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Thomas S. May, M.A.Medical Writer |
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Addiction: When the Pain Is Gone But the Craving Remains
Thomas S. May, Medical Writer
Introduction
Missy is a 30-year-old woman who admits to having abused prescription
painkillers for several years. "I was first introduced to narcotic
painkillers when I had my wisdom teeth pulled," she writes on a forum for
prescription drug addicts. "I was prescribed Percodan and I'll never
forget how that drug made me feel. I was only given 20 pills at the time,
but when I took my last one, I longed for another."
Still Missy did not become hooked on painkillers until she was given a prescription for Vicodin many years later, following a trip to the dentist for root canal treatment. (Vicodin is a trade name for a narcotic painkiller containing hydrocodone.)
"From that point on, I found a great way to get the drugs," she writes. "I'd call dentist's offices after regular office hours and pretend to be one of their patients. In most cases, another dentist would be on call for the one I was asking for. I would then tell them I was having a toothache and, in most cases, they would phone in a prescription." Missy is just one of the many thousands of people in the United States who are addicted to prescription medications and using illegitimate means to obtain them. The typical abuser is a middle-class woman, and the addiction usually starts following a visit to her physician's office, where she gets her first prescription for pain relief medication, according to police sources.
"This is Middle America's dirty little secret," says Detective Sergeant
Jeff Dean of the San Diego Police Department. "They may be middle class,
but these abusers have lifestyles akin to heroin addicts. Their credit
cards are maxed out, they have no money in the bank, and they go from
doctor's office to doctor's office and pharmacy to pharmacy all day long
feeding the Vicodin habit." Who's at Risk? Although more women get arrested for obtaining them illegally, there is very little scientific evidence to suggest that more women are addicted to painkillers or other prescription drugs than men are, according to experts. For example, Linda Simoni-Wastila, PhD, a senior scientist with the Schneider Institute for Health Policy at Brandeis University, says that women are only slightly more likely than men to "nonmedically use" prescription medication. Seddon R. Savage, MD, an addiction specialist at Dartmouth Medical School's Department of Anesthesiology also doubts that major sex differences exist regarding prescription drug abuse. However, if they do exist, they may be related to "the social acceptance of women using medications and the relative stigma attached to heavy drinking or street drugging by females," he says. Theodore Parran, MD, an assistant clinical professor of psychiatry at Case Western Reserve University School of Medicine, says that doctors may prescribe controlled drugs to women more easily "because of cultural or historic reasons," and this may result in the "artificial statistic that women are more often addicted to prescribed drugs."
Parran argues that--regardless of their sex--people who have a history of
substance abuse or addiction, as well as those who have easy access to
controlled drugs, are the ones who are most likely to become addicted to
them. "Actually, the highest addiction rates for controlled drugs are
found among addicted doctors, nurses, pharmacists, and dentists," he says. Dangerous Drugs? Savage and Simoni-Wastila also agree that those who currently have (or had in the past) a drug or alcohol dependency problem are the ones who are at greatest risk for abusing--and becoming dependent on--prescribed painkillers. They also point out that the vast majority of people who take narcotic medications don't become addicted to them, even if they take them for a long time. But experts admit it is easier to become addicted to certain pain medications than it is to others. "Drugs that are likely to become objects of addiction are drugs that stimulate the pleasure centers in the brain," says Savage. "These include analgesic drugs [painkillers] that are in the class of drugs called opioids [derived from the opium poppy] or drugs that have a similar ability to stimulate opioid receptors in the brain."
"Schedule II substances (this is what they are called according to US drug
laws), which are the most potent narcotic analgesics available for medical
use, tend to be the ones most abused," says Simoni-Wastila. Oxycodone
(Percocet) is very popular, as are Demerol (meperidine), Dilaudid (hydromorphone),
and morphine. Propoxyphene (Darvon, Darvocet) is also popular among
abusers, she says. Preventing Painkiller Abuse Savage says that in order to minimize the chances of painkiller abuse and addiction, doctors should
Savage also notes that most people who use opioids to control pain regularly for more than a few days will develop some degree of physical dependence. "But only rare individuals who use opioids for pain control will become addicted to them," he adds.
Thomas S. May is a medical
journalist based in Toronto, Ontario, Canada. He has a master's degree in
psychology from Simon Fraser University in Burnaby, British Columbia. Source: Medscape Health
Reprinted from Medscape Health for Consumers.
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