It starts innocently enough with a doctor’s or dentist’s prescription for pain medication after a surgical procedure or physical trauma. What happens, though, is that over extended use, the body requires increasingly stronger doses to bring relief, and ultimately a person is left craving the painkillers long after the pain is gone.
The reason is that prescription pain pills are in a highly addictive class of drugs called opioids, which includes natural opiates derived from poppies as well as synthetic varieties created chemically. With repeated exposure to these drugs, the brain suffers real changes that cause it to function normally when the drugs are present, and abnormally when they are not.
Opioid pain medications are dosed either alone or in combination with other substances, and their names are probably very familiar to you. So familiar, in fact, that you may not have realized that they are actually narcotics. The most frequently prescribed are hydrocodone and oxycodone, both of which are available under several brand names. Here are some of the most common opioids prescribed in the United States:
- Hydrocodone, often combined with acetaminophen (the pain reliever found in Tylenol), and sold as Vicodin, Lorcet, and Lortab. Zohydro ER is another formulation of hydrocodone.
- Oxycodone, most commonly prescribed as OxyContin. Percocet, Endocet, and Roxicet are oxycodone combined with acetaminophen; Percodan is oxycodone combined with aspirin.
- Morphine, generally prescribed in hospital settings for severe pain, but available in outpatient prescriptions, most often for chronic pain. It may be habit-forming even at regular doses.
- Fentanyl, used as an anesthetic and for post-surgical pain in hospitals, and many times more potent than morphine. It’s sold as Actiq, Duragesic, and Sublimaze.
- Hydromorphone, a synthetic version of morphine, sold as Dilaudid.
- Codeine, often prescribed for cough suppression and for mild to moderate pain, such as after dental work. It’s sold under various brand names, sometimes in combination with acetaminophen or other pain relievers.
- Propoxyphene, sold as Darvon.
- Meperidine, sold as Demerol.
These medications are prescribed for a purpose, but some people have a hard time letting them go once the need is gone. They may believe they’re acting normally, but when they’re intoxicated on opioids, the signs are clear. Constricted pupils, drowsiness, slowed movement and reactions, slurred speech, poor memory and judgment, inability to concentrate, mood swings, and other symptoms all say that the person is still using. What’s more, continued use creates tolerance to the opioids and requires even greater doses to feel the same high.
Pain pill detox can be agonizing both physically and emotionally, and is most safely and effectively done under professional supervision. Withdrawal creates a variety of symptoms that only get worse before they get better. The longer a person has been abusing opioids and the more he or she has been taking, the more severe these symptoms will be. They may include, but aren’t limited to:
- Severe muscle and joint pain
- Nausea, vomiting, cramping, and diarrhea
- Extreme agitation and aggression
- Mood swings and irritability
- Respiratory distress
- Heart palpitations
While what someone goes through for a cure may sound worse than the addiction, continued and increasing use of pain pills can have tragic consequences, including death. According to the American Society of Addiction Medicine, two million Americans age 12 or older abused prescription pain relievers in 2015, and over 20,100 of them suffered fatal overdoses.
In addition to opioids, there are two classes of drugs that have similar effects when they’re abused. They are prescribed as sedatives rather than pain relievers, and produce feelings of well-being that can be highly addictive, particularly to people who are vulnerable to other addictions. These medications are:
- Benzodiazepines, including alprazolam (sold as Xanax), diazepam (sold as Valium), and lorazepam (sold as Ativan.)
- Barbiturates, including amobarbital (sold as Amytal), pentobarbital (sold as Nembutal), secobarbital (sold as Seconal), and phenobarbital (sold as Luminal.)
After prescription drug withdrawal, a person is no longer physically dependent, but psychological dependence can persist. When faced with stress and other triggers, the urge to relapse can be strong. That’s why a critical component of rehab is counseling that focuses on the emotional side of pain pill addiction and redirects the person to a healthy and sustained recovery.