Painkillers are prevalent in the US, both over-the-counter and prescription varieties. Prescription painkillers are typically narcotics, or opioid-based, because opium and similar synthetic molecules are very effective at dulling pain and elevating mood. When taken as prescribed, with a doctor’s supervision, prescription opioid painkillers are an important tool to relieve pain from surgery, injury, or illness.
These drugs are widely prescribed to ease pain for a few days after dental work; a few weeks or months after broken bones, a work-related injury, or major surgery. They are also used to treat chronic pain from illnesses like multiple sclerosis, fibromyalgia, cancer, or AIDS.
Opioid Painkiller Addiction Is an Epidemic
Narcotic painkiller prescriptions have become much more common since 1999, according to the Centers for Disease Control, and many medical professionals and lawmakers now believe that the wider availability of these medications has led to an opioid abuse epidemic. The CDC notes that, between 2000 and 2014, over a half-million people died from opioid overdose, including overdoses from prescription narcotics, heroin, or similar drugs.
The Most Common and Addictive Painkillers
- Morphine: This is the opioid that occurs naturally in the opium poppy. Other opioid medications are typically synthesized from morphine at some stage.
- Fentanyl: This is a potent synthetic opioid that is most often prescribed to people suffering chronic pain who have developed a physical tolerance to other opioid drugs.
- Hydrocodone: This is a semisynthetic opioid painkiller, originally believed to be less intoxicating and addictive than oxycodone. This was later found to be untrue, and the DEA moved hydrocodone medications from Schedule III to Schedule II. Two of the most common forms of hydrocodone are Vicodin and Norco.
- Oxycodone: This is a powerful prescription narcotic that, like hydrocodone, is semisynthetic. This is a tightly regulated medication that is prescribed to people with serious pain. There are both short-term prescription versions, like Percocet, and long-acting prescription versions, such as OxyContin.
- Codeine: There is a slight chemical variance from morphine to codeine, but not as much as between hydrocodone or oxycodone and morphine. Codeine used to be a common painkiller and cough suppressant in over-the-counter cold or flu medications, but since it is an addictive opioid, codeine is now rarely found. It is available via prescription only in the US.
- Meperidine: This short-acting synthetic painkiller is typically used to dull pain sensations before and after surgical sedation, and sometimes during childbirth. The most common brand name of this drug is Demerol.
- Tramadol: About 20 percent of this drug is an opioid medication, while the other 80 percent inhibits the uptake of serotonin and norepinephrine, which helps to improve mood related to pain. Tramadol is most commonly found under the brand name Ultram in the US.
- Methadone: A very long-acting synthetic opioid-like drug, methadone is primarily used to help taper people who have struggled with narcotic addictions for a long time off opioids. It is also being used as an inexpensive prescription painkiller in some cases.
Who Abuses Prescription Painkillers?
It is difficult to know who might begin abusing prescription narcotics and who will not. Currently, about 8.5 million Americans ages 18 and older struggle with addiction to prescription painkillers. These individuals most likely encounter the drugs through a doctor’s prescription and then find that they crave the drug and are unable to stop taking it. People who have family members with addiction or substance abuse problems are more likely to struggle with substance abuse themselves.
Mental health issues, environmental stress, and traumatic life events also put people at greater risk of developing an addiction to prescription painkillers or developing other substance abuse issues. Co-occurring disorders like bipolar disorder, depression, anxiety disorder, and post-traumatic stress disorder can lead a person to self-medicate, especially with CNS depressants like alcohol and opioid drugs.
Other people become addicted to prescription painkillers by trying the drug specifically to induce euphoria. In some cases, people who struggle with addiction to or abuse of other drugs, like alcohol, cigarettes, marijuana, MDMA, cocaine, or other prescription medications, may try opioid drugs in order to enhance their high or to induce a different high.
Symptoms of Prescription Painkiller Abuse and Addiction
- Slurred speech
- Loss of coordination
- Nausea or vomiting
- Confusion, difficulty thinking
- Abdominal cramps
- Itching or skin sensitivity changes
- Slowed breathing
- Fatigue, sleepiness
- Pinpoint pupils
- Heart rate changes, especially slower heart rate
- Taking more of the drug than prescribed
- Running out of the prescription early or asking for frequent refills
- “Doctor shopping,” or going to multiple doctors for prescriptions
- Requesting specific painkillers during doctors’ visits
- Stealing painkillers or illegally purchasing them
- Thinking about narcotics consistently and feeling excitement regarding the next dose
- Worrying about where the next dose will come from
- Cravings for the prescription between doses
When a person struggling with narcotic addiction is not able to take the medication regularly, or chooses to stop taking it, they will experience withdrawal symptoms. This is due to the body’s physical dependence on the medication to reach normalcy. Withdrawal can also occur in people who are not addicted to the medication, but who have been taking prescription painkillers for several weeks or months as directed.
Treatment for Painkiller Addiction
- Cravings for the drug
- Anxiety and irritability
- Cold or flu-like symptoms
- Rapid breathing and heartbeat
- Abdominal cramps
- Changes to appetite
- Changes to mental state
As a result of the potential intensity of withdrawal symptoms, and the related high likelihood of relapse during withdrawal, medical detox is always recommended for opioid withdrawal.
Help is needed and readily available for those who need to overcome an addiction to painkillers. It is important to work with a medical professional, such as a doctor, to begin the detox process. Often, comprehensive rehab programs include medical detox within their offerings. If they don’t, they can generally refer clients to a facility that can offer such services.
During medical detox, a doctor can prescribe medications like buprenorphine, which bind to the same opioid receptors in the brain without creating the euphoria related to use of narcotic drugs. This long-acting medication can help the person’s body overcome dependence on opioid drugs, so they can focus on other aspects of their treatment. The overseeing doctor may also taper the current opioid medication in the same way. In some instances, additional medications may be prescribed to address specific withdrawal symptoms, such as anti-anxiety or anti-nausea medication.
Once detox has been successfully completed, the treatment team will work will the client to address the underlying issues that led to the initial substance abuse. Addiction treatment comes in many forms, and the specific treatment plan will be determined based on the individual client’s needs. Throughout the course of treatment, the plan may change depending on the person’s progress in recovery. It’s important to choose a treatment facility that offers this kind of customized approach as there is no cookie-cutter solution to addiction recovery.
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