It’s been almost a month since the U.S. Centers for Disease Control hosted the National Rx Drug Abuse Summit in Atlanta, GA. There, some surprising truths about opiate addiction were unveiled. For instance, deaths due to prescription opiate overdoses have quintupled since 1980. In the previous decade, there were 125,000 deaths due to painkiller overdose. And, according to the CDC, for every overdose death, there are 115 people addicted to prescription painkillers, 26 emergency room visits, and $4.35million in healthcare costs. Still, every day at New Roads Behavioral Health, we see misconceptions and, frankly, minimizations about exactly what these prescription drugs are, how they are used, and what consequences are experienced.
Let’s set the record straight. Here are 3 truths about opiates and opiate addiction:
1. Long-Release Pills Offer Extra Overdose Opportunity
The FDA recently approved the controversial drug Zohydro, an extended-release opiate pain medication. In theory, it would allow a patient to take one big pill that would slowly release enough medication to mask pain for many hours. In practice, there may be a different story. We, as a field, have known for years that long-acting medications, like Methadone and in this case Zohydro, increase the chances of accidental overdose. It comes down to the half-lives of the drugs. They stay in our system for longer periods of time than what addicted people are used to. An addicted person is used to a very quick physical response, a “high” that dwindles rather quickly. When that euphoria dissipates, the addicted brain begins to crave, leading to immediate use. Unfortunately, in the case of these longer-acting drugs, there is still a significant amount in the person’s system, though the person does not recognize it. They then use another opiate to achieve the euphoria, which increases the risk of overdose. This led more than 40 health care and addiction groups to pen a letter pointing out that Zohydro is a “whopping dose of hydrocodone packed in an easy-to-crush capsule.” By crushing and snorting or injecting the pill, it’s all too easy to transform an extended release of low-dose medication into an immediate overdose. Again, the effects of a drug when used properly should not only consider drug approval, but also its potential for misuse. This is a big one: pills that are meant to dissolve over 8 hours can be snorted or injected in less than 8 seconds.
2. Dependence is a Multifaceted Disease
Dependence, as it’s described in the Diagnostic and Statistic Manual, affects multiple aspects of a person. It is physiological at its core. But the physiological or biological components of the disease drive compulsive addict behaviors. Physically, your body wants to feel “normal”. It constantly strives for homeostasis — that’s why your temperature stays at 98.6 degrees. It is also why, after extended opiate use, more of the drug is needed to achieve the same effect. Over time, the body adapts to the drug hanging out in its system and a new “normal” is created. When the amount of drug needed for this new normal is stopped, the body goes through the withdrawal process. The addicted person not only experiences withdrawal symptoms in the absence of the drug, but also compulsively seeks the drug in order to avoid these symptoms.
3. Prescription Drugs Cause More Deaths than Heroin and Cocaine Combined
The truth is that a pill synthesized in a laboratory and provided by a doctor can kill someone just like someone injecting a drug with a dirty needle in a back alley. The National Institute on Drug Abuse reports that accidental overdose deaths due to prescription opioids now outnumber the deaths due to heroin and cocaine combined. One reason prescription drugs are so dangerous is that users don’t respect them the way they might respect heroin or a drug with an uglier reputation. For example, users may combine prescriptions with alcohol or other drugs, which can lead to dangerous depression of body function like respiration. Heroin may kill by its impurity, but prescription drugs kill by their assumed safety.
Prescription drug abuse is up. As parents, treatment providers, patients and those experimenting and therefore at risk of addiction, it’s time we knew the truth about these dangerous drugs. I hope you’ll join me in adding what you know to the comments below.
Eric Schmidt is the CEO of New Roads Treatment Centers, affordable drug treatment programs for young adults.
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Last reviewed: 18 Jun 2014