While the vast majority of people who rely on prescription painkillers do so as directed and don’t develop any issues, studies show that as many as 6000 people per day start using them non-medically.
In this post I want to discuss several subjects…among them: Where is the line between appropriate use and addiction? What are the warning signs? Why can it often be so difficult to stop using pain meds? What can be done if you (or a loved one) needs help?
What Is Appropriate Pain Medication Usage?
Pain medication can be essential for many people. There is no reason to suffer needlessly out of a fear of addition. That can be, after all, significant cost (poor quality of life) if pain is not treated. In fact, the vast majority of people who are prescribed pain medication (and use it as directed) do not develop an addiction.
Why Can Pain Meds Lead To Trouble In Some Cases?
Most pain medication falls into a class called “opioids”. There are many types of prescription opioids (with names like OxyContin, Vicodin, and Percocet). There are other opioids (like heroin) that are considered street drugs.
The challenge with opioids is that many people can become tolerant and dependent and, upon stopping their use, can start experiencing withdrawal symptoms. Normal withdrawal lasts 24-48 hours and can include flu-like symptoms. Often, rather than feeling sick, people decide to take more medication to feel better and the cycle begins.
From there, the situation can spiral. More severe cases of withdrawal can make people extremely sick, can last weeks, and can make it nearly impossible to function in daily life. At this point, of course, it would be very difficult for anyone to break this cycle.
What Are The Warning Signs To Look For?
– Tolerance and/or Increased Usage
Tolerance means an increase in the amount taken with a decrease in effect. If that happens, speak with your doctor. It is not always a bad thing to take an increased dose…as long as it is done in conjunction with your doctor and in conjunction with a plan to eventually taper off. If, however, you’re increasing your dosage on your own, it’s a big red flag.
– Taking Pills Longer Than Intended
It’s important not to take pain meds after the condition has improved. If you find yourself trying to convince your doctor that you are still in pain and that you need the medication “just a bit longer” there could be an issue.
– Taking Pills To Alleviate Withdrawal Symptoms
This was mentioned above, but it’s a crucial warning sign. It leads to an extremely hard-to-break cycle and often leads to addiction.
– Unsuccessful Attempts At Quitting
If you “want” to stop taking pain medication but are having trouble stopping, it’s a major warning sign.
– Time Spent Trying To Obtain Prescriptions
A person at great risk of addiction will typically find themselves preoccupied with getting more. It becomes the top priority. They will often spend a great deal of time and effort trying to obtain more drugs. This generally takes the form of visiting multiple doctors (unknown to the other doctors) and trying to convince them to prescribe more pills.
– Change In Personality
A marked change in a person’s personality can be a warning sign as well. Look for shifts in mood, energy, and concentration. Behavior can become erratic and volatile. Many times, people experiencing an addiction issue will also withdraw from family and friends, social events, and even recreational events.
– Change In Daily Habits and Appearance
Sleeping and eating habits will often change. There can be a lack of personal care and hygiene as well. Clothing and appearance concerns might become an issue. And, there can often be a persistent cough, runny nose, and irritated eyes.
– Neglecting Responsibilities
Be on the lookout when a person calls in sick to work frequently, avoids basic household responsibilities, or puts themselves (or others) in danger.
– Continued Use Despite Knowing That Adverse Effects It Is Having On Their Life
In many cases, the addicted person knows they are addicted and they know their addiction is having a very negative effect on themselves and those around them. Yet, they cannot stop.
What Are The Costs Of NOT Doing Anything About It?
Obviously, an addiction to pain medication is going to make leading a successful and happy life a challenge. Among the challenges faced by those with opioid addition are:
– Loss of career and family (functioning normally can become a major challenge)
– Financial issues (opioid addiction can run into the thousands of dollars per month)
– Loss of health (chronic use leads many health issues, ranging from death by overdose to long-term organ damage)
– Legal issues (obtaining pain pills not prescribed to you is illegal and can result in fines, lawyer fees, and even jail time)
What Treatment Options Are Available?
As you can see, if you (or someone you know) is suffering from opioid addiction, it’s imperative that you (or they) seek help. In many cases, it is nearly impossible to overcome on your own, so please seek the help of a qualified specialist.
There IS help available.
You are NOT the only person dealing with this.
And, you will NOT be judged.
Treatment options include:
– Replacement Therapies
These are medications prescribed by specially trained doctors in a normal office setting. This class of medication acts like an opioid so that you don’t have to go through the normal physical withdrawal symptoms (therefore the name “replacement” therapies). This is a great option for many patients.
– Opioid Blockers
This class of medication blocks the effect of opioids. In other words, if you use an opioid while on a blocker, you won’t feel the effects. This can be a good option for someone who is no longer actively using, but wants to reduce the risk of relapse.
– Inpatient Detox
These programs are designed to help a person weather the storm of withdrawal in a medically supervised setting. Most likely, it will require a stay at a hospital or a similar facility where the staff will help (through medication and other treatment) make the withdrawal as comfortable as possible.
These programs are often recommended for people after completing a detoxification program. You would go to a facility for several weeks, attend therapy sessions, and really work on fixing the underlying symptoms that led to the addiction in the first place.
Prescription pain medication is a safe and effective treatment for most patients. And, working closely with your prescribing physician should lessen the chances of any issues developing.
However, there are some risks inherent with these medications. It’s important to be aware of the warning signs of dependency and addiction.
What’s more, if you (or someone you know) has several of the warning signs, it is ESSENTIAL to get help.
There IS help available and it is very effective. You do NOT have to suffer needlessly.
Dr. Amanda Itzkoff
My name is Amanda Itzkoff, MD. I am a New York City based Psychiatrist and Assistant Professor at Mount Sinai Medical Center.
For additional information, please feel free to email our office at Amanda.Itzkoff@gmail.com.
To schedule an appointment, call our offices at 917-609-4990.