The number of people becoming addicted to their prescription medications is on the rise. Most notorious among the addictive prescription drugs are opioids, and that may be largely due to the somewhat lackadaisical prescribing habits of many physicians.
According to the Centers for Disease Control and Prevention (CDC), 20% of patients who visit physician offices with complaints of noncancer pain symptoms or pain-related diagnoses (both acute and chronic) leave their visit with an opioid prescription in hand. In 2012, prescribers wrote a total of 259 million prescriptions for opioid painkillers — which translates to enough drugs for every adult in the United States to have their own bottle of pills.
Meanwhile, opioid prescriptions per capita jumped 7.3% from 2007 to 2012 — with opioid prescription rates increasing more within the family practice, general practice and internal medicine compared with other settings. Rates of opioid prescribing vary greatly across states in ways that cannot be attributed to the actual health of the population. This trend places a spotlight on the lack of consensus among clinicians on how to use prescription painkillers. Globally, the number of prescriptions written for painkillers has catapulted from about 76 million in 1991 to nearly 203 million in 2013.
Approximately 15,000 people die each year due to an overdose involving painkillers. Additionally, about 12 million Americans aged 12 or older reported inappropriate and nonmedical use of painkillers in 2010. This translates to one in every 20 people in the United States.
According to the National Institute on Drug Abuse (NIDA), the most commonly abused therapeutic drug classes include prescription pain drugs (opioids), central nervous system (CNS) depressants used for anxiety and sleep disorders and stimulants for ADHD and narcolepsy.
NIDA cites the following drugs as some of the more abused in their respective classes:
- Opioids – Common types of opioids include:
- Fentanyl (Duragesic)
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin)
- Oxymorphone (Opana)
- Propoxyphene (Darvon)
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
- Diphenoxylate (Lomotil)
- CNS – This type of medication includes:
- Pentobarbital sodium (Nembutal)
- Diazepam (Valium)
- Alprazolam (Xanax)
- Stimulants – Common stimulants are:
- Dextroamphetamine (Dexedrine)
- Methylphenidate (Ritalin and Concerta)
- Amphetamines (Adderall)
Physical pain is one of the most common complaints from patients. A recent survey conducted by the National Institute of Health Statistics revealed low back pain to be the top cause of pain (27%), while severe headaches/migraines (cluster headaches) account for 15%, neck pain for 15% and facial ache/pain (trigeminal neuralgia) for 4%.
Data from the American Academy of Pain Medication reveal that more Americans suffer from chronic pain than diabetes, heart disease, and cancer combined. 100 million Americans have been diagnosed with chronic pain, while 25.8 million, 23.3 million and 11.9 million Americans suffer from diabetes, heart disease (heart attacks/stroke) and cancer, respectively.
According to the American Society of Addiction Medicine, 1.9 million Americans ages 12 or older suffered from an addiction to prescription pain drugs. 586,000 others were addicted to heroin. NIDA estimates suggest that around 23% of people who use heroin end up developing an opioid addiction because prescription painkillers affect the same areas of the brain as many illicit drugs.
Notably, the CDC purports that opioid abuse could disproportionately affect women because this population is more likely to seek professional relief and request pain drugs for their condition. Those prescriptions tend to be for higher doses and last for a longer duration than those of their male counterparts. Sadly, the mortality rate among women for prescription opioid overdose has quadrupled since 1999.
Beyond chronic pain, the topmost painful medical conditions include:
- Post-surgical pain
- Kidney stones
- Peripheral neuropathy, which is a complication of diabetes
- Cancer pain — the most excruciating cancers are pancreatic, brain tumors and sarcoma.
- Postherpetic neuralgia — this nerve pain lingers in some patients after they’ve had the shingles. It is reportedly difficult to treat.
- Interstitial cystitis — an inflamed bladder
- Complex regional pain syndrome
The notion that everyone who takes a prescription painkiller for a long enough period of time will become an addict is an outright myth. Nevertheless, developing an addiction or physical dependence is possible. You can avoid prescription addictions, and there are certain precautions pain patients can take to make sure this risk remains low.
