Opiates

HOW DOES OPIATE ADDICTION HAPPEN?
Some people may begin increasing their medication for chronic pain without their doctor’s permission when it feels like it’s stopped working. Or they go to the dentist for a procedure and discover that the oxycodone makes them feel better than they ever have in their lives so when it runs out, they start getting it from friends. Or they’re working 60 hours a week and somebody offers them some opiate pills that give them the energy to make it through what would normally be an impossible task. They get used to having this extra energy and can’t stop.

Nobody starts using opiate medications planning to become addicted. Anyone who takes a pain medication daily for even a few weeks may have withdrawal symptoms (chills, runny eyes and nose, muscle aches, anxiety and insomnia) for 3-5 days on stopping, but not everyone will develop the mental craving and seeking out of more medicine that characterizes addiction. It is easy to blame the individual for developing the addiction, but the main predictors of who gets hooked are a genetic vulnerability and too much life stress.  While most of us have fallen victim to excess stress, many people don’t even realize they have the genetic vulnerability until they try an opiate for the first time, feel an amazing euphoria that catches them off guard, and don’t know to stop and seek help until it’s too late. If you or a family member does get excess energy or an overall feeling of well-being after taking opiate pain medication, you are at higher risk for having the genetic wiring for opiate dependence.

There are doctors who overprescribe these medications, and most of us believe that doctors are experts and we should listen without question. However, most doctors and dentists do not have training in addiction issues. It is not safe nor needed to get a prescription for 120 hydrocodone pills for a sprained ankle or pulled tooth. It is okay to ask for less pain medication, or try non-opiate pain relievers such as ibuprofen first.
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And be honest with yourself. Make sure you are only taking the opiate for pain, not to relax, numb out, relieve stress or get extra work done. Overdose is a real and ever-present risk. Despite the attention heroin and fentanyl are receiving in the news, the majority of opiate use and overdoses are with the opiate pills.

TREATMENT:
Opiate dependence can be treated. Opiate replacement with medications such as methadone and buprenorphine/naloxone (Suboxone®, Zubsolv™) are one option and Dr. Felgus does prescribe these medications when appropriate. Some people choose other methods, such as non-opiate medications that treat anxiety or cravings, counseling, or spiritual work. There is no one-size-fits-all approach and every individual seeking treatment for opiate dependence will have an in-depth evaluation of his or her unique needs.