In 2012, medical professionals dispensed more than 255 million prescriptions for opioids.
That came to 81.3 prescriptions for 100 people — a mind-boggling amount that had steadily increased over a six-year period, according to the U.S. Centers for Disease Control. Although those numbers have declined since then, the prescribing rates remain high — 58.7 per 100 people in 2017, a total of more than 191 million opioid prescriptions, the CDC reports. While that’s the lowest it’s been in 10 years, there are still several alarming facets to that number:
- In 16 percent of U.S. counties, enough opioid prescriptions were dispensed “for every person to have one,” according to the CDC.
- In some U.S. counties, the rate was as high as 410.9 prescriptions per 100 individuals — seven times the national average.
- There were more than 70,000 overdose deaths in 2017, a 10 percent increase over the previous year, and 24.2 percent of them involved prescription opioids.
While narcotic pain medication has a role in the treatment of acute and chronic pain, the very nature of these medications makes them ripe for potential abuse and addiction. Let’s be clear: There are times and medical issues where pain management through prescription opioids is necessary. While news headlines are rife with reports of “pill mills” and doctors writing prescriptions to make money rather than provide treatment, the vast majority of medical professionals are stuck between a rock and a hard place when it comes to managing pain responsibly, according to Dr. Tracy Harrison, a pediatric anesthesiologist at the Mayo Clinic.
“Our current problem came about from physicians ultimately wanting to do the best for the patient, relieving pain,” Harrison said in an interview on the Mayo Clinic’s website. “But pain is a complex experience, and not all pain needs to be addressed by using opioids. As physicians, we need to do a better job setting expectations for pain resolution after trauma.”
Harrison goes on to point out that there is a difference between addiction and chemical dependency. Many individuals who rely on narcotics for pain management may become physically dependent on those medications. But, Harrison said, that’s “very different from addiction, which is drastic behavior an individual exhibits to obtain opioids, such as stealing medications, buying street drugs to treat pain or engaging in risky behavior in exchange for drugs.”
Addiction warning signs
How, then, can individuals who have been prescribed opioids know when they’ve crossed the line from dependency to addiction? What are the signs that someone may be addicted to opioids? Here are 10 clues that are good indications:
- An individual seems fixated on the euphoria the medication provides rather than the relief of pain. “If you use opioids for the intended purpose, you ideally should get no high,” according to Dr. Jonathan D. Morrow, an assistant professor of psychiatry at the University of Michigan. “You get lots of side effects such as nausea and constipation. It’s really not pleasant. It’s once you go beyond the amount you need for pain control that you start getting a high.”
- An individual takes an opioid for longer than intended, or in larger amounts than prescribed. According to Morrow, opioids are meant to be a short-term fix for acute conditions like minor surgery recovery or dental work. Rare are the times when opioid use should exceed a week, and because physicians are often under strict legal and professional limitations, the number of pills dispensed are meant to cover the prescribed dosages for a set length of time.
- A person obsesses over their medication. They’re fixated on the next time they can take a pill, often making excuses about why they can take one early, or why it’s acceptable to take more than the recommended dosage. Their medication is with them at all times, and they’re keenly aware of exactly how many pills are left and how soon they can get it refilled, if at all.
- They’re consistently “losing” their medication or coming up with excuses about why they need a refill — it was “stolen,” or their condition has “worsened.” They may badger their prescribing physicians, sometimes to the point of belligerence or hysteria, in an attempt to persuade those doctors to write a refill, and in many cases, they ask friends or family members to borrow leftover prescriptions those people have in their medicine cabinets.
- They steal medication. If you have leftover opioid prescriptions in your house, don’t hang on to them “just in case,” and don’t keep them in the medicine cabinet of the bathroom that you encourage guests to use. Chances are, they’ll conveniently disappear, and if you don’t even remember keeping them, you’ll be none the wiser … but the addicted individual in your life will have a few more pills in his or her stash.
- An individual seems to be “doctor shopping” — consistently making appointments with a variety of physicians in order to obtain different prescriptions for the same medication. This is, of course, illegal, and in recent years narcotics databases have limited the effectiveness of this tactic, but that doesn’t prevent those whose addiction short-circuits rational thinking from trying it.
- An individual spends an excessive amount of time obtaining, using and recovering from the use of opioids. “The hustle,” as it’s known in addiction parlance, is no easy task, and if an individual has resorted to obtaining narcotics through illegal means, then it can quickly become a full-time occupation. Are they abruptly leaving work, either calling in sick a few hours later? Are they leaving because they seem visibly ill, only to return in a short time seemingly “cured” of what was ailing them? Is their work or education suffering? These are all valid questions that might have something to do with their possible opioid addiction.
- Withdrawal makes them desperate. Withdrawal symptoms themselves aren’t unique to addicts. Those who are chemically dependent will have physically adverse reactions when they stop taking their medication. For addicts, however, withdrawal can become a horrifying psychological ordeal as well. Chemically dependent individuals know their symptoms will abate in a few days; addicts become convinced that withdrawal may very well kill them. It may not make any sense to those with no experience with addiction, but addicts often develop a phobia of withdrawal that can be crippling — and terrifying enough to lead them to extreme measures to prevent it or end it.
- They continue to take opioids in spite of negative consequences. With an outsider’s perspective, you may be able to point out just how much an individual has changed because of their habit. You may be able to clearly explain all of the problems and warning signs that you, as a friend and observer, have witnessed. And yet the individuals about whom you’re concerned will continue to use in spite of the evidence, even as they pay your implorations feeble lip service. In other words, they’ll agree with you and seem contrite … but they’ll continue to use.
- The opioids stop working, and they seek to switch drugs. Addiction is a beast that’s never satisfied; no matter how often or how much it’s fed, it always demands more, and sooner or later, those who suffer develop a tolerance to the substances to which they’re addicted. Many opioid addicts hit a plateau with how much they can reasonably take without adverse consequences that ruin the euphoria they seek. Or, the aforementioned hustle becomes too costly in terms of both money and resources. Or, the pills to which they’re addicted become harder and harder to procure. A great many opioid addicts have turned to illegal street drugs such as heroin in recent years for these very reasons.
Get the help you or your loved one needs
Fentanyl is a synthetic opioid that’s contributed greatly to the overdose crisis. In 2017, according to the CDC, 28,000 overdose deaths were attributed to synthetic opioids other than methadone. Opioids like hydrocodone and oxycodone are considered semi-synthetic opioids; while they also pose the threat of addiction, fentanyl and fentanyl analogs are the biggest killers in the ongoing opioid epidemic.
There are, of course, other signs of addiction to opioids, but if you or someone you know displays one or more of these 10, then there might be a problem … one that statistics demonstrate can be quite deadly. More people died of overdoses in 2017 alone than in the entirety of the Vietnam War, and the best way to prevent those statistics from growing is to seek help, or to encourage those who suffer to do so.
At Cornerstone of Recovery, our 30-year track record assisting addicts safely and comfortably detox from opiates, combined with our treatment philosophy and our various therapies, give addicts the best chance at long-term, sustained recovery. Our Admissions counselors are waiting to assist you; we can’t stress enough how important it is to call now, so that you or someone you love doesn’t become another number in a government report.