January 17th, 2012 13:34 EST
The Fastest Growing Drug Problem in America: Prescription Painkillers
Prescription drug abuse is the fastest growing drug problem in the United States. The dramatic increase in accidental drug overdose deaths in recent years is largely attributed to increased use of prescription painkillers (narcotics), known medically as opioid analgesics. It is estimated that about 9 million people in the U.S. use opioids long term for medical purposes whereas about 5 million use them for "nonmedical" purposes, meaning without a prescription or for medical need.
The number of overdose deaths involving prescription opioids has increased fourfold in the last decade and appears to be higher in states where doctors write more prescriptions for these medications. Since 2003, more drug overdose deaths have involved prescription opioids than heroin and cocaine combined. In 2010, there were enough prescription painkillers prescribed in the United States to medicate every American adult around the clock for a month.
The addictive nature of opioids is nothing new; however, there has been an alarming increase in the number of people misusing and becoming addicted to these prescription analgesics.
Opioids are the most powerful pain relievers known to man. They are prescribed mainly for pain associated with traumatic injuries, surgery, dental procedures, back and spinal problems, and a variety of chronic pain conditions. Opioid medications include hydrocodone (e.g., Vicodin), oxycodone (e.g., Percocet, OxyContin, Roxycodone), meperidine (Demerol), hydromorphone (Dilaudid), fentanyl (Actiq, Duragesic), morphine, codeine, methadone, and many other related drugs. In addition to pain relieving properties, some opioid medications-codeine (Hycodan syrup) and diphenoxylate (Lomotil) for example-are prescribed to relieve coughs and severe diarrhea.
What makes opioids highly attractive to some people and thus highly addictive is their extraordinary ability to reduce not only physical discomfort, but also psychic or emotional pain. Opioids can relieve emotional distress, blunt negative feelings, enhance moods, and induce a generalized feeling of well-being or euphoria ("high")- effects that most people who are appropriately prescribed these medications for medical purposes are unaware of- including the fact that these drugs affect the same brain receptors and neurotransmitter systems as heroin.
These "added benefits" of opioids on mood and mental state become more readily apparent and more intense at higher doses. So, what may start out as appropriate medical use of opioid analgesics for pain relief can give rise to an escalating psychological and physical dependency as the drugs are taken at higher and higher doses over longer and longer periods of time- to override the progressive tolerance (immunity) that develops to their effects and to stave off withdrawal symptoms that emerge when the daily dose regimen is markedly reduced or stopped. When opioid use gets to this point, the addiction trap has been sprung.
Some of the factors that may increase vulnerability to getting addicted to opioids include, for example: (a) problems with alcohol and/or other drugs; (b) high levels of emotional or psychological stress; and, (c) problems with anxiety, depression, and other mood disorders.
Why is Painkiller Abuse on the Rise?
Multiple factors are likely at work. Increased prescription opioid abuse appears to be due, in part, to increased availability and the appearance of newer more potent forms of these medications. Increased availability is the result of overprescribing by physicians, diversion of drug supplies into the illicit "street" market, and access to controlled substances via the internet. In an attempt to treat patients` pain better, physicians have markedly increased their rate of opioid prescribing over the past decade. Moreover, many patients who abuse opioids have learned to exploit practitioner`s increased sensitivity to treating pain. They obtain prescriptions for higher doses and repeated refills from multiple doctors at the same time. Diversion of opioid pills into the street has been fueled an increasingly lucrative and widespread black market for these drugs all across the U.S. While internet access to these and other controlled substances has been curbed to some extent by greater law enforcement, countless pain doctors and clinics ("prescription mills") continue to advertise their services on the internet.
What Can be Done About it?
Proposed strategies for reducing prescription opioid abuse have included: (a) encouraging physicians to modify prescribing practices without depriving patients of appropriate pain relief; (b) establishing more sophisticated pharmacy tracking systems; (c) educating the public about dangers of excessive opioid use; and, (d) providing greater access to treatment for people who become addicted to these drugs. Some of the newer medications for treating opioid addiction can be extremely helpful, especially when utilized in combination with individual and/or group counseling. These include: (1) buprenorphine (Suboxone), a safer and less addictive substitute drug that prevents opioid withdrawal and drug cravings; and, (2) Naltrexone (Trexan), a non-addictive medication that helps to prevent relapse by blocking the opioid-induced high.
By Dr. Arnold M. Washton
Arnold M. Washton, Ph.D., a widely known addiction psychologist and author of several books has specialized in treating addiction for over 35 years. Dr. Washton has served as substance abuse advisor to major corporations, professional sports teams, and government agencies, and has directed addiction treatment programs in both the public and private sector. He currently serves as Executive Director of the Washton Lukens Institute (washtonlukens.com) an executive addiction treatment program in Palm Beach, Florida, and maintains a private practice in New York City (recoveryoptions.us).
Links to Dr. Washton`s books: http://www.amazon.com/-/e/B001K8OZ34
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