Painkillers: How Tolerance Turns into Addiction

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An unfortunate trend has been plaguing the United States for nearly 20 years: painkiller addiction. It’s taking the lives of teenagers and adults alike, and it is contributing to the growing population of middle-aged adults who are dying. It’s estimated that between 26.4 million and 36 million people worldwide are addicted to prescription opioids. According to the Center for Disease Control and Prevention (CDC): “Among those who died from prescription opioid overdose between 1999 and 2014:

  • Overdose rates were highest among people aged 25 to 54 years.
  • Overdose rates were higher among non-Hispanic whites and American Indian or Alaskan Natives, compared to non-Hispanic blacks and Hispanics.
  • Men were more likely to die from an overdose, but the mortality gap between men and women is closing

Overdose is not the only risk related to prescription opioids. Misuse, abuse, and opioid use disorder (addiction) are also potential dangers.

  • In 2014, almost 2 million Americans abused or were dependent on prescription opioids.
  • As many as 1 in 4 people who receive prescription opioids long term for noncancer pain in primary care settings struggles with addiction.
  • Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.”

Those numbers are staggering and growing yearly. It’s becoming more and more common to hear of people who are overdosing on  prescription pain pills or graduating to heroin use and losing their lives that way. So what do we need to know about prescription painkillers, and how do people get their hands on these powerful drugs?

How Do Prescription Painkillers Affect the Brain?

The National Institute on Drug Abuse (NIDA) says, “Opioids are medications that act on opioid receptors in both the spinal cord and brain to reduce the intensity of pain-signal perception. They also affect brain areas that control emotion, which can further diminish the effects of painful stimuli. They have been used for centuries to treat pain, cough, and diarrhea.” These are oral medications that are used to relieve pain. Unfortunately, if misused, a tolerance can grow over time, requiring the user to use more and more of the drug. In order to increase the pill’s effects, some users have even been known to crush and inject the drug into their system. This is how an addiction to prescription painkillers begins. What starts as an attempt to decrease pain spirals into a full-blown substance abuse disorder.

Who Becomes Addicted to Prescription Painkillers?

The beginnings of addiction are rarely seen as a risk. The intentions of both the patient and the doctors are good. For many people, they are prescribed painkillers from their doctors. Some get surgery and others suffer from chronic pain, and those who are prescribed pain medications don’t ALL become addicted. Therefore, there is no single, identifiable reason why someone becomes addicted. We do know that those with a genetic predisposition to addiction may have trouble saying “no” to the euphoric side effects of prescription drugs and continue to take them. Also, those who self medicate for other reasons (like a chaotic home life, mental illness or trauma) may have a hard time ceasing use. Others, especially adolescents, obtain the drug through friends who misuse the painkillers.

The Dangers of Street Drugs – The Heroin Epidemic in the United States

What happens when the supply of prescription painkillers runs dry? Well, many Americans are turning to the street drug heroin when they can’t get their hands on prescription painkillers anymore. Perhaps their doctor refuses to prescribe more or maybe the friend or family member they were getting them from have stopped providing pills. Either way, in the throes of addiction, people can become desperate. This is the biggest reason for the rise in heroin use in the United States. According to the American Society of Addiction Medicine (ASAM), “Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin in 2015.” Heroin is much cheaper and far more accessible than prescription painkillers. Due to its lack of regulation, it can be cut with anything including the drug fentanyl – an opioid 100 times stronger than morphine. There really is no way to know what is in illicit, illegally obtained drugs. Another risk factor of heroin use is how it’s taken. Intravenous use removes the ability for healthcare professionals to do things like stomach pump in order to remove the toxic drug from the body. Once a drug like heroin is injected, there’s no turning back.

Who Can You Tell if Someone is Becoming Dependent on Prescription Painkillers?

If you suspect a loved one is addicted to prescription painkillers or other street opioids like heroin, check for these signs and symptoms:

  • They are tired all the time. They may start nodding off at the dinner table, in the middle of a conversation or while watching TV.
  • Changes in their sleep pattern. They may be sleeping for 18 hours straight or not sleeping for days depending on if they are using.
  • They are losing weight. With brain changes come weight changes. Opioids can literally change your metabolism.
  • They are no longer interested in sex. Opioids decrease testosterone and estrogen levels in the body.
  • Losing their friends. Are they hanging out with different people? Do old friends seem to have disappeared?
  • Stealing money or items. They may be stealing or selling items to get money to buy more drugs.
  • They are spending more money than ever before. If credit card envelopes are being delivered more often or creditors are calling, there may be a problem.

The worst thing that can happen is an overdose. These drugs are dangerous and they do have the potential to kill. If you believe you may be a painkiller or opioid addict or you believe someone you love may be struggling with this addiction, contact a local rehab or detox center that specializes in this type of treatment.