Prescription Painkiller Addiction

Prescription painkillers are types of medication that are necessary for people struggling with pain. However, because of the effects produced by painkillers, they are also responsible for many addiction problems. So, what exactly are painkillers, and why are they so dangerous? 

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What Are Prescription Painkillers?

Prescription painkillers are for patients with extreme pain. Usually, painkillers are administered to those after  surgeries, traumatic injuries, or painful diseases. Pain, an extremely common symptom for many health conditions, is a major challenge to tackle. In both hospital settings and homes, pain can be bothersome. Pain is experienced differently by every individual and this variation makes it harder to treat. One of the most common methods of treating pain is painkillers. 

Painkillers on the table

Types Of Painkillers

Non-steroidal anti-inflammatory drugs or NSAIDS: This class of drugs is widely used and is given for common conditions like headache, dysmenorrhea, joint pain, etc. These are also used for chronic conditions like rheumatoid arthritis, migraines, etc. Aspirin, one of the most common NSAID is also used to prevent colorectal cancer.[1]

Paracetamol: The most common over the counter drug available for pain. Commonly sold as Tylenol or Panadol as trade names, it is a wonder in the pharmaceutical world.

Opioids: This class of painkillers are amazing at their function. They are most commonly used to treat severe pain and pain refractory to other classes for example, pain after a surgery or in terminal conditions like cancer. Weak opioids such as codeine are available as an over the counter medicine to treat pain. Opioids are also used to treat pain associated with neuropathies, and certain arthropathies.

Why Are They So Addictive?

Opioids belong to the family of narcotic analgesics and are derived from various species of the poppy plant, Papaver Somniferum. They are both used medically and also in a recreational setting. They are used to treat moderate to severe pain in the hospital setting. Opiods are also used to treat cough, diarrhea and constipation. These cough syrups are also frequently abused due to their relaxing and sedative effect. Opioids also possess anesthetic properties.[3]

Opioids acts on the specific opioid receptors in the brain and other tissues like Gastrointestinal tract. There are three important receptors, mu, kappa and delta (Although 17 receptors have been reported altogether). Different receptors are associated with different functions. For example, morphine, a very famous opioid acts on the mu1 receptor to exert its analgesic effect. This causes serious addiction. Similar to the type of addiction in heroin, morphine is a catalyst for creating dependency for its users.

Commonly Abused Opioids

Most commonly used opioids are:

  • Hydrocodone and oxycodone, widely used prescription opioids
  • Fentanyl, a very powerful synthetic opioid
  • Heroin, an illicit drug

 

Examples of other prescription opioids: meperidine, propoxyphene, oxymorphone, hydromorphone, codeine, tramadol, methadone, butorphanol, etc.

Side Effects Of Prescription Painkillers

Along with treating pain, opioids are known to cause these side effects as well:

  • Sedation: tolerance to this effect also develops within a week.
  • Nausea and vomiting
  • Respiratory depression: This is the most dreadful effect of using opioids. However, the body adapts to this as the patient continues to use the drug. (they develop tolerance to it)
  • Euphoria: Major reason of abuse of the drug.
  • Constipation: This occurs in a vast majority of people taking opioids. And this side effect does not go away even with persistent use of the drug requiring the patients to take laxatives to relieve this.
  • Tolerance and physical dependence in the long run
  • Drowsiness
  • Itching

The euphoric effect of opioids tempts users to abuse these prescription medicines and this eventually results in addiction. Furthermore, studies suggest that a lot of heroin users were once prescribed opioid for a certain condition by their doctors.

Prescription Painkillers showing the addiction they cause

Addiction, Withdrawal, and Overdose

This disorder is the chronic use of opioids that causes significant impairment or distress. It is defined in the American psychiatric association DSM-5. People with this disorder have a strong compulsion to take the drug, despite the harmful consequences it brings to themselves and others. This disorder is usually treated with opioid replacement therapy using buprenorphine or methadone. Naltrexone is used to prevent relapses. 

Withdrawal

Chronic use of these pain-relieving medications can increase the person’s tolerance. This requires higher and higher doses every time to produce the same desired effect. Eventually, the person might even become addicted (doctors call this opioid use disorder). Due to this, immediate withdrawing from the drug can be really challenging as this leads to severe withdrawal symptoms, requiring professional treatment and immense support from friends and family.

Withdrawal symptoms include:

  • Muscle aches
  • Salivation
  • Lacrimation
  • Anxiety
  • Runny nose
  • Diarrhea
  • Nausea, and vomiting
  • Dilated pupils
  • Blurry vision

Overdosing

Many people across the world bite the big toe as a result of opioid overdose. When the person overdoses on an opioid, the respiratory centres in the brain are severely depressed resulting in very sluggish breathing or at times even cessation of breathing resulting in death.

An overdose of these medications can happen for a number of reasons including:

  • Taking an increased amount of dose to get the extra ‘high’
  • Mixing the painkillers with other drugs, like Xanax or valium or alcohol.
  • Accidental overdoses can occur in cases of children
  • If you have a liver or kidney disease. This will interfere with the metabolism and excretion of the drug allowing the drug to stay in the body for a much longer time and hence produce it devastating effects.
  • Older people are much more likely to overdose because of their deteriorating body functions

Signs Of Overdose

Signs and symptoms of opioid painkillers overdose:

  • Very weak and flaccid body
  • Cyanosis (bluish discoloration of the skin) of the lips and fingernails
  • Very shallow breathing, sometimes unable to be noticed
  • Very slow heartbeat
  • skin looks very pale
  • The sufferer’s body is cold to touch and sometimes sweaty
  • Vomiting

Treatment For Painkiller Addiction

Naloxone, the antidote, will assist in any who is seeking treatment. It should be administered promptly by a medical team and breathing and blood pressure stabilized. Finding a drug rehab near you, after you are separated from the substance, can help save your life.

Painkillers have many benefits. These drugs are remarkable in relieving pain for millions of people around the globe. However, we are weighed against the detrimental consequences of potential abuse and the impact they have on the person and others. The debate whether these drugs should be given as medications will continue for the years yet to come.

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