some patients may need replacement drugs that can mimic painkillers and keep symptoms and cravings away.
At Michael’s House, we have comprehensive programs that can help people overcome an addiction to painkillers. Our programs are appropriate for people who have developed addictions due to prescriptions, and for people who developed addictions due to recreational use.
Please call us today to find out more about what we can do to help.