Donna Lilly, LCSW, Chemical Dependency Coordinator with Deaconess Cross Pointe
Did you know that more people abuse prescription drugs than cocaine, heroin, hallucinogens and inhalants combined? In the U.S., one in 20 people have used prescription painkillers for non-medical reasons.
So how does a prescription drug abuse problem start? Sometimes people find that their medication isn’t working the way they think it should, and so they begin to take matters into their own hands and adjust their medication themselves, which can get them into trouble. The most common prescription drugs that are abused are painkillers (OxyContin, Percocet, Lortab, Vicodin and their generics), anti-anxiety medications (Valium, Xanax, Klonopin, Atavan and their generics), and stimulants (such as Ritalin and Adderall and their generics).
It’s safe to say that most people don’t set out to become addicted to prescription medications. Addictions can occur gradually. People who become addicted usually have risk factors, such as a pre-existing addiction from an earlier time (such as alcohol or other substances). People who become addicted sometimes have traumatic issues, such as abuse in their past, which make them more vulnerable to the effects of drugs and the “escape” feeling they can cause. They may also have a genetic predisposition to addiction.
Signs of addiction can include:
What to do if you think you or a family member or friend has a problem with prescription drug abuse:
Taking more of the drug than intended, such as a patient thinking “I’ll only take 6 today” and they actually take 12, because they are not able to limit their consumption.
Family members or friends express concern or are affected by the user. (For example, the person with the addiction may be missing family responsibilities, not working, not going to school, etc.)
Having withdrawal symptoms when use is stopped or interrupted because of running out of medication. These symptoms may include flu-like symptoms—aches, chills, fatigue, as well as insomnia. (Each drug has specific withdrawal symptoms.)
Having cravings for the medication.
Giving up social activities or family activities because they are either unable to attend or don’t want to risk being confronted.
An increase in tolerance (When more of the substance is needed to achieve the effects the person is used to.)
Continuing to use, even though there are consequences associated with use. Potential consequences include risking arrest for buying them illegally; trading or selling; risking being dismissed from physician; having a court order not to use drugs as related to a child welfare case.
The situation is different for each category of drugs (stimulants, painkillers and anti-anxiety).
If a person is abusing stimulants, withdrawal from them is not a life-threatening situation. Use can be discontinued abruptly with few medical complications. However, because of the nature of the drug, very powerful cravings occur when a patient is attempting to discontinue. Trying to discontinue without at least some social support is very difficult. With all stimulants, the effects are quick, and they leave the body quickly. That’s why it sets up a craving. For example, cocaine (which is not a prescription drug) leaves the body in minutes. A person who is addicted to cocaine is going to compulsively use because the drug gets out of their system so quickly. With prescription stimulants (mentioned above), they’ll do basically the same thing: get in the body and leave fairly quickly, which is why there’s such a potential for abuse. The XR (extended release) medications would be a much better choice for people prone to abusing substances are prescribed stimulants for attention deficit disorders and related issues. Physicians need to be made aware of any past issues with addiction whenever these medications are being prescribed.
It’s the fastest-growing area of abuse in the country. The number of people who are abusing prescription painkillers is really quite frightening. Many times, people want to know why their doctors keep prescribing so many painkillers for them and are angry with their doctors. But doctors are trained to treat pain. If someone comes in with a pain complaint, they’re going to get treatment for that pain. Most people can take pain medication without any problem at all, but those who have risk factors for addiction need to be very careful about long-term use of pain medication. Withdrawal tends to be extremely uncomfortable and can take a long amount of time. This means that after the initial physical symptoms have subsided, there are a lot of minor physical symptoms such as insomnia, aches and pains, and difficulties with concentration and thinking. A lot of times, people think they can just “cut down.” If they’re truly addicted, cutting down doesn’t work very well. So abstinence—complete avoidance—is the goal, and a cold-turkey approach is what is usually needed. This can require professional assistance to accomplish. To break this addiction requires different interventions depending on the medication taken, the amount taken and for how long. An evaluation at a treatment center would be the first step. There’s a broad spectrum—from outpatient rehabilitation to inpatient care—that may be needed.