Pain Killer Addiction
Pain Killers, also known as opioids, are commonly prescribed because of their pain relieving properties. Many studies have shown that properly managed medical use of pain killer compounds is safe and rarely causes addiction. Taken exactly as prescribed, opioids can be used to manage pain effectively.
Among the compounds that fall within this class—sometimes referred to as narcotics—are morphine, codeine, and related medications. Morphine is often used before or after surgery to alleviate severe pain. Codeine is used for milder pain. Opioids act by attaching to specific proteins called opioids receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these compounds attach to certain opioids receptors in the brain and spinal cord, they can effectively change the way a person experiences pain. In addition, opioids medications can affect regions of the brain that mediate what we perceive as pleasure, resulting in the initial euphoria that many opioids produce.
Chronic use of pain killers can result in tolerance to the medications so that higher doses must be taken to obtain the same initial effects. Long-term use also can lead to physical addiction—the body adapts to the presence of the substance and withdrawal symptoms occur if use is reduced abruptly. Individuals taking prescribed pain killer medications should not only be given these medications under appropriate medical supervision, but also should be medically supervised when stopping use in order to reduce or avoid withdrawal symptoms. Symptoms of withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps (“cold turkey”), and involuntary leg movements.
Individuals who become addicted to pain killers can be treated. Options for effectively treating pain killer addiction to prescription opioids are drawn from research on treating heroin addiction.
Prolonged use of these drugs eventually changes the brain in fundamental and long-lasting ways, explaining why people cannot just quit on their own, and why treatment is essential. In effect, drugs of abuse take over the brain's normal pleasure and motivational systems, moving drug use to the highest priority in the individual's motivational hierarchy, thereby overriding all other motivations and drives. These brain changes, then, are responsible for the compulsion to seek and use drugs that we have come to define as addiction. This is likely the state people are in when they are reportedly "doctor shopping," feigning illnesses, and stealing from pharmacies to obtain the drug.
Fortunately, we have a number of effective options to treat pain killer addiction to prescription opioids and to help manage the sometime severe withdrawal syndrome that accompanies sudden cessation of drug use. These options are drawn from experience and clinical research regarding the treatment of heroin addiction. They include medications, such as methadone and LAAM (levo-alpha-acetyl-methadol), and behavioral counseling approaches.
Typically, the patient is medically detoxified before any treatment approach is begun. Although detoxification in itself is not a treatment for pain killer addiction, it can help relieve withdrawal symptoms while the patient adjusts to being drug free. Once the patient completes detoxification, the treatment provider must then work with the patient to determine which course of treatment would best suit the needs of the patient.
