In the United States, doctors are currently prescribing, on average, 71 opioid medications per 100 people, although in some states such as Louisiana and Alabama, it’s as high as nearly 150 opioid prescriptions per 100 people.
Taking the rampant over-prescription of opioids into account, it’s unsurprising that, according to the U.S. Centers for Disease Control and Prevention, more than 1,000 people are being sent to emergency rooms daily for treatment due to prescription opioid misuse in the United States.
In 2015, there were more than 50,000 fatal drug overdoses, with just under half of them related to prescription painkillers. Just one year later, overdose deaths jumped by more than 10,000, and if projection reports are anything to go by, they’re only going to continue climbing.
Prescription opioid addiction is at the heart of America’s opioid epidemic, and even more worrying, becoming a more common jumping off point for heroin use, as individuals dependent on prescription opioids are 40 times more likely also to be abusing heroin.
It is all-too-easy to transition from prescription opioid misuse to abuse and eventually addiction. Understanding the dangers of prescription opioid addiction and how best to treat it are key to being able to recover from dependence on prescription opioids, or, ideally, avoid becoming addicted altogether.
What are Prescription Opioids?
Opioids refer to a class of substances with narcotic, pain-relieving effects that are either extracted naturally from opium, like morphine and codeine or synthesized from opioid alkaloids, like oxycodone and fentanyl.
Opioid used to specifically refer to synthetic substances created to have the same effects as naturally-derived opiates, but now is used as the umbrella term for any substance, synthetic or natural, which act on the opioid receptors in the brain to mask pain and induce feelings of sedation and euphoria.
Prescription opioids are legal drugs that, unlike illicit substances such as heroin, have a proven medical use as anesthesia and for the treatment of post-surgery or chronic pain. While the majority of prescription painkillers are classified by the DEA as Schedule II drugs, meaning they have a high potential for abuse and addiction, they are nonetheless able to be purchased on a limited with a prescription from a physician.
Commonly Prescribed Opioids Include:
While prescription opioids have an undisputed use both for pain management as well as cough suppression in those with severe lung conditions, they are still incredibly addictive and part of the most abused class of drugs in the United States.
How Do Prescription Opioids Work?
Prescription opioids, as well as opioids in general, work by stimulating production in the brain’s opioid receptors to create an immense boost in opioid receptor activity. This is what enables opioids to overwhelm the brain and central nervous system and block out pain much more effectively than the brain could do on its own.
Opioid receptors are neurotransmitters in the brain that are responsible for transmitting pain signals throughout the central nervous and to and from the brain, as well as regulating stress and how we respond to pain. Prescription opioids bind to these neurotransmitters and provide a major boost in the following areas and ways:
- The spinal cord, which is what actually receives the body’s sensations before sending them on to the brain. Prescription opioids block the spinal cord from both receiving and sending pain signals, even those that result from serious injury.
- The brainstem, which is where prescriptions opioids both block the brain from receiving any stray pain signals as well as slow down breathing, which creates the feelings of sedation and also suppresses coughing.
- The limbic system, commonly known as the brain’s “pleasure center” is where opioids instead stimulated dopamine levels. Dopamine is another neurotransmitter that controls cognition, emotion, and how the brain processes motivation and reward. The spike in dopamine is what accounts for the intense feelings of euphoria.
The high provided by the dopamine is what creates the link in the brain that learns to associate prescription opioid use with the reward of more dopamine. As prescription opioid use activates the brain’s pleasure center and blocks pain signals, this is what causes the beginning of the cycle of prescription opioid addiction, eventually leading to dependence and withdrawal symptoms if prescription opioid use is stopped.
What are the Effects of Prescription Opioid Use?
When someone is misusing prescription opioids to the point of excess or for recreational purposes when these drugs are not needed, they will experience not only the intended effects of these medications but also a high that can range from the brief but incredibly intense high of fentanyl to the high from morphine, which is weaker but can last as long as six hours.
