In 2010, 12 million Americans aged 12 and over reported using a prescription painkiller non-medically in the past year, and the Centers for Disease Control and Prevention (CDC) reports the number of deaths from painkiller overdoses tripled between 1999 and 2008.
Of course, the reason behind this is ultimately addiction, and understanding how prescription painkillers lead to addiction and the risks associated with their abuse provides insight into the growing epidemic.
In addition, looking at the ways treatment can help, and how it’s sadly underused, shows how improving access to psychological and medical support could minimize the issue and stall the recent surge in heroin abuse, which is widely thought to be related to prescription drugs.
Painkiller Addiction Explained
The reason painkillers are addictive can be summed up fairly simply: they are opioid drugs, just like heroin, and they interact with the brain in the same way. Prescription painkillers like Vicodin, OxyContin, codeine, Dilaudid and others all have legitimate medical uses for people struggling with moderate to severe pain, and they have the effect of blocking pain receptors in the brain and increasing levels of dopamine.
This means that they can be invaluable when used medically (making otherwise agonizing days bearable) and that they have the potential for abuse — producing euphoria when used without a medical need, particularly when large doses are taken. They create a sense of detachment from pain, physical and emotional alike.
Dopamine is effectively the brain’s “motivator” and is closely tied to the reward system of the brain. The brain uses dopamine and the reward system to encourage us to continue doing things necessary for survival, such as eating, drinking and having sex — it provides positive reinforcement and helps us remember the circumstances leading up to these pleasurable experiences.
However, drugs — prescription painkillers included — short-circuit this mechanism, providing the pleasure we’re looking for in a much more extreme form without presenting any benefit to our survival.
This artificial dopamine boost is ordinarily larger than what we would get from natural sources, and when the body becomes accustomed to receiving it, we develop a “tolerance” to its effects. Not only does the same dose of the drug fail to have the same effect, but natural sources do next to nothing. The brain learns to ignore the more natural sources in favor of the drug, and this is a sign that addiction has truly taken hold. This is why addicts often don’t eat enough, allow important personal relationships to suffer and forgo hobbies in favor of taking substances.
Risks of Painkiller Addiction
The biggest risk associated with painkiller abuse is that of overdose, because as tolerance develops and you need to take more and more to get the same euphoric effects, it’s easy to approach a dangerous dose.
In 2012, more than half of all fatal drug overdoses involved prescription medicines, and 72% (over 16,000) of these involved painkillers. The risks are multiplied if the drug is taken with alcohol, and it’s often the breathing difficulty related to opioids that leads to death.
Short-term effects of prescription painkillers — Even in non-overdoses, the short-term effects of prescription painkillers include:
- inability to concentrate
Withdrawal symptoms of prescription painkillers — When the drug is stopped, users face withdrawal symptoms such as:
- muscle aches
- abdominal cramps
The Importance of Treatment
Addiction traps users in a dangerous cycle of cravings, increasingly dangerous doses, withdrawal and then more cravings due to its impact on the brain. The only way to overcome this is to re-establish normal brain function by becoming abstinent from the drug.
Groups such as Narcotics Anonymous (NA) offer meetings in order to enable users to understand the complex array of causes of addiction and why drugs are a poor method of coping with deeper-seated emotional and psychological issues. Inpatient treatment facilities using the same 12 step methodology provide support during the detoxification and withdrawal process and also have the advantage of moving the individual away from the situations and people that led him or her to use drugs.
Sadly, the National Institute on Drug Abuse reports that addiction treatment is underused in the U.S. Around 9.4% of the population is in need of treatment for addiction, but only 10.4% of those in need actually receive treatment.
Tackling Painkiller Addiction the Right Way
Many approaches have been suggested for reducing the impact of prescription painkiller abuse in the U.S., but some — notably making “abuse-resistant” versions of drugs — often have the undesirable effect of pushing users to other opioids, typically heroin. The reason for this is that reducing the abuse potential (or access to) one specific drug doesn’t address the underlying reasons for addiction; it just removes one way to feed an addiction.
Rather than attacking specific substances, the only way to improve the state of painkiller addiction in America is to focus on addiction itself, and this is accomplished by improving access to treatment and encouraging those in need to get help. It might be a more complicated solution, but it’s the only one that stands a chance of genuinely working.