By: Alexander M. Ziperovich
The American Society of Addiction Medicine says that four out of five new heroin users started out misusing prescription painkillers. Many are not even aware that common prescription pain medications are in the same class of drugs as heroin. These include brand name, blockbuster medicines like Vicodin® (hydrocodone), Percocet® (oxycodone), and Tylenol® #3 (acetaminophen-codeine). These drugs, despite increasing scrutiny in recent years by the media and government, are still prescribed for a wide range of ailments, medical conditions, and injuries both minor and major. Here is a list of five behaviors that may prompt you to reexamine your relationship with these potent chemicals.
Assessing Motivation: “I take pain meds for reasons other than pain”
Opioids like Vicodin® and Percocet® are often misused to treat unmanaged anxiety, depression, and the untreated symptoms of PTSD. Frequently, people find that the medications they are prescribed for physical pain also provide temporary relief from symptoms of unresolved mental illness if misused. Notably, underlying mental illness is a major driver of addiction and compulsive drug use. Some 7.9 million Americans were found to have both mental illness and addiction in a national survey conducted by SAMHSA in 2014.
While mental illness does not necessarily cause addiction, there is ample data to suggest a strong correlative link, indicating that mental illness contributes to problematic drug use. A recent article in The Washington Post about a study conducted at Dartmouth-Hitchcock Medical Center and the University of Michigan suggests that roughly half of all opioid prescriptions written in the United States are given to patients that suffer from anxiety, depression or both. When addiction and mental illness occur together it is referred to as a co-occurring disorder, and is termed a dual diagnosis in treatment parlance.
Developing Tolerance: “I need more than I used to”
Taking opioids for a prolonged and sustained duration leads to the development of a phenomenon known as tolerance. Tolerance is a side effect of long-term exposure to opiates and leads to dose-increase, as one needs a progressively larger amount of medication to achieve the desired effects, whether for remission of pain or the psychic effects (e.g. euphoria) sought by addicts.
The development of tolerance in patients that chronically consume opioid-type drugs results from the unique physical response the human body has to drugs of this class. Indeed, as patients become tolerant to opioids, they must take progressively larger and larger doses of their medication to achieve remission of pain. This same biological process takes place in heroin addiction, as addicts need larger and larger amounts of heroin to get high, resulting in a dangerous escalation of dosing that often results in unintentional overdose.
Early Refills: “My prescription of pain meds ran out early”
It’s very common in the early stages of opiate addiction to begin to develop an acute awareness of the significance of the availability of a steady, uninterrupted supply of opioid painkillers. The acquisition of these pills begins to take on outsize importance in one’s life and you may notice the onset of marked physical illness in their absence.
When opioids run out or prescriptions for them are discontinued, those that are dependent or addicted will experience an overwhelming desire for more of the drug. Cravings are the catalyst for much of the negative behaviors associated with opioid addiction. These include buying illegal opioids on the street such as heroin, doctor shopping, prescription fraud, theft of medication, and faking injuries to receive pain medication in hospitals.
Withdrawal Syndrome: “Without pain meds I am physically sick”
It’s important to understand opioid dependence in the context of the phenomenon of withdrawal. Withdrawal occurs as a result of the cessation of opiates in a person that has developed a physical dependence through uninterrupted use of opioid-class drugs, resulting in the manifestation of acute physical illness. Symptoms of withdrawal include fever, diarrhea, nausea, anxiety, depression, insomnia and profound desire, or craving, for more opioids.
Although withdrawal is a sign that physical dependence on opiates has occurred, it is not always a sign of addiction, as physical dependence manifests in those that take opioids for severe pain for long durations under proper medical supervision, as well as addicts that abuse opioids.
This is an important distinction to make when considering the possibility of addiction in someone with severe pain issues. In fact, the pain-ameliorating properties that opiates produce in patients suffering from legitimate pain issues are the same qualities that make opioids so attractive to addicts. Thus, there exists a fine line between legitimately taking properly prescribed and dosed medication for pain and misusing these drugs that can make it difficult to know where you stand without enough information. Learn more about how detox and withdrawal from opiates here.
Family Problems: “My family is concerned about my pain medication”
In many cases, it is the people we love that notice that we have a problem before anyone else. If family or friends have made it known that they are concerned about the way you take pain medications, it may be a reason to consider the role these drugs play in your life. Problems at work or in your home are opportunities to reevaluate yourself and the possibility that you may have become addicted to these drugs.
Fortunately, there are resources if you or someone you love thinks they may have a problem with prescription painkillers. It is crucial to educate yourself about the possibility that you may be dealing with addiction. Call Transcend Recovery at (800)-208-1211 and discuss your concerns with a trained treatment professional that can help educate you and your family or visit transcendrecoverycommunity.com for more information about solutions for addiction.