Do Not Hoard Medications For the Sake of You, Your Family, or Friends
Many people are unsure how to prevent prescription drug abuse in their home, and too often the home medicine cabinet is where drug abusers get their start. In fact, 70% of people who abuse prescription pain medications report obtaining them from family or friends. You can avoid this issue by taking care not to hoard unused prescription pain medications. Failing to properly dispose of unfinished medications can have dire consequences.
A study published in the Journal of the American Pharmacists Association analyzed data from Medicare Advantage members with Part D coverage to determine which prescription medications patients most often left unused. Of the 247 different prescription medications reportedly left unused, the top therapeutic categories were:
- Pain treatments (15%)
- Hypertension medications (14%)
- Antibiotics (11%)
- Psychiatric disorders (9%)
Broken down further, the researchers found that only 11% of unused prescription drugs were disposed of via drug take-back programs, while 55% were left in the home medicine cabinet, 14% were discarded in the trash and 9% were flushed down the toilet. When taken advantage of, drug take-back programs can help parents protect their children from the temptation of unused medications left around the house.
In April 2016, the Drug Enforcement Agency (DEA) hosted its 11th Drug Take-Back Day, and Americans rose to the occasion by dropping off 447 million tons of unwanted medications. Some of the most common medications implicated in prescription drug overdose deaths are hydrocodone, oxycodone, oxymorphone, and methadone. The majority of these are obtained from home medicine cabinets, family and friends. Drug overdoses are currently the leading cause of injury-related deaths, having now surpassed motor vehicle accidents.
In this latest take-back day the top five states with the largest collections were:
- Texas (40 tons)
- California (32 tons)
- Wisconsin (31 tons)
- Illinois (24 tons)
- Massachusetts (24 tons)
In total, the DEA and more than 4,200 of its state, local and tribal law enforcement partners collected 893,498 pounds of unused, expired or otherwise unwanted prescription drugs at almost 5,400 sites across all 50 states.
Take Your Medications Exactly as Prescribed
It is critical for people with any kind of medical condition to try and adhere to their doctor’s medication instructions as closely as possible. Despite this advice, many people fail to follow their doctors’ instructions. Common reasons for this include:
- People may start feeling better and decide they no longer need the medication.
- Life sometimes gets in the way and makes it more difficult to remember the prescribed schedule. This is especially true when taking multiple prescription drugs at different times of the day or having to take a medication on a nontraditional schedule, such as once a week.
- People become impatient when they don’t experience immediate relief from their symptoms, which can cause them to stop taking their medications because they “don’t work.”
- Many people are confused as to what to do if they forget or skip a dose.
- Some medications are cost-prohibitive, which can cause some patients to pick up and take their prescription drugs on an irregular basis.
To minimize the risk of addiction, in particular, your prescribing health provider should assess your family history of substance abuse or addiction prior to prescribing a psychoactive medication and monitor patients who are prescribed such drugs. They should also educate you about the potential risks so you understand the consequences of not following the medication instructions closely and disposing of them properly.
Even the most powerful opioids are not always able to completely eliminate pain, and many people develop tolerance over time. One very unfortunate misconception is that the more of a drug you take, the more effective it will be in managing your symptoms.
If you are a legitimate pain patient, you should always be honest with your doctor about your levels of discomfort and take your painkillers exactly as they’re prescribed to you. Don’t wait until your pain worsens because this could increase your likelihood of abusing medication in the future.
Individuals who are concerned about becoming addicted to these medications may try and wait to take them until their pain becomes virtually unbearable. This is also unwise because this behavior could lead to you to eventually break down and consume more pills than is necessary. It is a much safer idea to just take the medications as recommended by your health professional.
The bottom line is never stop or change your dosing without first consulting with your doctor or pharmacist.
Look for Alternatives When You Can
Many health conditions have prescription medication options with a lower risk for addiction development. For example, there are nonstimulant options for treating ADHD. ADHD-specific nonstimulants, such as atomoxetine (Strattera), clonidine ER (Kapvay) and gaunfacine ER (Intuniv) are specifically formulated to treat the disorder and have received FDA approval for that exact indication.
