Prescription medications such as pain relievers, central nervous system depressants (tranquilizers and sedatives), and stimulants are highly beneficial treatments for a variety of health conditions. Pain relievers enable individuals with chronic pain to lead productive lives; tranquilizers can reduce anxiety and help patients with sleep disorders; and stimulants help people with attention deficit hyperactivity disorder (ADHD) focus their attention. Most people who take prescription medications use them responsibly. But when abused that is, taken by someone other than the patient for whom the medication was prescribed, or taken in a manner or dosage other than what was prescribed – prescription medications can produce serious adverse health effects, including addiction. Opiod medications can, in fact, alter the brain’s activity leading to addiction.
The nonmedical use or abuse of prescription opiods is a serious and growing public health problem in this country. Most people take prescription medications responsibly; however, an estimated 48 million people (ages 12 and older) have used prescription drugs for nonmedical reasons in their lifetimes. This represents approximately 20% of the U.S. population. In fact 9.3% of 12th-graders reported using Vicodin without a prescription in the past year, and 5.0% reported using Oxycontin – making these medications among the most commonly abused prescription drugs by adolescents. When asked how prescription pain relievers were obtained for nonmedical use, 59% of 12th-graders said they were given to them by a friend or relative. Among those who abuse prescription drugs, high rates of other risky behaviors, including abuse of other drugs and alcohol, have also been reported.
What Is Driving This High Prevalence?
#1 Misperceptions about their safety. Because these medications are prescribed by doctors, many assume that they are safe to take under any circumstances. This is not the case: prescription drugs act directly or indirectly on the same brain systems affected by illicit drugs; thus their abuse carries substantial addiction liability and can lead to a variety of other adverse health effects. Opiods act on the same brain receptors as heroin.
#2 Increasing environmental availability. Between 1991 and 2010, prescriptions for stimulants increased from 5 million to 45 million, a 9-fold increase, and opiod analgesics increased from about 30 million to 180 million, a 6-fold increase.
#3 Varied motivations for their abuse. Underlying reasons include: to get high; to counter anxiety, pain (physical and or emotional), or sleep problems; or to enhance cognition (although they may, in fact, impair certain types of cognitive performance). Whatever the motivation, prescription drug abuse comes with serious risks.
Commonly Abused Prescription Medications
Although many prescription medications can be abused, the following three classes are most commonly abused:
Opioids – usually prescribed to treat pain
CNS depressants – used to treat anxiety and sleep disorders
Stimulants – prescribed to treat ADHD and narcolepsy
For the remaining part of this article I would like to focus on prescription pain relievers or opiods.
What Are Opioids?
Opiods are analgesic, or pain relieving, medications. Studies have shown that properly managed medical use (taken exactly as prescribed) of opioid analgesics is safe, and manage pain effectively, and rarely causes addiction. Among the compounds that fall within this class are hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin – an oral, controlled-release form of the drug), morphine, fentanyl, codeine, and related medications. Morphine, fentanyl, and oxycodone are often used to alleviate severe pain, while codeine and hydrocodone are used for mild to moderate pain.
How Are Opioids Abused?
Opioids can be taken orally, or the pills may be crushed and the powder snorted or injected. A number of overdose deaths have resulted from the latter routes of administration, particularly with the drug OxyContin, which was designed to be a slow release formulation. Snorting or injecting opioids results in the rapid release of the drug into the bloodstream, exposing the person to high doses and causing many of the reported overdose reactions.
How Do Opioids Affect The Brain?
Opioids act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these compounds attach to certain opioid receptors in the brain and spinal cord, they can effectively change the way a person experiences pain.
In addition, opioid medications can affect regions of the brain that mediate what one perceives as pleasure, resulting in the initial euphoria or sense of well-being that many opioids produce. Repeated abuse of opioids can lead to addiction. Addiction is an individual engaging in compulsive drug seeking and abuse despite its known harmful consequences.
What Adverse Effects Can Be Associated With Opioids?
Opioids can produce drowsiness, cause constipation, and, depending upon the amount taken, depressed breathing. Taking a large single dose could cause severe respiratory depression or death. These medications are only safe to use with other substances under a physician’s supervision. They should never be used with alcohol. They must be used with extreme caution with antihistamines, barbiturates, or benzodiazepines. Because these other substances slow breathing, their effects in combination with opioids could lead to life threatening respiratory depression.
What Happens When You Stop Taking Opioids?
Patients who are prescribed opioids for a period of time (sometimes daily use for 2 weeks) may develop a physical dependence on them, which is not the same as addiction. Repeated exposure to opioids causes the body to adapt, sometimes resulting in tolerance (that is, more of the drug is needed to achieve the desired effect compared with when it was first prescribed) and in withdrawal symptoms upon abrupt cessation of drug use. Thus, individuals taking prescribed opioid medications showed not only be given these medications under close, appropriate medical supervision, but they should also be medically supervised when stopping use in order to reduce or avoid withdrawal symptoms. Symptoms of withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (cold turkey), and involuntary leg movements.
Are There Medical Treatments For Opioid Addiction?
Individuals who abuse or are addicted to prescription opioid medications can be treated successfully. Initially, the patient may need to undergo medically supervised detoxification to help reduce withdrawal symptoms; however, that is just the first step. Treatment of an individual addicted to prescription opiods is a complex process.
#1 The individual must be properly detoxed off the opiod medication. The medication that I am currently using in my office to help individuals immediately discontinue their opiod use is buprenorphine or Suboxone. Buprenorphine or Suboxone is a synthetic opioid and is intended to be used in an office setting by a Drug Enforcement Agency (DEA) certified physician. The proper use of Suboxone allows the individual to immediately stop their opiod use with little to no withdrawal symptoms. The individual is then slowly weaned off the Suboxone.
#2 The individual must receive behavioral therapy or behavioral modification which can be found in individual counseling sessions and/or group counseling sessions. Individual and group counseling sessions can be found within the Reformers Unanimous recovery program. Reformers Unanimous also has a residential program for men and women located in Rockford Illinois.
#3 The individual must prioritize their life with the spiritual part of life at the core. This is absolutely essential for a healthy, lasting recovery program. The physical and emotional recovery must be built on a strong spiritual foundation. This spiritual foundation is found in a personal relationship with the Son of God, Jesus Christ. This relationship begins with salvation. This relationship can then be further enhanced by:
- A daily prayer life
-daily reading of the Bible
-daily meditating on the things of God
-daily praising God
-daily encouraging others in their walk with Jesus Christ
-daily living for God and others
Recovery must include the three aspects of our being, body, soul, and spirit, to be effective and complete. For further information regarding this form of total, complete recovery go to the web site of Reformers Unanimous at www.reformu.com.
There is hope for you! There is help for your loved one!