The abuse of narcotic painkillers has been on the rise and in the news. They’re easily accessible because doctors prescribe them, though now some say too often. But the truth is America’s addiction to these legal drugs started back in the 80s and 90s when no one could have foreseen this increasing dependence.
“There was growing attention to the fact that non-cancer pain was undertreated,” says Naum Shaparin, M.D., director of the Pain Service in the Department of Anesthesiology at Montefiore Medical Center. “There was a movement in the medical community that believed treating non-cancer pain with opioids was the humane thing to do and that the risk of addiction and abuse was very low, especially in people who had no history of abuse or addiction.”
Thirty years later, that thinking has changed.
“Today, we recognize that opioids, which are increasingly prescribed, can become addictive and can be abused by a wide variety of people,” Dr. Shaparin says.
In fact, it’s become an epidemic. More than 16,000 people overdosed on prescription painkillers in 2010, said U.S. Office of National Drug Control Policy director Gil Kerlikowske at a recent news conference.
Yet more patients than ever are getting these drugs. Research at Johns Hopkins Center for Drug Safety and Effectiveness found that while there was no significant increase in patients seeking a doctor’s care for pain complaints, prescriptions for opioid painkillers jumped from 11 percent to 19 percent from 2000-2010.
In a move to curtail this trend, last year the U.S. Food and Drug Administration (FDA) recommended cutting the number of times a patient can refill hydrocodone painkillers (Vicodin, Lortab) before seeing their doctor to get a new prescription. And doctors can no longer just call the pharmacy—patients have to go in person with the script. Now the FDA is taking steps to get even tighter restrictions on the medication.
What can you do if you’re in pain?
Talk to your doctor. You have a say in your medical treatment and your doctor won’t necessarily advise you to take medication you don’t want. “There is a big push in the medical community to attempt to treat pain with non-opioids as a first option,” Dr. Shaparin says. If you have to go an opioid, it should be in addition to a non-narcotic painkiller with the goal being to decrease the amount of opioids being used.
Know your options for treating injuries and chronic conditions. “For minor orthopedic injuries, first line therapy is ice and heat, stretching and physical therapy, and over-the-counter painkillers such as Advil or Aleve and Tylenol,” Dr. Shaparin says. If an injury is more serious, your doctor may prescribe higher-dose anti-inflammatory painkillers or muscle relaxants, such as Flexeril, to soothe pain from muscle spasms in addition to the heat-ice-stretch-physical therapy routine.
If you suffer from migraines, Dr. Shaparin says opioids can actually make the condition worse. For other chronic pain issues, like back pain, work with your doctor to create a longer-term treatment plan.
Will you get addicted?
Probably not, but if you take opioid painkillers, even as prescribed, you could become dependent on them. But that isn’t uncommon. “A level of dependence is relatively normal and can occur in people taking certain medications at a high enough dose, and for a long enough period of time,” says Dr. Shaparin. “If an individual stops taking the medication abruptly, that will lead to withdrawal symptoms. This is true of opioid medications as well as blood pressure medications.” So before you stop taking any medication, talk to your doctor first.
How to know if you have a problem
First, you have to know the difference between abuse and addiction, Dr. Shaparin says. Abusing painkillers is more common than an addiction to them, he says. “People that are truly addicted cannot control their impulses to use the drug and will go to extremes to get access to it.”
“An example of abuse is someone who doesn’t take the medication for medicinal purposes; rather they use it recreationally to get a buzz,” says Dr. Shaparin. If you ever find yourself taking a Vicodin to relax from a hard day, or just because you like the feeling it gives you, that’s a problem. Talk to your doctor before it becomes something more.
Originally published on Knowmoretv.com June 2014