Similarly, certain blood pressure medications can also help some people control ADHD. This is because many of these have the same active ingredient as the aforementioned ADHD-specific nonstimulants. Some antidepressants, including bupropion (Wellbutrin), nortriptyline (Aventyl) and desipramine (Norpramin) have been shown to be effective in managing ADHD by helping to alter the balance of chemicals in the brain. They’re also helpful for people who have ADHD and comorbid depression, anxiety or another mood disorder.
For conditions treated with CNS (central nervous system) drugs, such as anxiety or sleep disorders, there are several treatment avenues you can try if you’re looking to avoid the addictive properties of these depressants. You can try drinking chamomile tea, aim to get between one and three grams of omega-3s each day, use lavender aromatherapy, take melatonin to help you sleep and make sure to get outside for at least 15 minutes of sunlight per day.
Additionally, the American Academy of Family Physicians suggests that 35% to 44% of people coming to their physician with sleep issues are actually experiencing insomnia due to an underlying cause. These underlying issues can include:
- Congestive heart failure
- Gastroesophageal reflux disease
- Urinary incontinence
- Restless legs syndrome
By treating one of these underlying conditions, you may be able to avoid taking CNS drugs altogether.
The most notorious prescription medications with respect to addiction risk potential are, as mentioned earlier, opioids. Although it’s true that most pain treatment regimens involve the use of opioids, consideration of non-opioid strategies for pain management can beneficial amid risks. There are other pharmacologic options you can pursue if you fear addiction.
Alternative treatment options for managing acute pain include:
- IV Acetaminophen (Ofirmev)
- IV Ibuprofen (Caldolor)
Alternative treatment options to manage chronic pain include:
- Anticonvulsants gabapentin and pregabalin (Lyrica)
- Serotonin or norepinephrine reuptake inhibitors like duloxetine (Cymbalta)
- Tricyclic antidepressants
- Topical nonsteroidal anti-inflammatory drugs (NSAIDs)
Meanwhile, there are also a few natural ways to alleviate pain that could reduce your need for a prescription painkiller:
- Massage. Many patients living with pain and looking for an alternative to prescription painkillers turn to massages. In fact, a 2008 survey from the American Massage Therapy Association shows that approximately 21% of adults in the US had at least one massage during the previous year, while nearly 25% have turned to massage therapy to relieve their pain symptoms at least once throughout their lifetime.
As one of the world’s oldest pain relief techniques, massaging help promote serotonin productions — which serves as one of the body’s anti-pain hormones. Massaging also has the ability to increase the amount of restorative deep sleep you are able to achieve, which helps to decrease pain immensely. These benefits may be enough to reduce your need for prescription opioids.
- Cognitive Behavioral Therapy (CBT). The idea behind CBT is that if you can learn to manage your body’s thoughts and feelings, you can also learn to control how your body physically experiences pain. Overall, the key aspects of a successful CBT program for providing pain relief are:
- Encouraging a proactive attitude to approaching problems. A key factor in this is eliminating the idea of helplessness. You can do something about your pain. You do have a degree of control over how you feel.
- Promoting homework. Employing skills learned in CBT outside of therapy sessions is crucial to ensuring those skills become a part of your normal routine.
- Fostering life skills — namely, coping mechanisms that can be applied to dealing with bouts of path or any other tribulations that may come your way.
- Provides you with the tools and confidence you need to keep up pain management after you stop visiting the CBT therapist.
- Acupuncture. Acupuncture is a fairly popular way to treat physical pain. In fact, 3.5 million Americans report having tried acupuncture within the past year. After completing certain physical examination assessments, the acupuncturist recommends a particular treatment. You then lie on a table while precise needles are gently placed in the affected areas. The needles remain in place for anywhere between five and 30 minutes.