Despite the differences in potency and how long these short-term effects will linger, they are essentially the same for all prescription opioids and include:
- Pain relief
- Possible unconsciousness
- Feelings of heaviness in limbs
- Impaired coordination
- Depressed or shallow breathing
However, these side effects can vary depending on whether or not someone is taking prescription opioids in nonstandard or unprescribed ways. This usually means crushing up the tablets or pills into a powder and snorting them for a faster, more intense high and mixing them into a solution and injecting them directly into the bloodstream.
Intravenous injection of prescription opioids has its own unique set of extremely serious and potentially life-threatening side effects, including:
- Increased risk of HIV and hepatitis from needle-sharing
- Infections at or around the injection site
- Pulmonary embolism
- Infections in the valves and lining of the heart
What are the Signs of Prescription Opioid Addiction?
When someone begins to engage in prescription opioid abuse, it is not be immediately apparent, as it does not conform to what people would envision as the stereotypical image of substance abuse. However, as it begins to progress into a full-blown addiction, along the way, there will be many warning signs that someone is suffering from prescription painkiller addiction.
These signals and markers can be seen through the psychological and physical effects of prescription opioid dependency as well as behavior that is almost entirely driven by the goal of obtaining and using prescription opioids, which will have become a priority over everything else in the life.
Being able to spot these symptoms before it’s too late can make all the difference in getting help and finding treatment before too much damage has been done or an overdose has occurred. Some common signs that point to prescription painkiller addiction include the long-term effects of chronic use, such as:
- Intense depression and mood swings
- Abdominal bloating
- Regular bouts of nausea and vomiting
- Tolerance to the effects of prescription opioids
- Brain damage from a lack of oxygen due to respiratory issues
- Liver damage
- Kidney disease
As someone becomes more dependent on prescription opioids and base all of their decisions around using prescription opioids, they will exhibit noticeable alterations in their behavior that are signs of not only prescription opioid addiction but also substance abuse disorders in general, including:
- Inability to function normally in daily routines without prescription opioids
- Noticeable decline in personal hygiene and appearance
- Lying, hiding, and generally being secretive about prescription opioid abuse
- Money or valuables going missing to pay for prescription opioids
- Attempting to rationalize or justify prescription opioid abuse
- Significant worsening of work or school performance
- Legal problems caused by prescription opioid abuse
- Prioritizing using prescription opioids above responsibilities, hobbies, and relationships
If you have either experienced these signs yourself or observed them in someone you care about, then it is vital that you seek out professional detox and treatment as soon as possible. This can help avoid the event of an overdose and stem whatever physical and mental damage that might have already been caused by prescription opioid addiction.
What is Involved in Prescription Opioid Addiction Treatment?
Prescription opioid addiction treatment starts in the same way as nearly any other substance addiction treatment, and that’s with medical detoxification to flush the opioids from the body. Prescription opioid withdrawal is rarely, if ever, a potentially life-threatening process, but due to the intensity and unpredictability of some of the withdrawal symptoms, such as seizures and hallucinations, prescription opioid detox is best undertaken under the supervision of a medical professional in the safe and controlled environment of a medical detox center.
Detoxing at a medical facility also avoids the danger of relapsing midway through the prescription opioid withdrawal process and potentially overdosing in an effort to alleviate withdrawal symptoms. Doctors can instead administer medications to help ease the symptoms of prescription opioid withdrawal.
Someone undergoing prescription opioid detox can also be put on a tapering schedule to slowly wean them off of opioids by lowering their dosage over time until it is safe to stop using completely without causing a seizure or other complications.
Many detox facilities will also use medical maintenance therapy as part of the tapering process by reducing cravings and other withdrawal symptoms while also blocking the effects caused by prescription opioids.
The medication a detox professional may choose to administer will depend on the severity of someone’s prescription painkiller addiction and how they respond to treatment. Some common drugs used in medical maintenance therapy include:
However, it is important to remember that even though methadone, buprenorphine, and Suboxone are much weaker opioids or combination drugs involving opioids, they still carry a potential for addiction and abuse and should be very careful administered in restricted doses. If one of those drugs is the prescription opioid that someone is addicted to, it will most likely not be used in treatment in favor of a non-opioid such as naltrexone.
