By Jose S. Vazquez, M.D., Princeton HealthCare System
While recent stories of celebrities’ stints in rehab, TV show plotlines and tragic deaths provide grim reminders of the dangers of prescription drug abuse, the problem is far from just a Hollywood concern.
Prescription drug abuse is indeed on the rise across the United States, statistics show.
An estimated 2.1 million Americans abuse or are dependent upon prescription drugs, with painkillers being the most commonly abused, according to the 2007 National Survey on Drug Use and Health.
In 1990, the number of people dependent upon painkillers totaled 573,000. Today that number has nearly tripled, to 1.7 million. Moreover, painkillers are second only to marijuana for dependence and abuse, according to the survey.
It’s important to note, however, that most people who take pain medication as prescribed by their physician do not develop addictions and that pain relievers successfully help countless patients recover from a variety of injuries and surgeries every year.
Yet the prevalence of abuse and addiction cannot be ignored, as it can have serious consequences on a patient and his or her loved ones.
Prescription pain medications fall under a class of drugs known as opioids and include compounds like hydrocodone (Vicodin), oxycodone (OxyContin, Percocet), propoxyphen (Darvon), hydromorphone (Dilaudid) and meperidine (Demerol). These drugs act by attaching to certain proteins in the brain and spinal cord to alter the way a person experiences pain. Additionally, opioids often temporarily produce a sense of euphoria and a relaxed feeling of well-being.
People most at risk for abusing painkillers and becoming dependent include patients with a family history of substance abuse, including alcohol and/or drug abuse, and patients who have suffered multiple traumatic injuries. Patients who suffer from depression or other mental health disorders are also at greater risk for developing addictions.
At the same time, adolescents are also at increased risk for developing addictions to painkillers, as a rising number engage in an alarming practice called “pharming,” wherein they raid their families’ medicine cabinets and take prescription medication to get high. Too often this dangerous trend leads to long-term addiction. Parents should take precaution to keep their medications in a safe and secure place and to properly dispose of any remaining drugs that are not going to be used in a timely manner.
For adults, dependence on pain medication typically develops when a patient begins taking more than the prescribed dosage and continues to use the medication for longer than a week or two. Patients then not only become physically dependent, but they may also become psychologically dependent. Moreover, withdrawal from opioid abuse causes uncomfortable side effects such as muscle cramping, bone pain, runny nose, nausea, goose bumps, vomiting and diarrhea. To avoid these withdrawal signs, people often continue taking the drugs and perpetuating the cycle of addiction.
Patients who develop an addiction to prescription pain killers often show signs of social withdrawal and isolation. Some signs and symptoms may include trouble maintaining relationships and becoming distant from friends and family; inability to function at work, falling asleep during meetings and missing appointments; increased anger and irritability; changes in mood; depression; impulsive behavior, and financial trouble.
In addition, patients may resort to stealing from friends and family to support their addiction.
If you suspect a friend or family member is abusing prescription medication, it’s important to help him or her recognize the problem and get help.
Once a person decides to seek help, he or she may require hospitalization during the detoxification period, which is then typically followed by intensive outpatient therapy. If outpatient therapy is ineffective, patients may require inpatient rehabilitation services.
There are various steps family and friends can take if an individual remains in denial about the problem or refuses to seek help. One such option is an intervention meeting facilitated by a doctor or therapist, in which family and friends can gently confront the individual in a safe and supportive setting to all involved.
Treatment may also include medication. One of the safest and most effective medications to treat opioid addictions is a relatively new drug with the brand name Suboxone. Suboxone, generically known as buprenorphine, helps control cravings and reduces symptoms of withdrawal. The medication can be prescribed by a physician certified to administer the drug, and patients must be under a physician’s care while taking the medication.
While addictions can never really be cured, many people are able to remain successfully in recovery with the right support. Recovery, however, is a lifelong process. Fortunately, it is possible and many patients are able to live happy and healthy lives free from drug abuse.
Jose Vazquez, M.D., is chairman of the Department of Psychiatry of Princeton HealthCare System.
Princeton House Behavioral Health, a unit of Princeton HealthCare System, provides treatment and personalized care for people who need psychiatric support, have chemical dependencies or who struggle with a combination of emotional and addiction problems. For help, call 24 hours a day at 800-242-2550.