Many people report feeling relaxed during and after treatment. As an added bonus, many insurance plans cover the cost of acupuncture, and it has proven effective in alleviating other conditions, such as:
- Allergic rhinitis
- Dysentery, acute bacillary
- Malposition of fetus, correction
- Morning sickness
- Hypertension and hypotension
Acupuncture, however, is not for everyone. The procedure may be dangerous for certain patient populations, including people with pacemakers, have a high risk of developing an infection, suffer from chronic skin issues or are pregnant. Always consult with a physician prior to pursuing an acupuncture treatment regimen.
Other nonpharmacologic treatment options for pain include:
- Herbal remedies and supplements — certain herbs and supplements can help to reduce the inflammation that exacerbates pain, including omega-3 fish oil supplements, vitamin D and anti-inflammatory spices like turmeric.
Really Consider Whether or Not You Still Need Your Medications
Although you should take your medications as prescribed, it is still important that you ask yourself a few questions before pursuing another refill:
- Are my symptoms bad enough to interfere with my overall function?
- When do my symptoms occur, and are there any noticeable triggers?
- Is there anything about my lifestyle I can change to better alleviate my symptoms?
- Am I taking the lowest possible dose to relieve my symptoms while avoiding a bad side effect profile?
Certain prescription drug classes are not intended for long-term use because of their addictive potential. For example, you may be given a benzodiazepine like diazepam (Valium) or alprazolam (Xanax) to help you manage your anxiety, acute stress reactions or panic attacks. Benzodiazepines with more powerful sedative properties, such as triazolam (Halcion) and estazolam (ProSom), are usually prescribed for just short-term treatment of sleep disorders. Just because your prescriber fails to taper you off these drugs does not mean they are safe for continued use.
Seek Help If You Suspect a Rx Drug Addiction
You can prevent prescription drug addiction by recognizing the signs and knowing when it is time to seek professional treatment. If you have a loved one you suspect might be becoming addicted to or physically dependent on their pain medications, it’s important to recognize the tell-tale signs. These signs can include:
- Running out of a prescription prior to the refill date
- Claiming the prescription has been lost
- Visiting multiple prescribers to obtain the medications
- Requesting a specific painkiller by name
- Visiting the emergency department between scheduled doctor’s appointments to obtain more of the drug
- Asking others to use their medications
Meanwhile, you must also try to maintain self-awareness and recognize whether or not you are developing an addiction. Signs you may already be addicted or on your way to physical dependency include:
- Your medications became the center of your thoughts.
- You continue to take the drug despite any demonstrated harmful effects on your physical health, emotional well-being or your personal relationships.
- You no longer have control over when, where and how much of the drug you use.
- You become dishonest about your use with the people in your life and experience feelings of guilt or remorse when you use.
- You start isolating yourself from your loved ones who don’t use the drug.
If this is the case, your best defense is to seek help at a treatment facility from professionals trained to see you through such a trying time. It’s important to know that prescription drug detox is extremely dangerous on your own. You should only detox under the supervision of medical staff.
Get Help for a Prescription Drug Addiction
At JourneyPure At The River, we a team that includes a Medical Director, Psychiatrist, Clinical Supervisor, Nurses, and Mental Health Technicians to provide around-the-clock care, minimize withdrawal symptoms and help clients start the road to recovery.
Our facility’s prescription drug detoxification program can help you get back on your feet. It employs a comprehensive, holistic approach to healing that begins with and focuses on treating you as an entire person — not just your addiction. The mental health professionals on staff will evaluate you for co-occurring mental health issues, including anxiety and depression. This helps to establish whether or not there is a dual diagnosis, which could have led you to self-medicate with prescription medication, alcohol, and other drugs.
In addition to the coping skills and healthy lifestyle changes you can learn through therapy and treatments, you will also be encouraged to accept the 12 Step Program. This can help guide you toward a greater spiritual purpose to enjoy during life beyond treatment. Additionally, all prescription drug detox clients receive access to recovery professionals and our facility’s Recovery Coach software as an added safety net to prevent relapse after treatment. Call today to start reviewing your options and reclaiming your health.
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From the JourneyPure team where we get to explore a wide variety of substance abuse- and mental health-related topics. With years of experience working alongside those suffering from substance abuse and mental health issues, we bring important messages with unparalleled knowledge of addiction, mental health problems, and the issues they cause.