After detox and the end of the withdrawal phase, the next step in prescription opioid addiction treatment should be entering into an addiction recovery program. Whether this is done on an inpatient or outpatient basis, it is crucial that detox is followed by aftercare. Otherwise, an individual will be unlikely to remain sober for any significant length of time.
In an addiction rehabilitation treatment program, people will be able to gain the skills necessary to address the root of their addictive behaviors and learn how to manage them well enough to avoid relapse in the long-term.
Generally, before starting the actual treatment, the individual will work with their counselor or therapist to create a treatment plan that can be evaluated and assessed for its effectiveness in best treating their needs. A given treatment program might involve family therapy, support groups, addiction education workshops, as well as more holistic therapies.
How Dangerous are Prescription Opioids?
As the opioid crisis rages on, there is simply no way to exaggerate just how dangerous prescription opioids can be if misused or abused. Despite the significant press coverage dedicated to illustrating the consequences of prescription opioid addiction, many people, especially teens and young adults, are under the impression that if a medication is prescribed by a doctor that it’s not dangerous.
Prescription opioid abuse becomes even riskier when used in combination with alcohol or other drugs. Central nervous system depressants like benzodiazepines and alcohol are especially dangerous due to their own sedative effects compounding with the ones produced by prescription opioids that can slow down someone’s heart rate and breathing to the point of entering a coma or dying from lack of oxygen.
In fact, the CDC reports that roughly half of all overdose deaths in the United States caused by prescription opioids involved the contribution of a secondary drug, with the benzodiazepines Valium and Xanax accounting for roughly 17 percent.
Excluding the often permanent damage that long-term chronic prescription opioid abuse does to both the brain and the body’s vital organs, the incredible frequency overdose deaths as a result of prescription opioid addiction present what is perhaps the greatest danger. The signs to be aware of that indicate someone is overdosing on a prescription opioid include:
- Confusion or Delirium
- Pinprick pupils
- Cold and clammy skin
- Extremely slowed heart rate
- Dangerous slow and shallow breathing
- Complete stoppage of breathing
- Loss of consciousness and unable to be woken up
- Blue skin around the lips and fingertips
The most dangerous element of a prescription opioid overdose is shallow, slowed breathing, because the lack of oxygen in the body and brain can cause brain damage, organ failure, coma, and if not caught and reversed in time, death.
In the event of an overdose, it is critical that emergency services be sought out immediately so that they can arrive in time to administer Narcan and reverse the overdose. Unfortunately, even if that happens, a successful reversal is not guaranteed, especially in the case of fentanyl, which can take anywhere from three to even six doses of Narcan to be effective.
Prescription Opioid Abuse Statistics
- According to the CDC, more than 100 Americans a day died of an opioid overdose in 2016. Of those overdose deaths, prescription opioids accounted for 46.
- The CDC also reported a 30 percent increase in opioid overdoses across the country between 2016 and 2017.
- The U.S. Department of Health and Human Services estimates that about 11 million people a year misuse oxycodone for nonmedical purposes.
- When factoring, criminal justice costs, accidents, health care costs, and lost employment, the United States spends nearly 500 billion dollars a year on morphine addiction.
- In 2007, Purdue Pharma, the pharmaceutical company behind OxyContin, was criminally charged with falsely marketing the drug as a safer, less addictive alternative to other prescription painkillers and had to pay 600 million dollars in fines.
Start Your Journey to Recovery Today
Don’t let yourself or someone you care about become another tragic statistic of the prescription opioid epidemic; take action today! The path towards addiction recovery starts with medical detoxification, and no one provides a higher standard of detox care than Maryland House Detox. Call now at 1-855-928-0596 to learn more about our detox services from our addiction specialists, or contact us online.