An Overview of
Pain Medication and Narcotic Addiction
Narcotic addiction or opioid addiction is one of the most common forms of drug abuse in the United States. Chemicals like heroin, methadone and pain medications are commonly called Opioids. Opiates are made from opium, which comes from the poppy plant. The addiction to pain medication and narcotics generally begins with a legitimate prescription and grows first into a dependency and then becomes an addiction. There are many pain killers that are not addictive, but narcotics are appealing to many because they work well, and work quickly. For this reason, they are often the first choice for pain management. When you begin to reach for the pill bottle more often than is necessary or safe, it may be time to re-evaluate and get help for narcotic addiction.
Terms like opioid addiction, narcotic addiction, drug dependence, and drug addiction are often used interchangeably, but the medication definitions are very specific:
Dependence: Dependence is when the body develops tolerance to the drug, requiring higher doses to achieve the same effect.
Addiction: Addiction occurs when the person has drug dependence, but also displays psychological effects such as craving for the drug; and continued use despite negative consequences in their lives. Addicts use the drug for other reasons than pain relief, such as to “get high” or “escape”.
Signs and symptoms of opioid abuse include:
- Analgesia (feeling no pain)
- Euphoria (feeling high)
- Respiratory depression (shallow or slow breathing)
- Small pupils
- Nausea, vomiting
- Itching or flushed skin
- Slurred speech
- Confusion or poor judgment
Chemicals like heroin, methadone and pain medications resemble the naturally occurring endogenous opioid chemicals in our body that bind with opiate receptors in the brain and other parts of the body. There are three types of opiate receptors: mu, delta, and kappa, each involved in different functions. The mu receptors are responsible for the pleasurable effects (addiction) and pain-relieving properties. The opioid chemicals get attached to the opioid brain receptors and stimulate the brain chemical Dopamine, which makes the experience pleasurable. Repeated use of opioid changes the brain’s network and causes addiction.
According to the Substance Abuse and Mental Health Services Administration, prescription pain addiction is the second most common drug use in young teens. In 2012, nearly 15 percent of high-school seniors used a prescription drug non-medically.
Overall, 31.8 million Americans have used pain relievers non-medically in their lifetime.
Importance of Treatment
Our body naturally produces opioids chemicals called endogenous opioids that are important for normal bodily function. They help us naturally manage pain, immunity, mood, breathing, and stress. When you use opioids like heroin and abuse pain medication, it disrupts the natural opioid function.
Heroin abuse and non-medical use of pain pills are associated with fatal overdose and spontaneous abortion. Chronic users may develop collapsed veins, infective heart diseases, and high risk for HIV/AIDS and hepatitis for IV drug users
The goal of treatment is to help people stop misusing opioids and regain control over their lives. A combination of therapy and medication has proven its effectiveness for treating opioid addiction.
Detox is the process of taking an individual off an addictive drug. It can be a rapid or gradual process. The goal is to minimize withdrawal and prevent relapse. Addiction experts strongly believe that a detox intervention without a long-term follow-up treatment plan leads to relapse.
Several medications have been FDA approved as safe and effective in treating opioid addiction. Medications that are used in treating opioid addictions are – Methadone, Buprenorphine (Subutex® and Suboxone®), Naltrexone and Clonidine.
- Methadone: This synthetic opiate medication binds to the same receptors as pain pills and heroin to help with drug craving and helps with the detoxification process by preventing the withdrawal effect. Methadone is used by medical experts as a safer alternative to street heroin and is administered in a specialized opiate treatment program known as Methadone maintenance treatment program.
- Buprenorphine: This medication was recently approved by the FDA for treatment of Opioid addiction. Buprenorphine works by stimulating the brain’s opioid receptors in a similar way to heroin or pain killers, but without causing full stimulation. This prevents withdrawal, reduces craving, and produces less risk for abuse, overdose, and withdrawal effects compared to methadone.
- Naltrexone: Naltrexone medication works by blocking opioids from binding with their receptors. If you take heroin or pain medications when you are on Naltrexone, it will not give any pleasurable effect and it can trigger early withdrawal effects. Naltrexone is usually prescribed in outpatient settings. Individuals must be medically detoxified and opioid-free for several days before starting Naltrexone to prevent withdrawal symptoms.
Treatment during Pregnancy
Heroin abuse during pregnancy is associated with low birth weight and can affect normal development of the fetus. A baby born to a mom who uses drug regularly may be born physically challenged and can suffer from medical complications. Although the FDA has not approved any maintenance therapies for opioid addiction in pregnancy, experts feel that for pregnant heroin users, a methadone maintenance program combined with prenatal care can improve the outcome of both mother and baby.
Most people who take their pain medication as directed by their doctor do not become addicted. However, those who have been addicted to substances in the past or those with a family member who is or has been addicted to drugs or alcohol may be at increased risk of becoming addicted to narcotics. Share with your doctor any personal and/or family history of substance abuse or addiction. Your doctor needs this information to prescribe the medicines that will work best for you.
The best way to prevent addiction to narcotics and pain medication is to only use your pain medicine exactly as your doctor prescribes.
- Heroin National Institute on Drug Abuse – http://www.drugabuse.gov/publications/drugfacts/heroin – Accessed March 11, 2013.
- Nationwide Trends National Institute on Drug Abuse – http://www.drugabuse.gov/publications/drugfacts/nationwide-trends – Accessed March 11, 2013.
- High School and Youth Trends National Institute on Drug Abuse – http://www.drugabuse.gov/publications/drugfacts/high-school-youth-trends – Accessed March 11, 2013.